Magazine article Addiction Professional

Relapse: Our Dirty Little Secret

Magazine article Addiction Professional

Relapse: Our Dirty Little Secret

Article excerpt

We tell our patients, "We're only as sick as our secrets." But the addiction field has its own secret of which we rarely speak openly. What happens when a staff member relapses? How often does this happen? Data on this issue are sparse, although figures are given such as 38 percent of recovering staff relapse at some point in their counseling careers.

Even this is a misleading question as we speak of relapse for recovering counselors but not of other behavioral concerns for non-recovering counselors, such as significant weight gain, return to tobacco use, stress-related illnesses and other behavioral addictions. Do we treat all staff the same way, regardless of their recovery status when there is abusive use of substances?


Most agencies, at least in the past, have had policies stating that staff in recovery must have at least two years of abstinence from substances. I am not a lawyer, but I'd suggest this policy is illegal because it discriminates against the recovering person. I believe the policy ought to read that all employees must have two (or more) years of non-abusive use of substances. This levels the playing field and treats all personnel equally, regardless of recovery status. And if we're not sure what "abusive use of substances" means, check the DSM-IV--it's clear.

Issues to consider

However, of late I am questioning for myself even this policy. Here are some questions for a clinical supervisor and management to consider:

1. Do we treat all employees the same? Do we hold management to the same standards as line counselors, especially if management does not provide direct care? How do we deal with "ancillary personnel" such as housekeeping, drivers, counselor aides, etc.? Do we make exceptions if an employee is deemed "too valuable" to an organization to lose because of abuse of a substance?

2. We say addiction is a disease of relapse, like other chronic illnesses. Patients have individualized treatment plans to address potential relapse. In some programs, when a patient relapses while on a weekend pass (or should I call it a "lapse"?), the treatment staff assesses the potential for continuing treatment on a case-by-case basis. Shouldn't we do the same for staff when they lapse?

3. George Vaillant, the grandfather of addictions, says that when you treat a disease without a cure, treat it with hope. Hope is a memory for the future. What hope do we offer staff when we automatically terminate an employee because of an abusive use of a substance, or other forms of relapse? Wouldn't it send a more powerful message about what we believe about the disease of addiction if we considered each situation individually to determine what's best for the person, rather than having a blanket policy of termination?

4. Are we consistent in our approach to various lapses? I know of an agency where a counselor aide in recovery relapsed and was disciplined for that, while a counselor "relapsed" into chain smoking by his self-report. Another counselor was described as "unpredictable, volatile, angry and paranoid." Do we treat substance abuse differently because of the nature of our services, and should we? How do we deal with personality disorders, eating disorders, tobacco use? …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.