When someone relapses, it can be hard for them not to feel like they’ve ruined all of the hard work that they had put into maintaining their sobriety. Suddenly, everything they’ve worked for is gone, and they’re back to square one.
However, this is not the case. Relapse does not mean that someone has failed. Addiction, like any other chronic illness, requires lifelong management. With statistics showing that about 40 to 60 percent of people in recovery from substance use disorder relapse at some point, it’s fairly common and something to prepare for.
Relapse can happen months or even years into someone’s recovery. This can be particularly dangerous, as someone who has maintained a lengthy sobriety will have lost their tolerance for the substance they were previously dependent on.
This means that if they relapse and take the same amount they were accustomed to before, the likelihood that will overdose is high. Relapse can also occur as a response to acute withdrawal symptoms that can become unbearable and dangerous if not supervised during a medical detox.
While relapsing does not make someone a failure, it does mean it’s necessary to reevaluate their relapse prevention plan to fix the aspects of it that are ineffective. Working to create a solid, practical relapse prevention plan can significantly decrease the risk of falling back into addiction.
Relapse prevention involves not only gaining the tools and techniques needed to help cope with different internal and external triggers, but it also allows you to identify and, therefore, prevent situations that can leave you vulnerable to relapse. To create an effective relapse prevention plan, it is first necessary to have a full understanding of how relapse works.
Addiction rehabilitation treatment can make you better at managing your addiction behaviors, but you still need to be aware of the four key types of situations that could potentially make you vulnerable to a relapse:
- Negative emotional states triggered by feelings such as depression, frustration, boredom, and anxiety. These can be caused either by your own perceptions or as a reaction to external events.
- Positive emotions can also have their risks, like for example, recalling the good feelings associated with using drugs or alcohol or passing by a favorite bar or club.
- Social pressure is also a powerful trigger, which can either be direct or indirect. An example of direct pressure would be friends urging you to drink at a party, while indirect is more like being invited to a social gathering where alcohol will be present.
- More than half of all relapses also come from negative interpersonal situations like conflict, disappointment, guilt, or heartbreak.
The moment one of these high-risk situations presents itself is the moment relapse can begin.
The Stages Of Relapse
It’s also important to recognize that relapse itself is not a single event comprised of just lapsing back into drug or alcohol use. Instead, it is a multistage process that can be broken down as follows:
This is the first stage of relapse, which can start before someone is even really thinking about using drugs or alcohol again. The emotional stage of relapse is largely mood-based, involving symptoms such as depression, anxiety, and agitation, as well as lack of appetite, erratic sleep patterns, and insomnia.
Several common behavioral signs can accompany the emotional stage of a relapse, including:
- A significant change in eating and sleeping habits
- Not following previously set personal rules for recovery
- Bottling up or failing to deal with emotions
- Isolating themselves from their support systems (family, friends, etc.)
- No longer engaging in mental or physical self-care
If these signs are recognized for what they are and properly addressed before reaching the second stage, a potential relapse can be stopped before it happens.
Someone at this point in the relapse process now has the conscious urge to go back to drug use or alcohol use and will begin to struggle with that urge and the desire to remain sober. People at this stage are extremely vulnerable, in part because if they do decide to use again, very little can be done after that to stop it from happening.
Common behavioral signs indicative of the mental stage of relapse include:
- Bargaining, i.e., “I’ll just use this one time, and then I never will again.”
- Lying to their support systems about the fact that they’re thinking about using again
- Romanticizing past drug use or attempting to retroactively minimize its impact
- Actively looking for opportunities or reasons for them to relapse
This final stage in the relapse process is the part that people generally associate with the word “relapse.” If a mental relapse cannot be stopped, the physical stage will follow shortly after, and the individual will return to using drugs or alcohol, breaking their sobriety.
Depending on the substance, intense cravings can return after just one use, increasing the chances that they will transition back into regular substance abuse. At this point, the stages of relapse have been completed, and the best thing that can be done for someone is to get them back into treatment as soon as possible.
The common behaviors that can signal the physical stage of relapse are:
- Using drugs or alcohol “just once”
- A return to continuous substance abuse
Having a good relapse prevention plan in place can help not only to stop a relapse-in-progress before it can reach the physical stage but also to prevent the situations that can put someone at risk for starting one to begin with.
Creating A Relapse Prevention Plan
The idea of all that is involved in relapse prevention can often feel overwhelming, but there’s no reason that it has to be that way. A relapse prevention plan does not have to be complicated and all-encompassing. If you try one that is too complex, the odds are that it will not be terribly effective.
Instead, one useful way to create a relapse prevention plan is to make it as simple as possible by breaking it down into small pieces. One popular method is implementing five main rules to focus on during the long-term recovery process.
RULE 1: MAKE CHANGES IN YOUR LIFE
For many, the concept of having to change their life can feel like a whole lot all at once, but it’s not an “all or nothing” sort of rule. It just means looking at aspects of your life that have contributed to addictive or unhealthy behaviors and working to alter or remove them to make it easier to stay sober. One way to do this is to make attainable goals of changing one small thing at a time, even if it’s just waking up earlier or exercising more.
RULE 2: PRACTICE HONESTY
Lying and keeping secrets is a big part of active addiction. This is because people who struggle with substance abuse are frequently in situations that require lying to family, friends, employers, and even themselves about how much harm their dependence is causing. Much like the first rule, this can be done in small steps, like being honest with someone about needing help, until it eventually becomes a habit.
RULE 3: ASK FOR HELP
Speaking of being honest about help, anyone who believes they can get through recovery alone without a support system is setting themselves up to fail. There’s nothing wrong or weak about asking for help. In fact, it takes a great deal of strength for someone to admit that level of vulnerability. Something as easy as joining a support group where someone can safely express themselves and asking for help from those with the same experiences can make all the difference.
RULE 4: MAKE TIME FOR SELF-CARE
Self-care is a crucial element of relapse prevention therapy and addiction therapy in general, as it helps to avoid creating the negative internal emotions we mentioned previously. It also helps to create a new motivation and reward system to replace the one created by drug or alcohol use. Again, it doesn’t have to be anything big: a fancy meal, a relaxing bath, a special purchase, just something that allows someone to both acknowledge and celebrate their hard work.
RULE 5: FOLLOW THE RULES
While it might feel redundant, the rules of a relapse prevention plan won’t work if they aren’t followed or even if they’re bent. As previously illustrated, the first stage of relapse involves letting the good habits an individual has worked to build fall by the wayside. No matter how long someone has maintained their sobriety, they always need to be actively working at it and following the rules of the relapse prevention plan that they have set for themselves.
You can follow additional rules that help to ensure you stay on the right path toward sobriety. They include:
- Take time to self assess and reflect. What led you to use drugs or alcohol in the first place? Stress relief? Coping with the trauma you endured in your life? Sitting down and asking these questions is a crucial component in recovery. You can familiarize yourself with usage patterns and pinpoint what pushed you into substance abuse. You may want to consider making a list of times that you’ve relapsed and reflect on the situation that led you to that.
- Become aware of triggers and warning signs. A trigger is an experience that causes you to stray from your sobriety. Every individual is going to have different triggers, but becoming keen on what to look out for will help exponentially. Some triggers can be people you hung out with when using, places you frequented and consumed drugs or a holiday party where alcohol is present.
- Plan for the worst. It may sound dark, but you can never be sure of what the future holds. You can’t be stuck without a plan it a relapse does occur. Write a step-by-step plan that details what you will do if you relapse. You should also include a list of people who you can speak with if this happens.
- Involve others. You cannot overcome addiction alone, and you cannot fight off addiction alone. You must include others in your recovery. It can help you to distract yourself if you have cravings. These healthy distractions will keep your mind away from the cravings and help you to develop relationships with those who support your recovery.
Relapse Prevention Strategies
Having solid strategies in place for preventing relapse can make all the difference when it comes to responding effectively to high-risk situations. Some of these situations can even be everyday occurrences, which makes it that much more important to be able to deal with them productively.
Some useful relapse prevention strategies include:
- Learning to identify these high-risk situations. Relapse prevention therapy can teach someone the warning signs that accompany these situations, such as a rise in stress levels or attempts to rationalize or justify using drugs and alcohol again. The easier it is to identify these moments for what they are, the easier it will be to mitigate or avoid them.
- Working with a therapist to increase self-efficacy. Working through this period with the help of a professional can be a powerful relapse prevention strategy. Once a therapist has helped someone to determine their ability to resist cravings, and how they respond to high-risk situations, they can begin helping to build up the individual’s self-efficacy, along with the odds of successfully making it through these high-risk scenarios.
- Understanding that relapses are a possibility. The ability to manage these relapses and reevaluate and then adapt your relapse prevention plan both helps to stop a relapse from feeling like a failure and helps to lower the chances of experiencing another.
Because addiction recovery is never a one-size-fits-all situation, everyone’s relapse plan will look a bit different based on what strategies and techniques work the best for them. There’s no template for a perfect relapse prevention plan, and there’s no guarantee that relapse will be avoided, even with a plan in place. Still, the most important thing to do is have a plan at the ready to increase your odds of maintaining long-term sobriety.