Treatment maintenance ends only when patients achieve the treatment goals documented in their treatment plans and agree with their clinicians to stop ongoing treatment. An active way to use negative recall is to replace pleasure aspects with the consequences of engaging in sexual activity or substance use. It’s also a good idea to think of anyone in your own life who may have suffered as a result of your abusive relationship. This might include children, parents, siblings, and good friends. It’s part of learning about your resentments and why you use or drink so you can move past and make amends.

Avoiding high-risk places. Patients identify places they strongly associate with stimulant use and come up with strategies for avoiding them. Strategies include taking different routes home from work, avoiding certain locations at certain times, and using a buddy system when going to a high-risk area. These high-risk places are sometimes living environments, neighborhoods, or work situations patients cannot avoid. • Allow patients to voice concerns about the urine collection process, and respond in an empathic manner ( Scoglio et al., 2020). • Montréal’s Braids present their latest album Euphoric Recall with a UK-exclusive performance featuring string ensemble accompaniment and immersive visuals. Typically, urine toxicology testing tapers as treatment progresses, patients stabilize, and the clinical relevance of the tests become less important. Tests are spaced to ensure that results from the previous test are available before the next test is conducted and to avoid exceeding the sensitivity limits of standard laboratory testing methods, which generally means spacing tests no more frequently than every 3 days. More frequent testing generally provides little information of clinical relevance. However, if the patient appears intoxicated or has admitted to misusing substances, testing may need to be repeated to establish a baseline. SUD treatment providers also conduct random testing, although it is advisable to test on days that closely follow periods of high risk, such as holidays, paydays, and weekends.Financial instability and/or illegal activities ( Cheng et al., 2010; Gizzi & Gerkin, 2010; Maiorana et al., 2021). • At its core, euphoric recall involves a distortion of memory. It enhances the positive aspects of an experience, particularly the emotions of pleasure or happiness, while the negative aspects become blurred or ignored. This distortion can extend to exaggerate the frequency and intensity of positive experiences while reducing the recall of negative ones. Mutual-help strategies can be valuable components throughout treatment. These strategies, especially those that focus on substance use, are especially valuable as ancillary activities that support the treatment goals of maintaining abstinence. In general, mutual-help programs assist patients in developing appropriate social skills, creating healthy social networks, establishing healthy intimate relationships, and engaging in substance-free healthy activities. They also provide opportunities for patients to learn socially appropriate mores and norms, improve their ability to receive and give advice, and learn how to mentor others.

Provide patients with information about the urine collection process so they know what to expect ( Scoglio et al., 2020). •Once you can identify that you are in euphoric recall and choose to stop it, you can use one (or many) of these coping strategies. How to Cope with Euphoric Recall Negative Recall: Remembering the Realities of Addiction Someone struggling with drug addiction might remember instances of substance use and focus on the pleasurable effects. Failing to recognize the negative realities (such as worsening health, withdrawal symptoms, wrong decisions made under the influence, etc.) may prompt the cycle of addiction. Using alcohol with cocaine may increase an individual's perception of euphoria. Some research appears to show that the combination of alcohol and cocaine may be more reinforcing than either substance alone. This combination produces a toxic metabolite—cocaethylene—that can harm the liver and heart ( A. W. Jones, 2019; Liu et al., 2018). (For more information about cocaethylene, see Chapter 3.) •

When people go through addiction recovery programs, they’re encouraged to make a list of their shortcomings and all the ways they’ve harmed people during their addiction. Relapse prevention techniques help patients recognize high-risk situations for substance use, implement coping strategies when confronted with high-risk events, and apply strategies to prevent recurring use should an episode of substance use occur ( Glasner-Edwards et al., 2017; S. Grant et al., 2017; Marlatt & Gordon, 1985). The techniques involve several cognitive–behavioral interventions that focus on skills training, cognitive reframing, and lifestyle modification. After achieving initial cessation of stimulant use, patients need support and strategies to stabilize their lives without the substance. Strategies for this include the following: •

Understanding Euphoric Recall

Compulsive sexual behavior (especially for those who use MA), which is often reported to be at least as difficult to control as the stimulant use ( Berry et al., 2020; Loza et al., 2020). • Urine collection should be conducted in a trauma-informed way. Strategies for this process include the following: • Suggest healthy alternative activities (e.g., go for a bike ride or out for a meal), if the individual is someone the patient wants to be with. • Refrain from direct observation of specimen collection. Rather, collection should be supervised by a staff member. This entails requiring patients to leave their belongings outside the bathroom and to collect their sample without flushing the toilet.