Relapse Prevention: Don’t get caught off guard

December 19, 2011

Relapse Prevention – Be Ready

After alcohol and drug rehab, an addict is faced with many triggers that increase the risk of relapse of substances. Many of the relapse triggers are outside of the addict’s control. Thoughts and behaviors contribute in making relapse a two part process. To decrease the risk of relapse, the addict should learn about the process of relapse and formulate a relapse prevention plan prior to completing addiction treatment.

The Two Parts of Relapse

Addicts will have thoughts of using days, weeks and/or months prior to physically relapsing on substances.

Relapse is defined as going back to a previous state, returning to a prior condition and becoming ill after prior recovery. The disease of addiction is dormant while an addict is in recovery. The addiction becomes active when the addict uses alcohol and drugs.

Addicts will have thoughts of using days, weeks and/or months prior to physically relapsing on substances. Even prior to having thought of using, a change in behaviours or negative thoughts will begin to appear. Treatment for addiction addresses relapse as having two components, mental and physical. A mental relapse will always be a precursor to a physical relapse in the recovering addict.

Mental Relapse

The brain has an uncanny way of leading the addict back to using thoughts, regardless of the time he or she has in recovery. The brain produces uncontrollable, automatic positive or negative thoughts based on experiences. These thoughts generate reward and punishment feelings which are two main reasons that the addictive thinking pattern continues. Different events trigger automatic thoughts and feelings. Examples of events, thoughts and feelings are:

Loss of a job. “My life sucks. I am not good enough. I’m so angry. I wish I could just take a break.”
Fighting with a loved one. “I can’t do anything right. She hates me. I’m so frustrated. I just need to get my mind off of this.”
Death, grief and loss. “What’s the point of living? Someone else is just going to die. I am so sad. I need something to help me get some rest.”
A job promotion. “I did such a great job; I deserve to blow off some steam. I’m so excited. How can I reward myself?”
A new relationship. “If I go to the bar with her I’ll be fine. My drinking problem wasn’t really that bad. I’m so happy.”
Familiar songs, smells, situations. “Wow, I remember hearing this song the first time I snorted cocaine. What an intense euphoric feeling. That was a good time.”
Boredom. "Need to replaced unhealthy behaviours with healthy activities, otherwise there is a void."

At first, these thoughts may seem harmless but they leave an opportunity for addicts to insert alcohol and drug use as a response for reward or punishment. For example, “I’m so angry. I’m not good enough. It doesn’t matter if I am sober or not. I’ll just have one drink.” Sometimes, even he thought of using, without actually using the substance can make the addict / alcoholic feel "high".

A relapse prevention plan when the addict is in treatment for addiction will encourage him or her to find healthier ways to cope with their feelings. A physical relapse will occur when the recovering addict focuses on automatic thoughts without applying relapse prevention techniques.

Physical Relapse

It is essential for an addict to learn relapse prevention techniques prior to discharge from a drug rehab.

A physical relapse takes place in response to the mental relapse and the addict uses drugs and/or alcohol. The re-introduction of substances creates an intense euphoric effect, especially after a time period of abstinence. Most addicts do not realize that their bodies are unable to break down the same amount of substance they were using prior to a drug detox. The addict that ingests the same amount of substances prior to detox and addiction treatment is at risk for overdose and some times death.

The mental and physical relapse thoughts and behaviors continue to exacerbate one another deteriorating the addict’s physical and mental health.

Mental and Physical Relapse Collide

The addict focuses on the physical euphoria that substance abuse produces. The uncontrollable automatic thoughts convince the addict to continue using despite negative consequences. Fantasizing, obsessing, losing control over substance abuse and the guilt of relapse are all part of the cycle of addiction. The cycle of addiction is extremely chaotic and difficult for the addict to end alone. At this point the addict may need an intervention of alcohol detox and drug detox with addiction treatment.

It is important for the addict to be aware and prepare for relapse triggers prior to discharge from an alcohol and drug rehab. Having a relapse prevention plan will give the addict techniques to combat the mental relapse.

Sober Living begins with a Relapse Prevention Plan

In a quality addiction treatment program the addict will be required to formulate a relapse prevention plan before discharge. This plan should include triggers for relapse, supports, and new coping skills for healthy living. Questions that should be answered in detail should include:

What are five things I like about myself clean and sober?
Who are the people that might lead me to use again?
What are the places that might lead me to use again?
What are the situations that might lead me to use again?
What will I do if I get the urge or craving to use again?
What am I going to do during my normal using hours?
How will I handle strong feelings?
How will I deal with mistrust from those I care about?
How will I build support from other recovering people?

The disease of addiction produces thoughts and behaviors which are manipulative to encourage the recovering addict to relapse. A relapse prevention plan is helpful to remind the addict daily of his or her recovery program and assist with keeping the disease in remission.