consistent across a number of different addictive behaviours, with high rates initially
tapering off over a year. This relapse pattern is shown in Figure 5.5.
Marlatt and Gordon (1985) developed a relapse prevention model of addictions,
which specifically examined the processes involved in successful and unsuccessful
cessation attempts. The relapse prevention model was based on the following concept of
addictive behaviours:
Addictive behaviours are learned and therefore can be unlearned; they are reversible.
Addictions are not ‘all or nothing’ but exist on a continuum.
Lapses from abstinence are likely and acceptable.
Believing that ‘one drink – a drunk’ is a self-fulfilling prophecy.
They distinguished between a lapse, which entails a minor slip (e.g. a cigarette, a couple
of drinks) and a relapse, which entails a return to former behaviour (e.g. smoking 20
cigarettes, getting drunk). Marlatt and Gordon examined the processes involved in the
progression from abstinence to relapse and in particular assessed the mechanisms that
may explain the transition from lapse to relapse (see Figure 5.6). These processes are
described on page 126.
Baseline state
Abstinence. If an individual sets total abstinence as the goal, then this stage represents the
target behaviour and indicates a state of behavioural control.
Fig. 5-5 Relapse curves for individuals treated for heroin, smoking and alcohol addictionSMOKING AND ALCOHOL USE 125