“Your worst days in recovery are better than your best days in relapse.”
As those in recovery know, a relapse is never out of the realm of possibility–no matter how long you’ve been sober. As such, it is vital to have a plan for how to avoid relapse and what to do if it does happen to you. Such a plan is often referred to as a relapse prevention plan (RPP).
What is a relapse prevention plan?
A relapse prevention plan is a vital tool for anyone in recovery.
Having a plan helps you to recognize your own personal behaviors that may point to a relapse in the future. It also outlines ways to combat those behaviors and get back on track.
Relapse usually isn’t a spur-of-the-moment event. Typically it is a three-part process, including an emotional relapse, a mental relapse, and a physical relapse. With a relapse prevention plan, it is possible to acknowledge and act upon certain feelings and events, in turn avoiding a physical relapse (which is the stage when an addict uses or drinks).
What to consider when creating an RPP
While you can create an RPP on your own, it may be helpful to walk through the process with someone who has knowledge of the topic, like a substance abuse counselor. Relapse plans can be verbalized, but may also be written in order to have a more clear outline of what steps to take should a relapse seem to be a possibility. Regardless, it is important to assess certain factors before creating a concrete plan.
The following are factors to consider to take when it comes time to create an RPP:
Once you are sober and feel stable, assess your history with drugs and alcohol.
Terence Gorski, internationally recognized expert on substance abuse, mental health, violence, and crime and the author of Phases and Warning Signs of relapse, states,
“Relapse prevention planning probably won’t work unless the relapser is sober and in control of themselves. Detoxification and a few good days of sobriety are needed in order to make relapse prevention planning work.”
It is important to be in a stable mental state when creating a relapse prevention plan. After you feel you are in a good place, begin by trying to determine the factors surrounding your use.
Was there a certain time you were more prone to use? Did specific people factor into the times you used? If you’ve relapsed before, ask yourself why. Determining what caused a prior relapse is vital in avoiding future ones.
Determine any signs that could lead to relapse and have an action plan for each one.
If you’ve relapsed before, you will probably have some idea of what lead to that relapse and how it could have been avoided. If not, this part may be a little bit more difficult for you.
Regardless, try to brainstorm a list of scenarios that could lead to potential relapse and have a plan for what you will do instead of drink or use. For example, if going through a breakup could lead to a relapse for you, think of other outlets for your pain and frustration. Instead of drinking or using, you could plan to attend a support meeting or call a family member or close friend right away. The more specific your action plan is, the better, as this means you will be less likely to come within close reach of a relapse.
Have a step-by-step plan of what will happen if you do relapse or come close.
Know who you will call first, what you will ask of them, and if you will attend a meeting or return to rehab. The more detailed this plan is, the more likely you will be to get yourself back on track quickly. Talk to the people included in your plan and make sure they have the necessary knowledge should you need their assistance.
What to include in your RPP
Though relapse prevention plans are unique to each individual, there are specific components that are helpful to include in a final RPP. The following is a potential outline for such a plan:
First, list the people, places, and things that have the potential to lead to a relapse. Triggers are anything that could lead to using or drinking again. No matter how long and hard you think, it may not be possible to list every potential trigger. Sometimes, you won’t know a trigger until it is already in front of you, in which case it is important to have a plan to confront such triggers. Choosehelp.com states that the following questions could be helpful when listing triggers in an RPP:
- Who could I see that would remind me of drug use?
- What places did I use drugs that could trigger me?
- What addictive thoughts could make me relapse?
- What can I do if I cannot avoid things that trigger me?
The phrase “cravings” is used to refer to the feeling an addict has when they wish to use again. Cravings can sometimes lead to a relapse. However, if you have a solid plan to confront such cravings, a relapse won’t be on the radar. When it comes to cravings, compile a list of who you can call if you have a craving, what you can do to distract yourself from a craving and how you could stop a craving altogether.
3. Healthy tools
Compile a list of tools that have been helpful in your recovery. Think about what you could do instead of use, and how such activities would point you back on the right track. Some examples of such tools include writing a list of consequences should you relapse, attending a support meeting, exercising, journaling, or writing a gratitude list.
4. Recovery program tools
This may only apply to those who partake in 12-step programs. When facing a relapse, it can be helpful to revisit the 12 steps and assess where in the steps you find yourself. This is also where a sponsor comes into play. If you have a sponsor, they should be one of the first people you turn to if you feel like a relapse is a possibility. Since they’ve likely been in your shoes, they may have some insight and suggestions.
5. Damage control
RPPs can include ways in which you hope to amend the damages addiction has brought upon your life. Separating these damages into areas like relationships, legal issues, financial issues, or education can help you regain insight as to why you decided to get sober in the first place, and may make you decide not to put positive life changes in jeopardy by using again.
As time passes, it may be important to revisit your relapse prevention plan. The components you acknowledged in your RPP at the beginning of your recovery have the potential to change and develop over time, as do the people in your support system, so your RPP may need to be revised. This can be done on your own or by sitting down with a professional such as a substance abuse counselor. Each individual’s needs will vary, so it is important to assess where you are in your recovery and what you feel your needs are at that point in time.
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.