Instead of surrendering to the negative spiral, individuals can benefit from reframing the lapse as a learning opportunity and teachable moment. Recognizing the factors that contributed to the lapse, such as stressors or triggers, helps individuals to develop strategies and techniques to navigate similar challenges in the future. Jim is a recovering alcoholic who successfully abstained from drinking for several months. One day, when he was faced with a stressful situation, he felt overwhelmed, gave in to the urge, and had a drink.

the abstinence violation effect refers to

The relapse prevention programme combines a variety of cognitive behavioural strategies33. It skills training such as behavioural rehearsal, assertiveness training, communication skills to cope with social pressures and interpersonal problem solving to reduce impact of conflicts, arousal reduction strategies such as relaxation training to manage pain or anxiety as risk for relapse. Cognitive reframing of lapses, coping imagery for craving and life style interventions, such as physical activity are used to help develop skills to deal with craving and broaden the patient’s behavioural repertoire. Cognitive restructuring techniques are employed to modifying beliefs related to perceived self-efficacy and substance related outcome expectancies (“such as drinking makes me more assertive”, “there is no point in trying to be abstinent I can’t do it”). Individuals with fewer years of addiction and lower severity SUDs generally have the highest likelihood of achieving moderate, low-consequence substance use after treatment (Öjehagen & Berglund, 1989; Witkiewitz, 2008).

What Is The Abstinence Violation Effect?

However, a recent meta-analysis of 14 randomized controlled trials indicated that motivational enhancement interventions showed modest positive effects on smoking outcomes compared with brief advice and treatment as usual [53•]. Although the effect sizes and corresponding quit rates were lower than those found with group psychotherapy, these findings are clinically significant because participants in motivational enhancement trials are typically not seeking treatment and the interventions are often conducted opportunistically. Along with the client, the therapist needs to explore past circumstances and triggers of relapse. Also, the client is asked to keep a current record where s/he can self-monitor thoughts, emotions or behaviours prior to a binge.

Patterns of movement through the various stages are categorized as stable, progressive or unstable11. All rights are reserved, including those for text and data mining, AI training, and the abstinence violation effect refers to similar technologies. For example, I am a failure (labeling) and will never be successful with abstaining from drinking, eating healthier, or exercising (jumping to conclusions).

How Does The Abstinence Violation Effect Occur?

The realization that HIV had been spreading widely among people who injected drugs in the mid-1980s led to the first syringe services programs (SSPs) in the U.S. (Des Jarlais, 2017). Early attempts to establish pilot SSPs were met with public outcry and were blocked by politicians (Anderson, 1991). In 1988 legislation was passed prohibiting the use of federal funds to support syringe access, a policy which remained in effect until 2015 even as numerous studies demonstrated the effectiveness of SSPs in reducing disease transmission (Showalter, 2018; Vlahov et al., 2001). Despite these obstacles, SSPs and their advocates grew into a national and international harm reduction movement (Des Jarlais, 2017; Friedman, Southwell, Bueno, & Paone, 2001). An important part of RP is the notion of Abstinence violation effect (AVE), which refers to an individual’s response to a relapse where often the client blames himself/herself, with a subsequent loss of perceived control4.

the abstinence violation effect refers to

A recent meta-analysis examining the effects of self-help over 15 studies involving pregnant women showed that self-help interventions nearly doubled the odds of maintaining abstinence and preventing relapse over the longer-term compared with standard care [44•]. The latter findings suggest that self-help may be particularly desirable to clients who may otherwise feel judged or ashamed of their smoking in face-to-face interviews. The literature is more heterogeneous when regarding relapse prevention as any smoking intervention that is applied after achievement of abstinence. Specifically, a recent meta-analysis involving this literature indicated that coping skills training given after abstinence was attained was less effective than the application of the pharmacologic agent varenicline [20•]. That being said, the authors indicated that many of the included studies were underpowered and lacked methodologic rigor to provide definitive evidence for or against different means of relapse prevention.