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Relapse is part of recovery, "The Hole", a poem that depicts this message.

Approximately ten years ago, my wife and I learned our daughter was addicted to heroin.  In our naivety, we were convinced that if we could just get her into the "best" drug detox and rehab center, she would be sober for the rest of her life.  After 6-8 episodes of detox/recovery, short-term sobriety, and relapse, our unrealistic optimism decreased each time she fell back into the "hole" of addiction.  

In hindsight, this poem is an accurate depiction of our daughter's road to recovery.  Recovery happens on their addicts time-line, which can be very difficult for their loved ones to accept.  We all want recovery to be immediate and permanent, but it usually takes 5 or 10 attempts for the person in recovery to develop the awareness and perserverance to make the 'internal" changes that make long term sobriety possible. 

During this time it is important to put a "harm reduction" strategy in place.  This means that while your loved one predictably goes through multiple cycles of recovery and relapse, they need to be protected from harm and potential overdose death from opiates and fentanyl.  

Harm prevention includes three important aspects:  1.  Every loved one and friend should have multiple Narcan kits that will revive a person that has overdosed.  Please contact our office at 602-692-4626 for free kits.  We offer these to all our patients and anyone else at risk for overdose.  2.  Clean needles and needle exchange.  Making sure IV users have access to clean needles prevents transmission of HIV and Hepatitis C is preventable.  3. Fentanyl test kits.  Fentanyl is 100 times more potent than heroin and is responsible for the sharp increase in overdose deaths in the last 5 years.  Test kits allow the user to know if their street drug contains Fentanyl so they can adjust their "dosing" to prevent overdose.

During this period, parents and loved ones struggle with fear and doubt.  They usually don't know what to do to "help" their addicted loved one become sober.  The truth is, there is little we can do to help if the person is not "ready for recovery".  Rather than trying to "control" the addicts behavior, it is important to work on ourselves through counseling or a program like PALS (

Unless we change our parenting style, it is unlikely the person struggling with their opiate addiction will change.  This means stopping all financial and any other support that enables the addict's drug-induced "lifestyle."

This approach is difficult for the parent.  They worry that their child will die if they withdraw support.  The truth is, unless they change their relationship with their addicted child, there is no reason for the child to become sober and they will eventually end up in prison or overdose. 

During this time, PALS offers parents support and coaching, helping you realize you are not alone in your efforts to deal with your addicted adult child.  Usually, the changes a parent makes in their parenting style will be reflected in the child's road to recovery at least 6 months to a year later. 

Please call our office at 602-692-4626 to discuss how we can help once your child is ready to do what it takes to become sober.  Our services include: 

1. Medical assistance for out-patient opiate detoxification. 

2. Naltrexone pellet implants to take away the opiate cravings and prevent relapse once the drugs are out of the patient's system.

3. Helping to rebuild the brain and nervous system from years of abuse.   

The Hole  

The progression of multiple relapse and recovery


I walk down the street

There is a deep hole in the sidewalk.  
I fall in

I am lost......I am helpless

It isn't my fault.

It takes forever to find a way out.



I walk down the street

There is a deep hole in the sidewalk.

I pretend I don't see it. 

I fall in again.

I can't believe I am in the same place, 

but it isn't my fault.

It still takes a long time to get out. 


I  walk down the same street

There is a deep hole in the sidewalk.

I  see it is  there.

I still fall in.....its a habit.

My eyes are open.  I know where I am.

It is my fault.

I get out immediately.



I walk down the same street

There is a deep hole in the sidewalk.

I walk around it. 



I  walk down another street


Copyright @ 1993 by Portia Nelson, from the book, There's  A Hole In My Sidewalk; Beyond Words Publishing, Hillsboro, Oregon. 

Dr. William Nelson William Nelson, NMD, is a naturopathic medical doctor who brings years of medical expertise to his practice, Explore Health, in Scottsdale, Arizona. Dr. Nelson is heralded as the go-to physician for patients who feel they have exhausted their time and resources attempting to resolve complex health challenges. He is also respected internationally as a preeminent addiction medicine specialist and hosts ”Your Road to Personal Addiction Recovery,” which is one of the most-listened-to podcasts on the matter.

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