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. Author manuscript; available in PMC: 2023 Dec 1.
Published in final edited form as: Exp Clin Psychopharmacol. 2021 Jun 10;30(6):1024–1035. doi: 10.1037/pha0000477

Figure 1. Bidirectional Associations That Decrease Quality of Life in Recovery and Lead to Opioid Relapse.

Figure 1

Note. All of these factors can increase the risk for relapse at any given time (i.e., state changes), and may be part of a persistent dysregulation of diurnal rhythms that decreases the likelihood of successful, long-term recovery.

* Affective processes refer to high negative and low positive affect.