It looks and sounds like a highly technical term for something that most people can relate to – feeling guilty when you use a substance, like alcohol or marijuana, after promising yourself you won’t use it ever again. Additionally, abstinence violation effect (AVE) can affect people differently, based on different factors in their lives.
AVE is not a personal failure nor a permanent failure to abstain from using a substance of abuse. It is an aspect of relapse prevention that can be helpful for someone in addiction treatment or contemplating going into treatment.
Keep reading to learn more about AVE.
Abstinence violation effect is defined as “ the negative cognitive and affective responses someone feels after a return to substance use following a period of self-imposed abstinence from substances. AVE affects the stable, uncontrollable attributions, and the person feels a strong sense of shame and guilt following the relapse.”
Someone who is experiencing abstinence violation effect may tend to consider their relapse as a concrete action with no end. Common thoughts may be, “As long as I used (substance) again, I should just keep on using it since there’s no way to stop.” Another thought that is common is, “Addiction is a chronic disease, so there’s no harm in using again.”
Feelings of personal failure can lead to ongoing use of the substance. Someone who believes this strongly is more likely to relapse more than a few times. Self-guilt is one feeling that falls into the description of AVE. Guilt is a heavy emotion to bear, one that can constantly replay, causing someone to keep using the substance again to assuage the guilt they feel.
Although, it is essential to keep in mind that the National Institute on Drug Abuse (NIDA) estimates that 40 to 60 percent of people who were once addicted to a substance will relapse at some point.
One part of relapse prevention is knowing what triggers substance use, which varies by the person. For instance, someone with alcohol use disorder may feel like they want a drink when out with friends at a favorite hangout.
Another example is the urge to smoke at the times when smoking was enjoyed, such as with a coffee in the morning or when driving long distances.
It is known that the longer someone abuses a substance, the higher tolerance they will have for the effects it produces. This is why, after a period of abstinence, that person’s tolerance declines substantially, and why someone can accidentally overdose if they start to use again at the same level as before abstaining.
Relapse doesn’t have to be all-consuming, though. It can be a single time someone decides to use the substance again. That one instance can lead the individual to experience AVE, which could then trigger a longer relapse. It is, therefore, paramount to know the different stages of relapse and how to circumvent it.
There are three stages of relapse, as noted by Healthline:
At any point in time, any one of these can put someone at risk of relapsing.
Signs of an emotional relapse can be:
Other mental relapse signs are:
Someone in addiction treatment will learn relapse prevention skills and how to recognize their triggers and how to deal with them in therapy. Abstinence violation effect is a notable aspect of relapse education. Knowing what it is and how to handle it can help keep you on the right path to a lasting recovery.
SpringerLink. Encyclopedia of Behavioral Medicine. Abstinence Violation Effect 2013 Edition | Editors: Marc D. Gellman, J. Rick Turner. from https://link.springer.com/referenceworkentry/10.1007%2F978-1-4419-1005-9_623
Time. Why Falling Off the Wagon Isn't Fatal. Maia Szalavitz . Dec. 30, 2008 from http://content.time.com/time/health/article/0,8599,1868965,00.html
Substance Abuse Treatment, Prevention, and Policy. Marlatt's relapse prevention model: Historical foundations and overview. Relapse prevention for addictive behaviors. Christian S Hendershot, corresponding author, Katie Witkiewitz, William H George, and G Alan Marlatt from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163190
Healthline. Relapse Prevention Plan: Techniques to Help You Stay on Track. Medically reviewed by Timothy J. Legg, PhD, CRNP. Written by Stephanie Watson. March 29, 2019 from https://www.healthline.com/health/opioid-withdrawal/relapse-prevention-plan
University of Santa Cruz, Counseling and Psychological Services. Relapse Prevention. (Retrived October 2019) from https://caps.ucsc.edu/counseling/aod/relapse-prevention.html