“Your worst days in recovery are better than your best days in relapse.”
Relapse is returning to a behavior that was previously stopped. For drug and alcohol addiction, this means drinking or doing drugs again. But it can also apply to any kind of addiction, including gambling, sex, or food addiction.
Although it may seem immediate, relapse occurs in identifiable stages. The process of relapse prevention helps you identify these stages and develop coping skills to implement to stop its progression, so you don’t get to the point of experiencing a full relapse.
What it means to relapse
Relapse occurs when a person in drug or alcohol recovery falls victim to the temptation of drug or alcohol usage after an extended period of resistance. While this can be devastating for the victim and their loved ones, it is important to keep in mind this is does not symbolize failure. Drug and alcohol addiction is a chronic brain disease that can live in a person for the remainder of his/her life, and like any other disease, addiction is no different in that a full recovery may require multiple treatments coupled with a continued effort to keep fighting.
Drug and alcohol abuse changes the brain. So in the event a recovering person relapses with substance abuse, rather than viewing this as an indication this person no longer cares to reach sobriety, understand that the symptoms of addiction oscillate, like any other medical condition (e.g. recurring heart attacks within heart disease patients).
Stages of relapse
Among any other complexity, relapse is similar in that there are multiple layers you must comprehend before completely understanding relapse. In the Yale Journal of Biology and Medicine, Steven Melemis defines relapse to be a gradual process, rather than a sudden event, and further breaks down the phenomenon into three stages of relapse:
Emotional relapse doesn’t mean that you’re thinking about using again. Rather, this form suggests the recovering person’s emotions and behaviors are regressing into a similar state they once were during a time of drug and alcohol abuse or a previous relapse.
Warning signs indicating emotional relapse:
- Blaming others
- Withdrawal from support groups
- Focusing on others’ problems
- Bottling emotions
- Poor sleep and eating patterns
Mental relapse is a war of internal conflict. You want to use again, but then you don’t. Initially you remain idle in your thoughts of using. By a later phase, those mere thoughts evolve into serious consideration and diminish any and all cognitive resistance that was once built.
Warning signs indicating mental relapse:
- Drug or alcohol cravings
- Reminiscing about people, places, and things you used with
- Thinking of ways of how to better control using
- Hanging out with friends that were involved in using with you
- Looking for opportunities allowing you to relapse
- Planning a relapse
Simply put, physical relapse is when a recovering person begins using again. Though not every person may immediately fall into a state of uncontrolled usage again. This is where certain distinctions are made within physical relapse known as a “lapse” and “relapse.”
During a lapse, a recovering person ingests a moderate dose of the formerly abused substance, for example, having only one or two drinks of alcohol. While this may be a modest amount, this can quickly accelerate into an unruly usage pattern, as well as cause the individual to mentally relapse again.
Relapse is defined as a return to unmanageable usage again. With most relapses, these happen due to a window of opportunity. The recovering person is given a chance to enter back into previous behaviors with the feeling that they won’t get caught. With that, developing exit strategies for these individuals is imperative when participating in relapse prevention therapy.
Video: Stages of relapse
10 activities to help prevent relapse
A common recovery strategy is to replace your current addiction with positive activities. There are a number of substitutions to choose from, each helping to fill what might feel like a gap in your life.
- Useful Tasks – Cooking, doing the dishes, sweeping the floor, ironing your clothes, and cleaning your room are activities that lead to a sense of empowerment and contribute to an environment of well-being that supports sobriety.
- Exercise – Running, lifting weights, walking, and yoga are all hobbies that release endorphins within your body and allow you to feel healthier and alive, naturally.
- Games – Board games, card games, and video games can all serve as healthy distractions for a person in recovery and a safe activity away from harmful substances.
- Art – Music, painting, writing, sculpting, etc. are some more artistic approaches you can challenge your brain to think in new creative ways. These types of activities are often great coping methods as they serve as outlets for self expression.
- Crafts – Do-it-yourself projects, tie-dyeing shirts, sewing, creating jewelry, etc. also serve as self-expressive hobbies that allow people to find joy and accomplishment through a creative challenge.
- Entertainment – Watching a movie or going out to a show are great healthy distractions for people to focus their attention away from any negativity that may be experiencing.
- Social Activities – It’s important to be social. Though it’s more significant you’re socializing with the right people. Socializing with supporting friends and family is key while in recovery.
- Reading – Reading is a great exercise to expand your mind and to keep your brain preoccupied and away from harmful tempting thoughts.
- Sports – Becoming involved in a sport allows a person to commit themselves in a positive manner while gaining both the benefits of exercise and healthy socializing.
- Volunteering – Helping others will only reinforce your passion to help yourself. There is never a wrong time for encouragement, whether that pertains to you or a peer.
Coping strategies and techniques
When it comes to relapse, the biggest battle is the mental thought that you will now be able to control your substance usage. Or the thought that if you do use no one will know, so there is no harm done. These are not true.
Addiction is devious. Remember the negative consequences addiction brought you before your recovery began and how paralyzing the effects felt. There is no benefit to gain with your former substance abuse. Though you may know this addiction can be deceitful in making you feel otherwise.
Below are strategies to consider if you feel any mental urges crawling back to surface:
Voice your struggles. Thoughts often begin to boil when you’re by yourself. If you’re struggling with thoughts of using again, voice it. Talk to your friends and family immediately and allow them to remind you of the progress you’ve made and clarify how your thoughts might be getting the best of you. Though we understand friends and family might not always be available at the drop of a dime. In that case, there are plenty of national and local hotlines available with representatives ready to help.
Remain patient. Most of the time your urges will be more spontaneous than not. Understand these tempting moments are only temporary. Remaining calm and patient in these moments is imperative when fighting these sudden urges.
Stay pre-occupied. Allowing your thoughts to wonder can be dangerous while in recovery. Staying pre-occupied within healthy active activities can help prevent thoughts leading towards a mental relapse.
Remember, one step at a time. Thinking about the big picturing of remaining sober for the rest of your life can be crippling. Take your recovery one day at time. Focus on the battle right that lies in front of you. Not the war.
Find your peace, often. Remaining fraught for an extended period of time can lead to poor decisions. So find activities and areas that allow you to relax and enjoy yourself away from drugs and alcohol. These will be the things you will be able to find liberation.
Have a plan
Creating a relapse prevention plan is an essential step to have in place before you begin your walk in recovery, once completed detox.
Many times those who are not actively planning their recovery are preparing for a relapse. Organizing a well thought out plan not only creates structure but allows you to better understand yourself and your addiction. These plans can be as simple or detailed as needed, as long as they prove to be beneficial. Though typically the more effort you place into your plan, the more effective it will be.
In the content below are two notable models commonly used in the recovering community to help those who are striving for a life of sobriety.
Relapse Prevention Plan Models
Gorski Relapse Prevention Model
Terry Gorski is an internationally recognized expert within the field of substance abuse, mental health, violence and crime, etc. Within his model he states the following nine steps to be imperative in developing a relapse prevention plan:
- Stabilization:This first step within this model is to recenter yourself away from drugs and previous negative tendencies. Taking those first initial steps into sobriety by completing detox is your starting line.
- Assessment: Within assessment, any negative patterns or problems that contributed to past relapses are identified and resolved. This is inclusive of the following factors: life history, alcohol and drug use history, as well as recovery and relapse history.
- Relapse Education: This is where it’s time to get informed. Understanding the process of relapse is key while in recovery. This not only goes for the person in recovery, but their family and Twelve Step sponsors as well.
- Warning Signs Identification: Knowing what can bring you into trouble can equally help you stay of it. Writing out a list and analyzing each warning sign helps those in recovery continue in their walk of sobriety.
- Warning Sign Management: While knowing and understanding your warning signs is great, it means nothing if you don’t have a coping strategy in place to fight these temptations. Creating and committing through with exit strategies is crucial while in recovery.
- Recovery Planning: Recovery isn’t meant to be done alone. In recovery planning, the recovering person is placed into contact with people who will help them resist previous tendencies.
- Inventory Training: Inventory training prepares you with morning and nightly routines to anticipate, evaluate, and avoid high-risk situations.
- Family Involvement: Getting family involved can be the make or break in many situations. Bringing your loved ones into affiliation with groups like Alanon will help prepare them with everything they need to know in how to care for their family in recovery.
- Follow up: Recovery is never static. Here, it is crucial to follow up monthly for the first three months, then quarterly for the following two years, to then annually.
For further details for each of these steps visit Terence Gorski’s addiction website.
Marlatt’s Model of Relapse Prevention
Dr. Gordon Alan Marlatt, a University of Washington Psychology professor who received continuous funding for addiction research from organization like, the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, founded this relapse model centered around high-risk situations.
The Marlatt Model illustrates how both tonic (stable) and phasic (short-lived) influences interact with each other in order to evaluate the likeliness of a relapse. The difference between these two variables being: tonic processes represent how susceptible you are to relapse while phasic responses serve as factors that either cause or prevent a lapse.
For additional information on the Marlatt model see this resource.
Relapse prevention plan template
When creating a relapse prevention plan here are some things you may wish to include:
- Identify certain people and places that might spark an urge to use again
- Detail how you can steer clear from high-risk situations
- Creat exit strategies for unavoidable scenarios
How to manage cravings
- Develop methods to understand whether your craving pertains to an emotional, mental, or physical relapse
- Generate coping strategies for each type of craving
- Family and friend support
- National and Local Hotlines
- Proper dieting
- Stress/Anxiety Management
Support groups and rehab programs
- 12 Step Program
- Outpatient treatment
- Aftercare services
- Alcoholics Anonymous
- Personal Relationships
- Legal history
Video: The science of relapse
Doctors explore why we have cravings and how they contribute to drug relapse.
Relapse prevention workbooks and worksheets
Here are ten relapse prevention workbooks to help you maintain sobriety. Many contain worksheets that you may fill out to help you perform self-assessment and evaluation.
- The Mission Consumer Workbook
- Relapse Prevention Workbook by Bradley A. Hedges, Ph.D., LPCC Psychologist
- Course Handook – Mindfulness Relapse Prevention Program
- Relapse Prevention Plan Worksheets
- My Relapse Prevention Workbook by Montgomery County Emergency Service, Inc.
- Reducing Relapses IMR Workbook
- Cognitive Behavioral Relapse Strategies United Nations Office on Drugs and Crime
- Relapse Prevention Workshop from Relapse Prevention Therapy And Relapse Prevention Counseling Workbooks.
- Outpatient Treatment Client Handbook U.S. Department of Health and Human Services, Center for Substance Abuse Treatment
- Relapse Prevention Tool Worksheets by Peggy Ferguson, Ph.D.
Finding a group to prevent relapse