Therefore, one global self-management strategy involves encouraging clients to pursue again those previously satisfying, non-drinking recreational activities. In addition, specific cognitive-behavioral skills training approaches, such as relaxation training, stress-management, and time management, can be used to help clients achieve greater lifestyle balance. Such positive outcome expectancies may become particularly salient in high-risk situations, when the person expects alcohol use to help him or her cope Alcohol Use Disorder with negative emotions or conflict (i.e., when drinking serves as “self-medication”).
Like the conceptualization of urges and cravings as the result of an external stimulus, this imagery fosters detachment from the urges and cravings and reinforces the temporary and external nature of these phenomena. Some other examples of things a person might abstain from include drugs, sexual behaviors, unhealthy foods, tobacco, and social media. It arises when a person starts to feel that when a lapse occurs, it is indicative of a moral failure, loss of hope for continued recovery, or proof that recovery is ultimately not possible. This is a common risk factor, but psychologists, rehabilitation professionals, and treatment centers work hard to combat it because it's generally not constructive for the individual's future success. However, it can sometimes lead to the thought that you have earned a drink or a night of using drugs.
Additionally, the system is punitive to those who do not achieve abstinence, as exemplified by the widespread practice of involuntary treatment discharge for those who return to use (White, Scott, Dennis, & Boyle, 2005). Even when alcohol’s perceived positive effects are based on actual drug effects, often only the immediate effects are positive (e.g., euphoria), whereas the delayed effects are negative (e.g., sleepiness), particularly at higher alcohol doses. Asking clients questions designed to assess expectancies for both immediate and delayed consequences of drinking versus not drinking (i.e., using a decision matrix) (see table, p. 157) often can be useful in both eliciting and modifying expectancies. With such a matrix, the client can the abstinence violation effect refers to juxtapose his or her own list of the delayed negative consequences with the expected positive effects. Practicing healthy coping strategies, making appropriate lifestyle changes, and getting outside support may help to prevent relapse and maintain mental well-being. Oxford English Dictionary defines motivation as “the conscious or unconscious stimulus for action towards a desired goal provided by psychological or social factors; that which gives purpose or direction to behaviour.
Thirty-two states now have legally authorized SSPs, a number which has doubled since 2014 (Fernández-Viña et al., 2020). Regarding SUD treatment, there has been a significant increase in availability of medication for opioid use disorder, especially buprenorphine, over the past two decades (opioid agonist therapies including buprenorphine are often placed under the “umbrella” of harm reduction treatments; Alderks, 2013). Nonabstinence goals have become more widely accepted in SUD treatment in much of Europe, and evidence suggests that acceptance of controlled drinking has increased among U.S. treatment providers since the 1980s and 1990s (Rosenberg, Grant, & Davis, 2020). Importantly, there has also been increasing acceptance of non-abstinence outcomes as a metric for assessing treatment effectiveness in SUD research, even at the highest levels of scientific leadership (Volkow, 2020). Many advocates of harm reduction believe the SUD treatment field is at a turning point in acceptance of nonabstinence approaches. Indeed, a prominent harm reduction psychotherapist and researcher, Rothschild, argues that the harm reduction approach represents a “third wave of addiction treatment” which follows, and is replacing, the moral and disease models (Rothschild, 2015a).
Nicotine pouches, mouth spray, and liquid nicotine, which do not contain tobacco, may provide new means of reducing harm by eliminating the risk introduced through carcinogens in tobacco. These products have shown efficacy in recent initial randomized controlled trials; however, they must be further tested before any clinical recommendations can be offered. To most precisely convey the state of the current research on relapse prevention, we report on findings for 1) relapse prevention psychotherapy as applied to smoking cessation and as defined by Marlatt and colleagues 17, 18, 24; and 2) relapse prevention defined as any intervention delivered after abstinence has been attained. That said, the effectiveness of abstinence can depend on the person’s own self-efficacy, their reason for abstaining, their support system, and various other factors. The abstinence violation effect (AVE) describes a common response among people practicing abstinence when relapse occurs.
