In formal treatment circles, this sense of failure is referred to as the abstinence violation effect or AVE and is perhaps the single greatest contributor to a return to active involvement in one’s SUD. While some assert that relapse occurs after the first sip of alcohol or use of another drug, certain scientists believe it is a process which more closely resembles a domino effect. Social-cognitive and behavioral theories believe relapse begins before the person actually returns to substance abuse. Being in recovery from drugs or alcohol addiction teaches people many things, including some of life’s most important lessons. As people progress in their recovery process, they will learn more about themselves as sober individuals, allowing them to truly flourish as substance-free people. CBT treatments are usually guided by a manual, are relatively short term (12 to 16 weeks) in duration, and focus on the present and future.

Abstinence violators realize that their actions (e.g. “I drank”) do not line up with their personal goal (e.g. “I want to abstain”) and feel compelled to resolve the discrepancy. In this case, individuals try to explain to themselves why they violated their goal of abstinence. If the reason for the violation is attributed to internal, stable, and/or global factors, such as lack of willpower or possession of an underlying disease, then the individual is more likely to have a full-blown relapse after the initial violation occurs. On the other hand, if the reason for the violation is attributed to external, unstable, and/or local factors, such as an extremely tempting situation, then the individual is more likely to recover from the violation and get back onto the path of abstinence. Teasdale and colleagues (1995) have proposed a model of depressive relapse which attempts to explain the process of relapse in depression and also the mechanisms by which cognitive therapy achieves its prophylactic effects in the treatment of depression.

What factors influence relapses?

Further, internal and global attributions predicted marijuana use during the subsequent 6 months. Results are discussed in terms of support for the AVE construct, treatment implications, and the failure of the RP treatment to modify reactions to a lapse. The revised dynamic model of relapse also takes into account the timing and interrelatedness of risk factors, as well as provides for feedback between lower- and higher-level components of the model. For example, based on the dynamic model it is hypothesized that changes in one risk factor (e.g. negative affect) influences changes in drinking behavior and that changes in drinking also influences changes in the risk factors. The dynamic model of relapse has generated enthusiasm among researchers and clinicians who have observed these processes in their data and their clients.

This approach would be applicable to recovered depressed patients and would serve as a means of preventing relapse. Teasdale and colleagues provide a description of this training which teaches generic psychological, self-control skills and can be used on a continuing abstinence violation effect basis to maintain skills after initial training. While no data on the effectiveness of this approach in preventing relapse exist to date, this appears to be a useful and stimulating conceptualization of relapse and relapse prevention that deserves further attention.

Abstinence Violation Effect/Limit Violation Effect

Trazodone hydrochloride (known as “trazodone”) is an FDA-approved antidepressant and sleeping pill developed in the 60s. It was initially not favored by the medical community because it had side effects such as dizziness, fainting, irregular heartbeat, and priapism… As of 2020, the number of drug-involved overdose deaths reached an all-time high of 91,799, https://ecosoberhouse.com/ according to the National Institute on Drug Abuse. At least 74.8% of those deaths involved opioids, 14% involved heroin, 26% involved psychostimulants, primarily… Although the benefits of 12-step participation may (and quite often do) outweigh the added AVE risk, clinicians should be aware of this particular risk and take steps to counteract it.

Mark received a bachelor’s degree in Business Administration, with a minor in Economics from the University of Rhode Island. He is a licensed residential home inspector in the state of Florida and relates his unique experience of analyzing a property and/or housing condition to determining any necessary course of action at our facility. This isn’t the only way in which our thinking might become twisted when we experience a lapse in sobriety. Abstinence violation effect fuels our negative cognition, causing us to judge ourselves quite harshly. This is especially true if we are involved in a twelve-step program, as we now realize we must reset our chips.

Finding the Beef: Additional Thoughts on Disputing Negative Self-Talk

This model notes that those who have the latter mindset are proactive and strive to learn from their mistakes. To do so, they adapt their coping strategies to better deal with future triggers should they arise. This protects their sobriety and enhances their ability to protect themselves from future threats of relapse.

Despite the empirical support for many components of the cognitive-behavioral model, there have also been many criticisms of the model for being too static and hierarchical. In response to these criticisms, Witkiewitz and Marlatt proposed a revision of the cognitive-behavioral model of relapse that incorporated both static and dynamic factors that are believed to be influential in the relapse process. The “dynamic model of relapse” builds on several previous studies of relapse risk factors by incorporating the characterization of distal and proximal risk factors. Distal risks, which are thought to increase the probability of relapse, include background variables (e.g. severity of alcohol dependence) and relatively stable pretreatment characteristics (e.g. expectancies).