Even after people have completed their rehabilitation treatment and returned to regular daily life, addiction is still something that will, like any other chronic disease, require lifelong management and monitoring. Failure to take this aspect of recovery seriously can result in a relapse that could potentially become a return to drug or alcohol dependency.
On the other hand, it is important to keep in mind that sometimes relapse does happen. More than sometimes, really, with statistics showing that about 40 to 60 percent of people in recovery from substance abuse disorders will relapse at some point.
A relapse can even occur sometimes as long as months or years into recovery, which can be particularly dangerous, as someone who has maintained lengthy sobriety will have lost their tolerance for the substance they previously had been abusing. This means that if they relapse and take the same amount they were accustomed to before, they could easily overdose, potentially fatally.
However, you can significantly decrease the risks of relapsing if you make creating an effective, realistic relapse prevention plan an essential part of your recovery.
Relapse prevention is a cognitive-behavioral approach to being able to both identify and prevent situations that make someone vulnerable to relapse. A relapse prevention plan aims to address the problem with techniques and tools to help deal with both the internal and external stressors that can put someone in a high-risk relapse situation. Gaining an understanding of how relapse works and the psychology behind it is critical in being able to prevent it.
Recent relapse prevention studies have concluded that a relapse is not a single event of lapsing back into drug use. Instead, it is a process that can be broken down into three major stages:
This the first stage of relapse, and it can occur before someone is even thinking about using again. It is characterized by strong feelings of depression, irritability, and anxiety as well as erratic sleeping and eating habits. These signs are also several of the same symptoms of post-acute-withdrawal syndrome. If these signs can be recognized and dealt with before the next phase, a potential relapse can be stopped dead in its tracks.
This stage is best described as an internal sort of tug-of-war struggle between the urge to go back to using and the desire to remain sober. A person at this point in the relapse process is especially vulnerable, because once they make the decision they’re going to use again, very little can be done to stop it.
The physical relapse stage is the part of the process that people typically think of when they hear the word “relapse.” If a mental relapse cannot be stopped, this final stage will quickly follow, and the individual will break their sobriety. All it takes is one use for intense cravings to make a speedy comeback, increasing the odds that they will transition back to consistent substance abuse. The best thing that can be done once a physical relapse has occurred is to get the person back into treatment immediately.
Each of these stages has its own warning signs that can alert either the person experiencing them or a friend or family member that something is wrong.
The idea of having to maintain constant vigilance when it comes to avoiding relapse can feel overwhelming, but it doesn’t have to be that way. A relapse prevention plan doesn’t have to be something huge and complicated, in fact, it can be broken down into just five simple rules that help you focus on what’s most important to your continued recovery.
It is important to note that these are not a “quick fix” guide, but a way to think about relapse prevention that makes the endeavor less intimidating and more achievable, giving you the motivation to stick to your plan.
RULE ONE: CHANGE YOUR LIFE
Admittedly, this can sound like a whole lot all at once, but all it means is looking at the aspects of your life that contributed to your addictive behaviors and working to alter or remove them to create a new life where it is easier to stay sober. This is not an “all or nothing” rule. Try to set an attainable goal of changing one small aspect of your life for the better at a time, even if it’s just getting up earlier, exercising more, or putting more time into self-care.
RULE TWO: BE HONEST
Lying is a huge component of addiction because people suffering from substance dependence are constantly in situations that require lying not just to your family, friends, or job, but also to yourself and how much harm your addiction is causing. Making an effort toward complete honesty can also feel like a big task, but you just need to approach it the same way as to change: keep it small and stay consistent. Be honest about needing help with something or from someone. Be honest about a way you might be feeling. Make it a habit, and it will eventually come easier to you.
RULE THREE: IF YOU NEED HELP, ASK FOR IT
As previously mentioned, a big part of learning, to be honest, is being open about needing help. People often want to prove they can get through recovery on their own, that they’re in control. But without a solid support system, you’re setting yourself up to fail and relapse. Something as simple as joining a self-help or support group where you can safely express feelings and ask for help from people who have experienced the same things as you make long-term recovery much more likely.
RULE FOUR: EXERCISE SELF-CARE
It should be apparent now that these rules blend and overlap with each other, which makes it easier to stick to them, as following one will naturally help you follow others. Self-care is essential to avoid creating negative internal emotions that can drive you back to using. It also works to create a new rewards system to replace drugs or alcohol. It can be as simple as a relaxing bath, a special dessert, or a bit of shopping to acknowledge and celebrate your work toward recovery.
RULE FIVE: STICK TO THE RULES
This might seem redundant, but the rules of your relapse prevention plan aren’t going to work if you try to bend them. The first stage of relapse involves letting these good habits lapse. It doesn’t matter how much time has passed since you’ve been sober. If you want to prevent relapse, you have to actively work at it.
(January, 2018).Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment
(July, 2018).Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
(September, 2018).Post-acute-withdrawal syndrome. Wikipedia. from https://en.wikipedia.org/wiki/Post-acute-withdrawal_syndrome
Melemis, S, (September, 2015).Relapse Prevention and the Five Rules of Recovery. US National Library of Medicine. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/