What is Relapse?
When it comes to categories, The Academy Awards has nothing on Medicine.
We have syndromes, isms, conditions, contusions, disorders, fetishes, neuroses, fractures, thromboses, and of course diseases-just to name a few.
We also have the Best Supporting Actor:
Al Pacino Apparently.
The amended surname is meant to suggest how many times we, as clinicians, and you, as parents, need to ask more questions of a person in recovery.
Even if it drives them crazy.
Take the definition of relapse as a flashpoint for the import of the word apparently:
"Relapse is a return a negative pattern of behavior after it has apparently been stopped."
To paraphrase a former president's assessment of the State of the Union:
"It's the apparently, stupid."
When our patient's urine screen shows no signs of any substance use, is she progressing?
But did we ask about the status of the co-dependent boyfriend, the uptick in cigarettes and Red Bull, the 12 step meetings and the counselling that are she's has suddenly stopped talking about?
Did we press on about the new job (marketing assistant at the new Vineyard) that she is so excited about?
So much of early recovery can be hide and seek, witness protection, and the Stockholm syndrome all rolled into one. Early recoverees should look protective, confused, and a bit too sympathetic with the old bank robbers.
Folks who appear to be OK without the sobriety that comes only with fellowship, counselling, and a new holistic way of approaching their relationship with their physician, can never be rubber-stamped.
Treatment needs to be a tighter collaboration of all three--fellowship, mental health, medical.
We can all communicate to our patients that preoccupation with the wrong people, places, and things will almost always be obvious, so encourage your patient to appear.
Before they disappear.