The risk for relapse is so high that it is often considered an intrinsic part of the addiction recovery process. But, after a full-blown relapse, going back to treatment a second (or third or fourth) time can be even more difficult than the first time around. Some may never give themselves a second chance at sobriety, which is why relapse prevention is a critical aspect of recovery from drug addiction.
But relapse is a scary thought. How can you go from fearing relapse to actively preventing it? First, you must take time to understand what a relapse is, the warning signs that you are headed for relapse, and actions you can take in your daily life to stay healthy and addiction free.
What is a Relapse?
As a chronic disease, addiction is prone to relapse. Addiction relapse is the return to actively using your substance (or process) of choice after a period of abstinence and improved health. Relapse occurs when old patterns of thinking, behaviour, and ultimately drug use completely take over.
A relapse occurs in stages — it is not simply the event of taking that first drink or drug after time in recovery. Changes in thinking, emotions, and behaviour occur days, weeks, or even months before a physical relapse. That is where relapse prevention comes in. Recognizing and taking action against early symptoms of relapse will help you minimise their impact on your recovery and prevent a full-blown relapse from happening.
Relapse Warning Signs
Before active drug seeking behaviour occurs there are emotional and mental warning signs that you should train yourself to recognise. If you’re not aware of the early warning signs and symptoms they can quickly become a slippery slope back to addictive behaviour.
Emotional warning signs:
- Feeling unhappy or depressed
- Feeling anxious or restless
- Feeling resentful or angry
- Poor eating and sleeping habits
- Isolating self from groups and activities
- Not asking for help
- Difficulty concentrating
- Neglecting healthy habits
Mental warning signs:
- Thinking about people, places, and things associated with past addiction
- Missing old “friends”
- Reminiscing about past use
- Fantasizing about using
- Returning to old hangouts
Catching yourself early on and utilising your relapse prevention plan as soon as you experience warning signs is imperative for your continued recovery.
Creating a Relapse Prevention Plan
Change requires time and practise. Creating a sober lifestyle for yourself will not just happen on its own; it takes planning and action. A relapse prevention plan is your personal guide to how you will recognise symptoms of relapse when they occur and actively prevent relapse from happening.
It is normal to experience cravings, as well periods of confusion, sadness, and loneliness in recovery. A major part of recovery is learning how to cope with life without using drugs, alcohol, or addictive behaviours. If you do not have a plan in place to deal with stress, emotions, and triggering situations it will be all too easy to revert to old coping mechanisms.
With a relapse prevention plan you are planning for success. Each individual’s relapse prevention plan will be tailored to his or her specific needs, but can generally include three major categories: recognising warning signs and managing triggers, adopting healthy lifestyle habits, and seeking support.
Step One: Avoiding triggers and recognising warning signs.
Triggers are the thoughts, feelings, and situations that bring back an urge to use, or remind you of your addiction.
First make a comprehensive list of the people, places, sights, sounds, smells, or behaviours that may be triggers for you. These could include driving past an old neighbourhood, hearing a song you used to listen to while drunk or high, running into an old using friend, or even staying up too late.
Sometimes triggers are not so obvious — like getting a promotion at work, which could trigger an urge to celebrate with alcohol, drug use, or gambling. Triggers do not have to be external events — feeling stressed, exhausted, sad, or lonely can also trigger a desire to use.
In all cases, once you have a list of possible triggers for you make a plan for what you will do when you encounter them. You can actively avoid some triggers like driving past your old hangouts, while others – such as seeing an ad on television – are unavoidable. If you are having trouble coming up with a list on your own, ask your sponsor or someone close to you to help. Once you’ve got your list, you must learn how to deal with these triggers.
Things you can do to avoid or manage triggers:
- Change your route to avoid passing locations that could trigger you
- Keep a list of phone numbers of people you can call if feeling triggered
- Keep a written reminder of why recovery is important to you in your wallet
- Avoid high risk situations such as becoming tired, hungry, and lonely
- Practise relaxation techniques
- Practise healthy distraction: take a walk, read a book, call a friend
- Practise self-care by keeping healthy eating and sleeping habits a priority
- List at least three people you can talk to if you slip into old patterns of thinking, start feeling anxious and depressed, or are struggling to keep up with your recovery plan
While external triggers are important to plan for, internal warning signs — that is the changes in thoughts feelings and behaviour listed above — are equally important to take note of and plan what you will do when they occur.
For each trigger and warning sign list how you will know you are feeling triggered and what you will do right away to avoid succumbing to relapse. Make a detailed written plan — having vague ideas about what you will do is often not enough.
Step Two: Create healthy habits.
You can use your diet and lifestyle to keep your life in balance and prevent yourself from slipping into the early stages of relapse. Filling your schedule with healthy activities will keep you from becoming bored which can trigger drug seeking behaviour.
Stress prevention is one of the main goals of keeping healthy diet and lifestyle habits. Your relapse prevention plan should include what lifestyle changes you need to stick to in order to be successful in recovery. Some ideas include:
- Eat 3 meals a day. Plan meals and snacks in advance to avoid becoming too hungry.
- Avoid consuming too much sugar and caffeine
- Drink lots of water
- Make getting enough sleep a priority. If you struggle with sleep talk to your doctor.
- Incorporate exercise into your day
- Practise mindfulness meditation
- Keep a journal: this will help you track your thoughts and mood and notice changes
- Practise gratitude
- Start a new hobby
In order for your plan to be effective you have to follow it. Keeping a written reminder of why recovery is your number one priority can help motivate you to stick to your healthy lifestyle choices.
Step Three: Having a support system.
You cannot beat your disease alone. Having a solid support network is crucial for relapse prevention. When you neglect having a sober support network you can be sure that your recovery is in danger. For many, the support of AA or another recovery – based group provides a lifeline when life gets difficult and recovery seems impossible. You may need to attend several groups to find one that resonates with you.
Your relapse prevention plan should also include a list of people you can call when you feel triggered or start to slip into old patterns, and people who support and participate in healthy activities with you.
Ways to build a good support network:
- Join a recovery group and attend often
- Get a sponsor
- See an addiction or mental health counsellor
- Get an exercise partner
- Share your recovery with close friends and family and enlist their support
Be specific with people you know about how they can support you. Tell them when you start to feel down or ask them to call you out on behaviours you know are not healthy for you — such as not getting enough sleep or neglecting meetings.
In order to stay sober, actively preventing relapse is imperative. Talk to an addiction counsellor, family, or friends about your plan so they can help you in preventing relapse.
If you do find yourself struggling with symptoms of relapse, or moving into a full-blown relapse — you are not a failure, but you may need to visit an addiction treatment centre to get the support and help you need to get back on track with your recovery.