Abstinence Violation Effect (AVE) | What It Is & Relapse Prevention Strategies

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.

The Abstinence Violation Effect

AVE describes the negative, indulgent, or self-destructive feelings and behavior people often experience after lapsing during a period of abstinence. 

This can include abstinence from substance abuse, overeating, gambling, smoking, or other behaviors a person has been working to avoid.

In other words, AVE describes the thoughts, feelings, and actions a person goes through after they make a mistake and have a drink or abuse a substance, despite trying to quit. 

It includes thoughts and feelings like shame, guilt, anger, failure, depression, and recklessness as well as a return to addictive behaviors and drug use.

A Lapse Vs. A Relapse

It’s important to establish that a one-time lapse in a person’s recovery from drugs or alcohol is not considered a full blown relapse.

Lapses are, however, a major risk factor for relapse as well as overdose and other potential social, personal, and legal consequences of drug or alcohol abuse. 

As a result, it’s important that those in recovery internalize this difference and establish the proper mental and behavioral framework to avoid relapse and continue moving forward even if lapses occur.

Otherwise, recovering individuals are likely to make the worst of a single mistake and accelerate back through the relapse process as a result.

Common Features Of The Abstinence Violation Effect

There are common false assumptions and thought processes associated with AVE. These may vary from person to person but underlay the decisions and actions a person takes after a lapse occurs.

These common assumptions may sound like:

• “I already failed, so I might as well enjoy a bigger failure while I can still get away with it.”
• “I tried but it didn’t work. So now I can’t continue my recovery.”
• “Addiction is chronic disease anyway. So what’s the difference if I relapse for a little while?

Cognitive Dissonance

AVE also involves cognitive dissonance, a distressing experience people go through when their internal thoughts, beliefs, actions, or identities are put in conflict with one another. 

For instance, a person recovering from alcohol use disorder who has a drink may feel a sense of confusion or a lack of control and they may make unhealthy attributions or rationalizations to try to define and understand what they’re doing.

Altogether, these thoughts and attributions are frequently driven by strong feelings of personal failure, defeat, and shame. These negative emotions are, unfortunately, often temporarily placated by a renewed pattern of substance abuse.

Relapse Prevention

There are many relapse prevention models used in substance abuse treatment to counter AVE and give those in recovery important tools and coping skills.

Relapse prevention therapy uses a combination of cognitive therapy and mind-body relaxation while focusing on two things:

1. Identifying high risk situations and precipitants/triggers that put a person at a higher risk of lapsing.
2. Developing coping strategies to avoid or address these situations effectively.

Triggers include cravings, problematic thought patterns, and external cues or situations, all of which can contribute to increased self-efficacy (a sense of personal confidence, identity, and control) when properly managed.

Understand The Relapse Process

Clinicians in relapse prevention programs and the field of clinical psychology as a whole point out that relapse occurs only after a long-term pattern of specific feelings, thoughts, and behavior.

These patterns can be actively identified and corrected, helping participants avoid lapses before they occur and continue their recovery from substance use disorder.

The state of relapse include:

1. emotional relapse (denial and poor mental, emotion, or physical self-care)
2. mental relapse (cravings, thinking about triggers, experiencing cognitive dissonance, and considering relapse opportunities)
3. physical relapse (without emotional or mental resistance, substance use resumes due to the abstinence violation effect)

The Five Rules Of Recovery

Along with the stages of relapse, participants in relapse prevention programs will also be instructed in five basic rules to guard against drug abuse and AVE:

1. change one’s life to make it easier not to relapse
2. be completely honest
3. ask for help
4. practice self-care
5. don’t bend the rules

Ark Behavioral Health

Relapsing isn’t a matter of one’s lack of willpower, and it isn’t the end of the road. With the right help, preparation, and support, you and your loved ones can still continue to build a long-lasting recovery from substance abuse.

Our addiction treatment network offers comprehensive care for alcohol addiction, opioid addiction, and all other forms of drug addiction. Our treatment options include detox, inpatient treatment, outpatient treatment, medication-assisted treatment options, and more.

For more information, please contact us today.