Relapse Prevention Therapy | Stages, Strategies, and Sample Plan
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Relapse Prevention

When someone relapses, it can be hard to 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, and with statistics showing that about 40 to 60 percent of people in recovery from substance abuse disorder relapse at some point, it’s fairly common, and should be something to prepare for.

Relapse can happen months or even years into someone’s recovery, which 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, there is a high likelihood of overdosing. 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 that it’s necessary to reevaluate their relapse prevention plan in order to fix the aspects of it that proved to be ineffective. Working to create a solid, practical relapse prevention plan can significantly decrease the risk of falling back into addiction.  

Understanding Relapse

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 be able to identify and therefore prevent situations that can leave you vulnerable to relapse. In order 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.

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  • 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 but instead a multi-stage process that can be broken down as follows:

     

    Emotional: This is the first stage of relapse, which can actually 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.

     

     

    • 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 able to be recognized for what they are and properly addressed before reaching the second stage, a potential relapse can be stopped before it happens.

     

     

    Mental: 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 make the decision to use again, very little can be done after that to stop it from happening.

    • Bargaining, ie, “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 the impact it had
    • Actively looking for opportunities or reasons for them to relapse

    Physical: 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 lapse back into 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.

    • 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.

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    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 something complicated and all-encompassing. If you try to make one that is too complex, 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, breaking it down into small pieces. One popular method is implementing five main rules to focus on during the long-term recovery process.

    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 in order 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.

    Lying and keeping secrets is a big part of active addiction. This is because people struggling 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.

    Speaking of being honest about help, anyone who believes that 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.

    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.

    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.

    DON’T GO THROUGH THE PROCESS OF RECOVERY ALONE.

    GET IN TOUCH WITH SOMEONE WHO CAN HELP.

    DON’T GO THROUGH THE PROCESS OF RECOVERY ALONE.

    GET IN TOUCH WITH SOMEONE WHO CAN HELP.

    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 in a productive manner.

    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, like 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 can also 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.
    • Understand that relapses can still be 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 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 end up working 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.

    Relapse Prevention Begins with Recovery

    Getting out from under the weight of an addiction and staying out can be difficult if not impossible on your own. You need the support of family, friends, and a support network that is geared toward your lasting recovery. By plugging into the recovery community, you’ll have people that can hold you accountable throughout your journey. Start thinking of sobriety as a lifelong commitment and you’ll start seeing the difference.

    Addiction recovery treatment can give those struggling with substance abuse the tools and skills they need to create and stick to a relapse prevention program. If you or someone you care about is currently battling a substance use disorder, call Maryland House Detox today at 1-888-263-0631 or contact us online to speak with one of our addiction specialists about getting on the path to sobriety. 

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