What is Relapse Prevention: A Drug-Free Future After Rehab
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It is not uncommon for individuals who are struggling with an addiction of some kind to have one or more relapses during the recovery process. What is a relapse? It is a progressive process where a recovering addict becomes so abnormal or dysfunctional that self-medication with drugs or alcohol seems like the best alternative.
For people in recovery, going back to alcohol or drug use is the worst thing they can do. The damage caused by a return to substance abuse after a period of abstinence is usually more than the initial damage caused by drug abuse or excessive alcohol use. Most people with an addiction are able to garner the strength to beat their dependence, but some rapidly fall back to unhealthy habits.
Relapse to alcohol or drug abuse does not mean treatment has failed. Addiction is a chronic condition. A return to substance abuse at some point during recovery is not only possible but in fact quite likely. If an individual goes back to using after rehab, it simply means treatment needs to be reinstated or adjusted or a new therapy needs to be tried. Read on to find out how to prevent a drug relapse by recognizing the triggers and symptoms.
Table of Contents
- What is Alcohol or Drug Relapse?
- Stages of Relapse
- Warning Signs of Relapse
- Relapse Triggers
- Slip vs Relapse: Understanding the Difference
- What is Relapse Prevention?
Relapse Definition: Understanding Return to Substance Abuse
Drug and alcohol dependence is a chronic disease that cannot be cured but can be managed. The key feature of any chronic condition is the potential for it to return. Therefore, a return to alcohol or drug use is similar to the recurrence of a chronic health issue. During the addiction recovery process, a return to substance abuse is typically provoked by exposure to risk factors that trigger unhealthy behaviors.
It is not uncommon for a recovering addict to go back to drinking alcohol or using drugs. Relapse rates for drug addiction are 40 to 60 percent, comparable to other chronic illnesses such as diabetes, hypertension, and asthma. In fact, many experts believe this is a part of recovery. Although relapses cannot always be avoided, they can be prevented by taking certain precautions.
Relapses are not random events, but rather they are a process. Recovery and relapse are interlinked. Exposure to certain risk factors increases the chances of re-using alcohol or drugs. Some people are more likely to return to substance abuse after stopping it for some time. These people find it difficult to avoid previous habits. If this becomes a recurrent pattern, it can linger for a lifetime in some addicts.
The good news is a return to use is not the end of the story. It is possible to build a better life after one or more relapses. An individual who has begun using again can re-establish the recovery process and succeed in staying clean of the substance they previously abused.
It is important for recovering addicts to understand that alcohol and drug relapses are not completely avoidable. However, taking certain necessary steps of drug relapse prevention can reduce the risk of further troubles with substance abuse.
Stages of Addiction Relapse
A relapse is a setback on the road to recovery. It does not occur suddenly or automatically. It is a not a single event. Rather, it is a gradual process that occurs over a period of time. There are a number of warning signs in the early stages. If caught in time, the return to sobriety is much easier. Addicts find it much more difficult to recover from a full-blown return to substance abuse. So, understanding the rules of recovery and identifying the early warning symptoms can help prevent recurrent substance abuse problems. The stages of relapse are as follows:
This typically begins weeks to months before the actual physical return to using drugs or alcohol. Illicit substances provide a temporary relief from life’s problems. Once sober, addicts must learn to cope with life stressors through techniques learned during rehab. However, emotions can easily sneak up during this difficult time. Anger, disappointment, rejection, and stress can set the stage for a return to using. It is important to process these feelings by talking to someone, writing down thoughts, meditating, listening to music, and focusing on the big picture. Reaching out to a counselor or relapse prevention group is also a good coping skill at this stage.
During this stage, addicts find themselves fantasizing about drug use, rationalizing use, bargaining mentally, or planning use in advance. This stage is characterized by falling back to the same destructive thought patterns that led to substance abuse in the first place. Fleeting thoughts about using again are common, but if left unchecked, they can activate the brain’s addictive centers and intensify cravings. It is common for recovering addicts at this stage to tell lies, minimize consequences, romanticize past use, skip therapy sessions, and detach from loved ones. These are risky behaviors but physical relapse is still avoidable at this stage if the individual or their family and friends recognize what is happening and take action. It helps to burn off some energy by exercising, change the environment to take the mind off cravings, and share feelings with a support group or sponsor.
At this stage, an addict has actually returned to substance abuse. This is the final step in a process that probably began weeks or months before. All is not lost, however. It is simply another challenge to overcome. If a recovering alcoholic or drug user has done it before, they can do it again. Feelings of anger, disappointment, helplessness, and shame are common at this stage. It is important for the addict to forgive themselves, but not forget. It is critical to identify the triggers that caused the return to use. Lastly, the recovering substance abuser must seek professional help once more to get back on track.
Addiction Relapse Symptoms
Addiction recovery is a long process. The duration of rehab for drugs and alcohol depends on the severity of the problem. Drug relapse statistics show that about 8 out of 10 people return to substance abuse within a year of treatment. In fact, within weeks to months of starting treatment, more than 6 out of 10 people in recovery start using again. While these relapse statistics may be discouraging, it is possible to nip the problem in the bud.
A good relapse prevention program helps individuals identify the early signs of a return to use and learn techniques to cope with them. Recognizing relapse symptoms is critical to reducing the risk of returning to drug addiction.
What are some common signs of relapse? Identifying the warning signs is a key element of a drug relapse prevention program. These signs and symptoms include:
- Engaging in destructive thoughts
- Bottling up emotions
- Spending time alone
- Poor eating and sleeping habits
- Avoiding previously enjoyed activities
- Neglecting work and family
- Relaxing self-imposed rules
- Skipping therapy sessions
- Not sharing thoughts at support group meetings
Triggers for Relapse to Drugs and Alcohol
A relapse trigger is a stimulus that initiates the desire to return to addictive behavior. These triggers prompt an individual to engage in destructive behavior or use the substance they previously abused.
Triggers are usually memories associated with prior addictive behaviors. The trigger for a recovering addict could be a person, place, thing, or emotion. It could be a person they interacted with in the past or a place they spent time when they were using drugs. An emotional situation or stress at work can prompt a return to alcoholism or illicit substance use. Addicts must develop coping skills for these common drug use triggers:
- Stressful situations (marital discord, work problems)
- People (dealers, drinking buddies, fellow users, ex-boyfriend or girlfriend)
- Places (bars, neighborhoods, childhood home)
- Smells (alcohol, drugs)
- Moods (anger, loneliness, frustration, depression, fatigue)
- Dates (anniversaries, birthdays)
Drug Relapse vs Slip: Are They the Same Thing?
Both a slip and a relapse are a setback in the recovery process for people with an addiction. However, they differ in the impact they have on the individual’s life. How is a slip different from a relapse?
A slip is a single event in which a person returns to alcohol or drug use after a period of sobriety but stops use almost immediately. A slip is characterized by a momentary return to former behavior, after which the person quickly realizes their mistake, comes to their senses, and gets back on track in the addiction recovery process.
A relapse is a gradual process and is more serious than a slip. It indicates a person has returned to former addictive behavior. It occurs over a period of time, beginning initially with a slip but then progressing over days to weeks to a full-blown return to use. Somewhere along the way, the individual completely abandons the plan to overcome addiction.
The individual can quickly return to their previous state of mind and behavior. If left untreated, the person may not have another chance to give up alcohol or drugs. So, the million-dollar question is how to prevent drug relapse from occurring?
Relapse Prevention Plans: Staying Clean After Rehab
Relapses are a part of the addiction recovery process. No one is immune to them. They are to be expected during drug and alcohol rehab. The important thing to remember is that it is possible to recover from a relapse. One simply needs an effective, comprehensive relapse prevention plan worksheet.
How to prevent a return to substance abuse? A good relapse prevention plan outline includes:
- A list of recovery behaviors and plans
- A list of high-risk situations that act as triggers
- Strategies to recognize and treat the warning signs of a return to use
An effective relapse prevention plan example is given below:
Recovery behaviors which should be practiced on a daily basis before there is any sign of trouble:
- Maintain a healthy sleeping schedule
- Eat regular meals
- Exercise regularly
- Practice self-care activities, such as grooming and hygiene
High-risk situations that can trigger slips and relapses:
- Strong emotions
- Different schedules at school/work
- Health challenges
- Marital or social issues
- Loss of a loved one
Early warning signs that should be recognized and addressed:
- Emotional detachment
- Skipping work
- Missing therapy or relapse prevention group meetings
- Neglecting health
It is a good idea to make a relapse prevention plan ahead of time. This should include strategies to cope with particular situations and get the individual back on track. An effective program has two main components:
- A strong, comprehensive support system of family, friends, and professional addiction specialists
- A willingness to guard against momentary slips into a return to alcohol or drug use
Learning about relapse and preventing it is one thing, but actually doing it is another. Yet, it is not impossible with a strong will to quit and deal with setbacks such as slips and relapses. Stay strong. Stay positive. That’s the only way to beat addiction, prevent relapse, and enjoy life to the fullest.
- Larimer M. E., Palmer R. S. & Marlatt A. Relapse Prevention: An Overview of Marlatt’s Cognitive-Behavioral Model. Alcohol Research & Health. 1999; 23(2): 151-160. https://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf.
- Hendershot C. S., Witkiewitz K., George W. H., Marlatt G. A. Relapse prevention for addictive behaviors. Substance Abuse Treatment, Prevention, and Policy. 2011; 6: 17. doi:10.1186/1747-597X-6-17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163190/.
- Substance Abuse and Mental Health Services Administrtation. Substance Abuse and Mental Illness Prevention. 2019. https://www.samhsa.gov/find-help/prevention.
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