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Figure 3 | Addiction Science & Clinical Practice

Figure 3

From: Management of chronic pain with chronic opioid therapy in patients with substance use disorders

Figure 3

The cognitive-behavioral model of the relapse process posits a central role for high-risk situations and for the SUD patient’s coping response to those situations. People with effective coping responses to high-risk situations (i.e., increased self-efficacy), are at decreased probability of a relapse. Conversely, people with ineffective coping responses (decreased self-efficacy) which, together with the expectation that drug use will have a positive effect (i.e., positive outcome expectancies), can result in an initial lapse. This lapse, in turn, can result in feelings of guilt and failure (i.e., an abstinence violation effect). The abstinence violation effect, along with positive outcome expectancies, can increase the probability of a relapse. Adopted from [75].

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