I saw this in my reading on addictive counselling since this has been a topic of late thought I would post it...
Levels of Severity of Relapse
Relapse can be viewed as having three levels of severity, which determine the appropriate therapeutic response. The counselor must understand the three types of relapse and the appropriate interventions to be used in each case. The counselor should communicate to the patient that any level of resumption of drug use is still a relapse, necessitating analysis of the process and recommitment to one's recovery program. In other words, a "slip" still is a relapse. The levels of severity are to assist the counselor in determining the appropriate action to be taken.
Slips
The least severe type of relapse is a "slip," a common occurrence that involves a very brief episode of drug use associated with no signs or symptoms of the dependence syndrome, as specified using the DSM-IV criteria (American Psychiatric Association 1994). Such an episode can serve to strengthen the patient's recovery if used to identify areas of weakness and point out solutions and alternative behaviors that can help prevent future drug use from occurring.
Several Days of Drug Use
The next most severe type of relapse is when the patient resumes drug use for several days, and the use is associated with some of the signs and symptoms of addiction. In such a case, the counselor probably would want to intensify treatment temporarily, which can be effective. We have found that intensified contact will usually reinstitute abstinence. The patient should be encouraged to review what happened and learn from the experience how to avoid a relapse in the future. The patient also should be encouraged to recommit to his or her recovery program.
Sustained Drug Use With Resumption of Addiction
The most serious form of relapse is a sustained period of drug use during which the patient fully relapses to addiction. Often a patient who relapses to this extent also will drop out of treatment, at least temporarily. In this case, if the patient returns to treatment, he or she may need to begin treatment with a detoxification phase, in either an inpatient or outpatient setting. The decision to detoxify a patient as an inpatient or an outpatient should be made conjointly by the treatment staff involved. Their decision should be based on the severity of the relapse, the particular drugs used, the availability of social support, and the presence of unstable medical or psychiatric conditions.