Recovering from a drug or alcohol addiction doesn’t end just because you stopped using. It’s actually a longer process, involving three stages—abstinence, repair and growth—with the last stage, growth, taking 3-5 years from the start of abstinence to reach.1 Working through these stages takes hard work and relapse is not uncommon. The National Institute on Drug Abuse estimates that 40%-60% of patients relapse.2 For some, recovery is the most difficult thing they’ve ever done and for far too many, it’s something they keep striving for or have given up on. It’s essential to know what can be done to help prevent relapses and enable people to move forward with their recoveries.
Relapsing is not just the physical act of using again. Like recovery, relapsing occurs in stages—emotional, mental and physical. Understanding these stages and recognizing the signs and triggers that accompany them gives you the foresight and opportunity to take preventive actions before the last stage occurs.
The stages of relapse are:3
- Emotional relapse. This is the set-the-table stage. Your thoughts, emotions and behaviors are laying the groundwork for a relapse. You’re not thinking about using at this point, but you may be isolating yourself and keeping your emotions bottled up. Increased levels of anger and/or anxiety may arise, and you’re not eating or sleeping well.
- Mental relapse. This stage is where the internal arguments come in—you want to stay clean but you also feel a desire to use. You’re thinking more and more about the good times. The friends, the places and things associated with your use. You exaggerate the positive and minimize the negative aspects of use, remembering only the good, not the bad. You begin bargaining with yourself and forming plans to use again.
- Physical relapse. As its name implies, this phase is when you resume the use of the substance you were abstaining from. Beginning with one physical relapse, this stage will lead back to regular use.
There are many circumstances that can trigger these stages. Some of the more common “triggers” include:4
- Relationship issues
- People who enable you or you used to use with
- Things that remind you of using (e.g. shot glasses, martini mixer, pipes, etc.)
- Places where you used
- Financial issues
Recognizing these triggers will help you develop relapse prevention strategies to avoid or address them in the future.
There are a variety of relapse prevention strategies that can be incorporated into your life. One or more may be helpful to you. The important thing is to create a relapse prevention plan that works best for you.
Some relapse prevention strategies that you can adopt are:5
Physical exercise, a healthy diet, and adequate sleep are an integral part of preventing relapse. Creating a routine for self-care will help ensure that you do it. Some basics to focus on:
- Sleep between seven to nine hours a night.
- Eat a balanced diet with lots of fresh fruit and vegetables, lean protein, and whole grains.
- Try to exercise in some fashion every day. The goal here is not to vigorously exercise every day, although some vigorous exercise will help. Rather, move your body in some fashion on a daily basis. A simple walk around the block can do the trick. You will not only feel better physically, but you will also feel more control over your life.
- Make time to do things that you like—things that you do simply for their pleasure and not because you feel you need to or should do them.
- Treat yourself kindly. This is often ignored, largely due to feelings of guilt or shame, and yet it plays an important part of ensuring a successful recovery.
Greater self-awareness improves your ability to recognize relapse signs and cope with triggers. Meditation can help you become more self-aware, as well as understand and control your addictive thoughts and behaviors. People who practice meditation in their recovery have a better chance of not relapsing than those who don’t. Focusing on what you are thinking and doing in a non-judgmental way allows you to live more in the moment and gain significant insights about, and more control over, your behaviors, including those that may result in relapse.
Support groups, of which there are many, are a common tool for preventing relapse. By decreasing loneliness and isolation and creating a non-judgmental forum where you can talk to others that understand what you are experiencing, support groups provide a safe environment where members obtain further and deeper insights and are held accountable for their actions.
Distractions and new habits
Regardless of what you do, you will undoubtedly have thoughts, and outright cravings, about using again. When you feel this starting to occur, focus on healthy pursuits, like going for a walk, playing with your dog, reading a book, or watching a movie. You may also have established patterns of behavior that you strongly associate with using (e.g. cocktails at 5pm). Replace the behaviors you associate with using with others that you don’t. Replace cocktail hour with a workout at the gym, or playing video games while high with learning chess.
Have a list of people that you feel comfortable calling when you find yourself struggling not to relapse, especially some that are also in recovery and can readily relate to what you are going through. Keep the list in your phone.
Recall the past and imagine the future
When you feel cravings or think about using again, take time to remind yourself why you stopped using to begin with. Remember what circumstances caused you to quit. Think about the hangovers, the poor health, needing to miss work, when you made a fool of yourself, or who you may have hurt.
Also, envision what will happen if you do relapse. Not just in the short-term but also over the long haul. Will you really be (i) able to control your intake either initially or over time, (ii) present in your relationships, or might you lose relationships instead, (iii) as in control over your emotions and life, or (iv) as fulfilled? Most importantly, though, will you end up in a different place than you were in when you stopped using? If you honestly examine these questions, the answers can help reaffirm your decision to stop using.
As with most things, your attitude plays a key role in how you feel and respond to things. Keeping a positive outlook and staying away from negativity is a powerful tool in preventing relapse. Also, acceptance—accepting who you are and that you are doing the best you can—helps keep you centered and focused on staying sober.
Often underestimated in its effect, deep breathing can significantly help you control your emotions and reactions. Able to be used anywhere, the increased oxygen flow from deep breathing, helps alleviate the anxiety and inner turmoil that can arise when triggered by something that can potentially lead to relapse. It also helps you relax, think more clearly, and can reduce toxins in the body.5
Similar to being kind to yourself, make sure to give yourself credit for and appreciate the small and large milestones you pass. Reward yourself in some small way to help keep you motivated.
There are also relapse prevention strategies involving professional treatment. In addition to participating in support groups, individual therapy is another option for preventing relapse. While there are a variety of therapies available, cognitive-behavioral therapy is one of the most widely used, helping people to develop the skills needed to overcome the challenges that can cause relapse.6 Also, there are a number of medications that can help, including disulfiram, naltrexone vivitrol, bupropion, methadone, and buprenorphine.7 Of course, you should first consult your physician to determine if medication is an option and what medications might be right for you.
If you or someone you know struggles with an addiction, we can help. We offer a full range of addiction recovery treatment options, including therapy and tele-mental health services. Contact us today. For more immediate assistance, call our 24-hour Crisis Hotline: (518) 483-3261 or (518) 891-5535.