The model also differentiates between lapse and relapse, and it does that using an idiographic approach. For some, a few days of use = relapse. For others, context matters—recent lapses can push the latent state closer to relapse.

An important additional finding is the effect of Skills for Improving Distress Intolerance (relative to supportive counseling) on model parameters. We would also like to thank NIDA (DA032582)

Thanks to the team – @hayafatimah.bsky.social and Mike Hunter!

Together, these parameters form a personalized relapse risk (RR). Folks vary on their steepness and tilt, and therefore their individual risk of relapse. #precisionmedicine

Tilt: Measures relative stability—how difficult it is to leave one state for the other. Which well is deeper for you?

The DWPM provides two key parameters: Steepness and Tilt
🔹 Steepness: Indicates the ease or difficulty of transitioning between abstinence and relapse. High steepness>deep well> more stable.

We introduce the Double-Well Potential Model (DWPM), a dynamic system model that redefines relapse as a continuous process. The DWPM conceptualizes relapse & abstinence as two stable states (or wells) in a latent behavior space: use and non use, that folks can transition in and out of. 🧵