A high-risk situation has been identified as “a circumstance in which an individual’s attempt to refrain from [substance use] is threatened” (Witkiewitz & Marlatt, 1999, p. 226, as cited by Chang et al., 2006, p. 56). The risk is that exposure to such a circumstance “may create an opportunity or may set a client up for failure in maintaining their recovery” (Grand Canyon University (GCU) PCN-265 Lecture 3, 2012). There may be interplay of various factors to create the situation, a culmination of a trigger event with internal or external dysfunctions which create a sense of loss of control for the client (Gorski, 1989). Marlatt and Gordon call it a “relapse taxonomy consisting of intrapersonal and interpersonal determinants” (1985, as cited by Chang et al., 2006, p. 56). In other words, a combination of negative or positive emotions, or poor physical health, coupled with an external conflict or pressure can create the false perception in a client that recovery is futile and that using substances is a better option. This is especially true for clients who are in the early stages of recovery when self-efficacy is still relatively low. It has been found that individuals who are unable to effectively cope with high-risk situations experience a decrease in self-efficacy which increases the...
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...yed his recovery. Within a few months of returning home, Christina had ceased attending her support group meetings and falsely believed she had no need of counseling. Eventually, she sought medical help for her chronic back pain and did not disclose to her doctor that she had been treated for alcoholism. She unwittingly found herself in a high-risk situation as a recovering alcoholic with a prescription for opioids. This is why people recovering from substance use disorder should make every effort “to develop a pain management plan which effectively controls the pain without these substances” (Ziegler, 2005). Alcoholics cannot safely use addictive substances in any form. Meanwhile, Taos has faithfully attended support group meetings, at first because his sober living house required it but now because he genuinely enjoys the sober fellowship and friends he has made.
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