Staying Sober Utilizing Mandates and Injunctions

When a person decides to get sober the idea of staying sober can be overwhelming. The fear of relapse looms large. A quick review of the literature suggests that the success rate is relatively small when compared to the number of people who attempt to find sobriety. According to a 2003 study, the Caron Foundation documented that nearly 50-90% of people relapse within the first year after treatment or involvement in a 12-step program. Precursors to relapse can include anger, frustration, stress, or positive emotional states. The National Institute of Drug Abuse have determined that relapse rates from addiction can be compared to those suffering from other chronic illnesses such as Type I diabetes (30 - 50%), Hypertension (50-70%) and asthma (50 to 70%). Drug addiction should be treated like any other chronic illness, with relapse indicating the need for renewed intervention.

It is important to make the distinction between addiction and dependence. Addiction is a change in behavior to accommodate or obtain the chemical, while dependence is indicated by measurable physical symptoms that arise when the chemical is not consumed. It is the general opinion of many addiction specialists that addiction is largely biochemical and that relapse is largely the result of cravings and proximity to alcohol/drugs or uncomfortable feelings.

Another skill which can be utilized to support recovery is the application of mandates and injunctions. A mandate is a set of thoughts that direct the addict to engage in using behavior when they have an urge to use. An injunction is a set of criteria that provides the recovering person a way to think about their recovery so they don’t compartmentalize the skills and gifts they bring to their sobriety. In its simplest form it’s a part of a relapse prevention plan.

This approach is another way a clinician can help a client develop additional skills to maintain abstinence. Part of this includes an emergency sobriety card and an accountability contract. An emergency sobriety card provides a brief list of specific and concrete instructions that a person in recovery can refer to anytime when he or she needs help. It’s a small discreet tool that helps the addict find and build confidence in their ability to remain sober. The accountability contract is a set of permissions that an addict gives to his or her family and friends when its determined their recovery is in trouble. The inclusion of family and friends as part of an addict’s recovery can provide support and help an addict get back on track.

Recovery need not be overwhelming and can be managed successfully. Matching a client to a recovery program is paramount, as we understand that recovery looks different for everyone. In recovery from addiction, it is important to change your lifestyle to include abstinence from alcohol and drugs; involvement in healthy relationships; good nutrition, rest and exercise; and working to resolve one's personal problems. Being mindful to incorporate the philosophy of mandates and injunctions will go a long way to build confidence in your recovery program.