The abstinence violation effect (AVE) describes the tendency of people recovering from addiction to spiral out of control when they experience even a minor relapse. Instead of continuing with recovery, AVE refers to relapsing heavily after a single violation. Meanwhile, a study published in the Journal of Family Planning and Reproductive Health Care found adult women who engaged in voluntary sexual abstinence were less likely to have used illicit drugs, misused alcohol, or be unemployed. While this does not necessarily mean abstinence caused these women to make certain lifestyle choices, it may be that women who make these choices are more likely to go through periods of sexual abstinence. Abstinence stands in contrast to concepts such as limited consumption or self-restraint, because the abstinence model requires complete avoidance of a substance or behavior.
- The result of this lackluster planning is that we recognize future disturbances, yet do nothing to truly resolve them.
- People commonly confront relapse as a part of their process in achieving long-term sobriety.
- Stages imply a readiness to change and therefore the abstinence violation effect TTM has been particularly relevant in the timing of interventions.
- Notably, these individuals are also most likely to endorse nonabstinence goals (Berglund et al., 2019; Dunn & Strain, 2013; Lozano et al., 2006; Lozano et al., 2015; Mowbray et al., 2013).
Important features common to these groups include low program barriers (e.g., drop-in groups, few rules) and inclusiveness of clients with difficult presentations (Little & Franskoviak, 2010). Teasdale and colleagues (1995) have proposed a model of depressive relapse which attempts to explain the process of relapse in depression and also the mechanisms by which cognitive therapy achieves its prophylactic effects in the treatment of depression. It hypothesizes that following recovery, mild states of depression can reactivate depressogenic cycles of cognitive processing similar to those found during a major depressive episode. Despite the growth of the harm reduction movement globally, research and implementation of nonabstinence treatment in the U.S. has lagged. Furthermore, abstinence remains a gold standard treatment outcome in pharmacotherapy research for drug use disorders, even after numerous calls for alternative metrics of success (Volkow, 2020). Models of nonabstinence psychosocial treatment for drug use have been developed and promoted by practitioners, but little empirical research has tested their effectiveness.
How AVE Affects Our Attempts at Recovery
The revised dynamic model of relapse also takes into account the timing and interrelatedness of risk factors, as well as provides for feedback between lower- and higher-level components of the model. For example, based on the dynamic model it is hypothesized that changes in one risk factor (e.g. negative affect) influences changes in drinking behavior and that changes in drinking also influences abstinence violation effect definition changes in the risk factors. The dynamic model of relapse has generated enthusiasm among researchers and clinicians who have observed these processes in their data and their clients. The abstinence violation effect (AVE) highlights the distinction between a lapse and relapse. Put simply, the AVE occurs when a client perceives no intermediary step between a lapse and a relapse.
- They are the result of a series of events occurring over the course of time, explains psychologist Alan Marlatt, Ph.D.
- Prior to joining Amethyst, she served as the Director of Enforcement for a state regulatory body.
- Many organizations, such as 12-Step programs like Alcoholics Anonymous, will often point to the notion that even thinking about using alcohol again represents a potential sign of a relapse.
- However, these interventions also typically lack an abstinence focus and sometimes result in reductions in drug use.
Instead of learning and growing from their mistake, an individual may believe that they are unable to complete a successful recovery and feel shame and guilt. Abstinence violation effect can be overcome, but it is far better to avoid suffering AVE in the first place. Enroll in Amethyst Recovery, and you’ll learn the skills you need to practice effective relapse prevention. This isn’t the only way in which our thinking might become twisted when we experience a lapse in sobriety. Abstinence violation effect fuels our negative cognition, causing us to judge ourselves quite harshly. This is especially true if we are involved in a twelve-step program, as we now realize we must reset our chips.
Does Abstinence Work?
This resistance to nonabstinence treatment persists despite strong theoretical and empirical arguments in favor of harm reduction approaches. Lack of consensus around target outcomes also presents a challenge to evaluating the effectiveness of nonabstinence treatment. Experts generally recommend that SUD treatment studies report substance use as well as related consequences, and select primary outcomes based on the study sample and goals (Donovan et al., 2012; Kiluk et al., 2019). While AUD treatment studies commonly rely on guidelines set by government agencies regarding a “low-risk” or “nonhazardous” level of alcohol consumption (e.g., Enggasser et al., 2015), no such guidelines exist for illicit drug use. Thus, studies will need to emphasize measures of substance-related problems in addition to reporting the degree of substance use (e.g., frequency, quantity).
At least 74.8% of those deaths involved opioids, 14% involved heroin, 26% involved psychostimulants, primarily…
Historical context of nonabstinence approaches
Starting from the point of confronting and recognizing a high-risk situation, Marlatt’s model illustrates that the individual will deal with the situation with either an effective or ineffective coping response. Effective coping skills can lead to increased self-efficacy, and a decreased probability of a lapse. However, if one lacks skills, then the model predicts a decrease in self-efficacy and an increase in positive outcome expectancies for the effects of using the substance. This is a likely predecessor of giving into temptation in the initial use of a substance. These properties of the abstinence violation effect also apply to individuals who do not have a goal to abstain, but instead have a goal to restrict their use within certain self-determined limits. The limit violation effect describes what happens when these individuals fail to restrict their use within their predetermined limits and the subsequent effects of this failure.