Q:  Drug Addiction Relapses & Accountability : Does BP Cause the Relapses?

I am an alcohol and drug counselor and this is about one of my clients: She is in recovery from drug addiction and relapse's about once every 3-4 months. She is on medication for the Bi-Polar and works hard on her recovery program (AA). How accountable should she be for those relapses and does the Bi polar cause the relapses?  I feel she needs to be accountable but others use her Bi Polar as a form of excuse for her using pot and being much less accountable.
 
Thank You
 

Dear Ms. Sanders -- 
Well, I'll confess to mixed feelings about answering that one.  In some cases, perhaps not this one, "accountability" can pretty easily be translated into "blame".  Should we hold the person who has relapsed because of bipolar less "accountable?   Should we blame the person who has relapsed just because they've relapsed, any more or less?  Everyone is accountable to do what they can to treat their cycling and their relapsing, and those would would associate with these people-who-use-drugs are accountable to do what they can to help without getting entangled enough in the outcome that they feel irritated or inclined to blame those who relapse, for whatever reason.  End of soapbox and I apologize if it was not warranted in this case. 

But, if the issue is more like:  "where should we turn to address this problem -- treat the cycling, or treat the relapsing?" ,  I do have an opinion there:  treat the cycling until it's clear that there isn't cycling (separate from the relapsing; though as you know from experience, that can be a difficult distinction an awful lot of the time).  After that, drug relapse is probably drug relapse and can be treated however you approach that (hopefully not from a blaming stance.  I much prefer the stance of Miller et al known as "motivational interviewing", which has some limited data in its favor).  

The dogmatic Dr. Phelps

Published September, 2003