In many Iranian families, there is a word that carries a lot of weight: aberu, meaning honor. When someone in the family has a substance use disorder, concerns about aberu can prevent everyone from speaking out — including the person in need of help and their parents, siblings and spouses. This silence comes at a cost. If you or someone you love is struggling, there is something I want you to know before we go any further. If you are in crisis or are considering suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline. The service is free and confidential, and help is available at any time of day.
The Iranian-American community is large and growing. According to a Pew Research Center analysis of the 2024 American Community Survey, there are approximately 750,000 Iranian Americans in the United States, including around 230,000 in the Los Angeles area alone. That is a significant number of families, and addiction and recovery touch families in every community.
Here is a number that may surprise you. In the 2025 National Survey on Drug Use and Health, SAMHSA reported that 22.3 million adults — about 73 percent of adults who felt they had ever had a drug or alcohol problem — considered themselves in recovery or recovered. Recovery is not rare. It is the outcome most of those surveyed adults reported for themselves. This article is about one hard part of that path: what a relapse really means, and how people pick themselves back up.
Key takeaways
- In the 2025 NSDUH, SAMHSA reported that 22.3 million adults — 73% of those who felt they had ever had a drug or alcohol problem — considered themselves in recovery or recovered.
- A return to using drugs is a setback, not a failure. A relapse prevention plan can help you to respond to the situation rather than giving up.
- The 2024 Mental Health Parity and Addiction Equity Act final rule took effect November 22, 2024, with provisions phasing in for 2025 and 2026 plan years.
- Peer support is a covered service in parts of California through the Medi-Cal Peer Support Services program, which was launched in 2022.
- If you would prefer, you can ask for an addiction therapist who speaks Farsi and understands your culture.
Table of Contents
What a relapse actually means
Let's start with the word itself, because it carries so much shame. The meaning of 'relapse' that people fear is 'I failed, and all my hard work has been undone.' This is not what it means. A relapse is simply a return to using substances after a period of abstinence. It's a setback in a long process — like stumbling while learning to walk again after an injury.
This matters because of how recovery actually works. A 2000 article in the Journal of the American Medical Association (JAMA) has long been cited as the source of a relapse range of 40 to 60 percent for treated drug dependence, and the National Institute on Drug Abuse references that article on its 2020 treatment-and-recovery page. However, the older research did not pinpoint this range to one follow-up period, so it is not possible to make a precise prediction for any one person. The point is simple: relapse is common, and it does not erase the progress you have made.
Consider recovery from a substance use disorder in the same way that doctors consider other long-term health conditions. Managing it well, experiencing setbacks, adjusting the plan and continuing are all normal parts of the process. A relapse provides information. It tells you and your treatment team what areas need more support.
Know your triggers before they find you.
Most relapses don't just appear out of nowhere. They build up. Relapse triggers are the people, places, feelings and situations that increase the temptation to use. For many in our community, these triggers can be specific, such as a holiday gathering where alcohol is served, feeling lonely far from family in Iran, the stress of keeping a small business afloat, or a cutting comment from an older relative.
Cravings — the strong, sometimes sudden urge to use — often arise alongside these triggers. A craving can feel overwhelming in the moment. However, cravings rise and fall, and they do not last forever, even when it feels like they will.
This is where a relapse prevention plan comes in. It is a practical plan that you create with an addiction therapist, a professional trained to treat substance use disorders whose licensing or certification requirements vary by state. It typically identifies your personal triggers, outlines your actions when a craving arises, and specifies who you will contact. Many therapists use cognitive behavioral therapy for this work — essentially a structured way of identifying the thoughts and situations that lead to substance use and practicing different responses. A licensed therapist can help you decide whether this approach or another fits your situation.
Do you need an Iranian therapist who speaks Farsi? Heritage Web can put you in touch.
How to recover from a relapse
So, a slip happened. What now? The first hours and days are crucial, because a return to use can itself be very dangerous — even deadly for some drugs — and the shame that makes you want to hide and carry on as normal only adds to that risk. Here's a steadier way through.
- Reach out to someone you trust right away. This could be a sponsor, a trusted friend, a family member who won't shame you or your therapist. Breaking the silence is key.
- Be honest about what happened, but don't dwell on blame. What was the trigger? Where did the plan fall short?
- Reconnect with your care. If you have an addiction therapist, arrange an appointment. If you don't, now is the time to find one.
- Update your relapse prevention plan based on what you have just learned. Remember that a setback is an opportunity to strengthen your plan.
- If you are taking medication as part of your treatment, you should talk to your doctor or psychiatrist. Questions about medication should be directed to them, rather than to an article or a friend.
Recovering from a relapse is less about willpower and more about having the right people and a solid plan in place. Nobody does this alone, and nor should you.
Building a sober support network that fits your life
A sober support network is simply a group of people who help you to stay well. This could be peers who have been through similar experiences, a counselor, a support group or family members who have learned how to help rather than cause harm.
Support groups and peer support are real, structured options. According to the 2025 NSDUH report by SAMHSA, 6.4 percent of people aged 12 or older with a substance use disorder in the past year took part in a support group, while 3.5 percent received help from a peer support specialist or recovery coach. A peer support specialist is someone who has undergone training and, in some places, certification, and has experienced recovery themselves and now helps others.
In California, this kind of support is covered by insurance for some people. The state launched Medi-Cal Peer Support Services in 2022, and the California Department of Health Care Services reported that, by September 2025, the benefit was offered in one or both of the participating behavioral health systems in 53 counties, with participation in substance use and mental health services varying by county. Whether you are eligible depends on your county and coverage, so it is worth contacting your plan directly for more information.
For Persian-speaking families, culturally appropriate support can be extremely beneficial. In 2026, the Pars Equality Center reported that it was providing mental health counseling and healthcare resources for Persian-speaking and other underserved communities through its locations in San Jose and Los Angeles. In 2025, the Los Angeles County Department of Mental Health reported that its ACCESS Center, which operates 24 hours a day, offered information and interpreter services, and that its ACCESS brochure was available in Farsi.
Why is silence so heavy in Iranian families?
Shame prevents people from seeking care, and the data supports what many of us already suspect. Among adults with a substance use disorder in the past year who perceived an unmet need for treatment in the 2025 NSDUH, SAMHSA found that 41.4 percent were concerned about what others might think or say, 40.5 percent did not know how or where to access treatment, and 39.2 percent thought it would be too expensive. People could give more than one reason.
These barriers have a significant impact on immigrant communities. A 2023 systematic review in the Journal of Immigrant and Minority Health identified language proficiency, stigma, cultural beliefs, and trust as factors influencing U.S. immigrants' decision to seek professional mental health support. A 2025 qualitative study in the International Journal of Intercultural Relations, which interviewed 20 first-generation Iranian Americans, found themes relating to service barriers, knowledge and attitudes, and cultural norms. However, that study examined mental health help-seeking more broadly than addiction recovery specifically.
Language is part of this, too. According to the 2025 American Community Survey, around 621,079 people aged five or over spoke Persian — including Farsi and Dari — at home, and approximately 36.8 percent had limited English proficiency. When it comes to something as sensitive as recovery, being able to speak Farsi isn't a luxury. It's how you get understood.
Paying for care and accessing it from home
Cost worries are real, but the rules have been shifting in ways that may help you. The 2024 Mental Health Parity and Addiction Equity Act final rule became effective November 22, 2024, with provisions phasing in for plan years beginning in 2025 and 2026. The U.S. Department of Labor reported that it addresses nonquantitative treatment limitations — things like how a plan reviews whether substance use treatment is "medically necessary." In 2026, Labor identified treatment exclusions, medical-necessity review, and network admission and reimbursement standards as enforcement priorities. Enforcement has had its own twists — in 2025, federal departments announced they would not enforce certain newer parts of the rule for a period tied to litigation — but the statutory parity obligation continues. In plain terms: your plan is generally supposed to treat substance use care comparably to medical care. Coverage still differs by plan, so call the number on your insurance card and ask what's covered.
Getting to care has gotten easier in one real way. As of 2026, the U.S. Department of Health and Human Services reported that Medicare permits behavioral-health telehealth in a patient's home without geographic restrictions, and the in-person visit requirement for Medicare behavioral-health telehealth is suspended through December 31, 2027. For someone juggling a business, family and privacy concerns, being able to see a counselor from home can be the difference between going and not going.
Here's one more licensing note worth knowing. The American Counseling Association reported that the Counseling Compact began issuing privileges in 2025, allowing qualifying independently licensed counselors to practice across member states. However, this applies to qualifying independently licensed professional counselors and does not automatically extend to a separate addiction counselor credential. If practicing across state lines via telehealth is important to you, ask a provider directly about their license.
Taking the first step
If there's one thing you take away from this, let it be this: a relapse does not mean the end of your story, and you were never meant to recover alone. Reaching out is the hardest part, but it's also the part that can change everything. You deserve support that understands you — both the language you grew up with and the unspoken language of knowing how our families work.
With millions of adults in the 2025 survey saying they saw themselves as in recovery or recovered, you are in far larger company than silence would suggest. Get in touch with a therapist who speaks Farsi and understands your culture. Submit your details via Heritage Web's secure referral form.
This article is general information, not medical or mental health advice, and it does not replace care from a licensed professional. If you are in crisis or thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 in an emergency.
Sources
- Mental Health Parity and Addiction Equity Act
- Pew Research Center
- National Survey on Drug Use and Health
- International Journal of Intercultural Relations
- Medi-Cal Peer Support Services
- U.S. Department of Health and Human Services — U.S. Department of Health and Human Services, 2026
- SAMHSA
- Journal of Immigrant and Minority Health
- National Institute on Drug Abuse
- 988 Suicide & Crisis Lifeline
- ACCESS Center
- Counseling Compact
