Relapse Prevention

Addiction is defined as a chronic disease of the brain. The American Psychiatric Association explains that addiction is a compulsive need to use substances, even though it can cause harmful consequences. Addiction is also called a severe substance use disorder. Someone with this condition is intensely focused on obtaining and using a substance(s) like alcohol or drugs, to the point where it takes over their life.

It is difficult to end addiction without help. Many people will relapse and start using the substance(s) again despite their best efforts to stop. In some situations, a relapse can be deadly. It doesn’t have to be, though. 

When an individual enters addiction treatment at an accredited treatment center, they start with medical detoxification and work their way through therapy programs specifically tailored for that person. This is commonly called the continuum of care, which are criteria set by the American Society of Addiction Medicine

One part of substance use treatment is relapse prevention.  But what is it, and how can it help you or someone you care about?

What Is Relapse?

The Merriam-Webster dictionary defines relapse as “the act or an instance of backsliding, worsening, or subsiding.” In addiction treatment, it is common. The National Institute on Drug Abuse (NIDA) states that the rate of relapse is 40 to 60 percent, which is close to what other relapse rates are for other chronic diseases.  

NIDA also explains that “treatment of chronic diseases involves changing deeply rooted behaviors, and relapse doesn’t mean treatment has failed.It is essential to know that someone may relapse several times before successfully ending the addiction.

This is why relapse prevention is often a part of addiction treatment and recovery.

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What Is Relapse Prevention?

Relapse prevention is an approach to relapse that includes identifying and preventing high-risk situations in which relapse can occur. This can be locations where substance use took place, like cars or parties, or people who encouraged substance use, like a significant other who drinks or does drugs. It can also be situations that can compel someone to start using drugs or alcohol after a period of not using, such as fighting with someone or very stressful workloads. 

A person in addiction treatment or recovery needs to take control of their life. Relapse prevention teaches an individual how to identify and manage the stages of relapse without substance use. 

The Stages of Relapse

Relapse is a process that can happen quickly or slowly. The final stage is when someone returns to a drug or a drink. However, different stages occur in relapse. It is critical to know and identify these stages and how to deal with them to stave off substance use.

The Emotional Stage

The emotional stage is the first stage of relapse. This can happen when an individual experiences a negative emotional state, such as anger, depression, or anxiety. These emotions are common substance use triggers. This stage of relapse can start before any thought of relapse occurs. 

The emotional stage of relapse can be experienced before any actual thought of relapse. If managed before moving to the next stage of relapse, the individual might successfully avoid using or drinking again.

There are behavioral signs that are known during the emotional stage include:

  • Self-isolating from others or from a system of support, such as loved ones or friends
  • Holding emotions instead of dealing with them
  • Avoiding taking care of one’s physical or mental well-being
  • A noticeable change in sleeping and eating habits
  • Ignoring and not following the personal rules for recovery

The Mental Stage

This is when the actual thought of using again starts to come into someone’s mind. It is especially hard to deal with this when it occurs. An individual in addiction treatment or recovery will wrestle with their thoughts about whether to use or not use. They will try to fight the triggers because they know that using the substance again will not help and could make it harder to quit again if they relapse. 

It is vital, at this point, to stop the relapse process because once the person has decided to use again, it is very difficult to prevent the relapse. 

The mental stage of relapse includes some behaviors to note:

  • Bargaining: Making deals with oneself like, “I will only have one drink, and then that’s it.”
  • Lying: Lying to loved ones about being tempted to use the substance again.
  • Minimizing the impact of past use: Making excuses to downplay how substance use affected you and everyone else.
  • Justification: Purposely finding reasons or opportunities to use the substance again.

The Physical Stage

This is the last stage of relapse when someone will actually start using the substance again. Sobriety is abandoned, and the person is back in active addiction.

At this stage, the person in recovery is open to easily continuing substance use and developing an addiction again. If this happens, the individual should return to treatment to stop the relapse as soon as possible.

It may seem like the odds are against you or someone you care about to maintain sobriety. However, relapse does not mean that addiction treatment or recovery failed or that the person is a failure. 

It means the relapse prevention plan needs to be adjusted to better fit the individual.

Relapse Prevention: How It Can Benefit You

Relapse prevention is crucial for individuals struggling with substance abuse who are working to stay sober. It can help make the process less intimidating and motivate the person to stay on track. There are positive steps to work into a personal relapse prevention plan. These can help make the process less intimidating and provide motivation to stay on track. 

Make Positive Changes in Your Life

Life in recovery is not just about abstaining from alcohol or drugs, but about making positive changes that will help maintain the right mindset and actions to achieve sobriety for the long-term. Changes you make in your life will help you grow as a person, feel stronger mentally, and thus, make it a bit easier to avoid alcohol or drugs. 

Be Honest with Yourself and Others

Relapse prevention includes being completely honest with yourself and others. Reflect on those times when substance use incurred lying to yourself and others about your addiction.  When you go back to lying to yourself and others, it hinders relapse. Keep being open and honest. It may not be easy, but it keeps you on the path to sustained recovery.

If You Need Help, Ask for It

There is no shame in asking for help if you need it. There are many support systems in recovery, and they are there to call upon when you need extra support. Surround yourself with positive people who are just as committed to your recovery as you are. This can also increase the likelihood of sustaining long-term sobriety.

Find and join support groups where you feel you fit in best and keep going. No one said recovery was a solo endeavor, and it shouldn’t be. Reach out, step in, and don’t go it alone. 

Take Care of Your Whole Self

Practicing self-care means taking better care of yourself physically, mentally, and spiritually. When you pay attention to your personal needs, it shows you have self-worth. When you feel more worthy, you won’t feel like you need drugs or alcohol to boost self-esteem.  Engaging in self-care can boost your mood and prevent negative thoughts that can creep back into your mind about yourself. 

Do Not Bend or Break the Rules

Relapse prevention means strict adherence to the rules of recovery. The rules were written and given for a reason, and that is to get you and keep you on the way to sustained recovery. If you think your own terms or way of recovering is better, you are fooling yourself. 

The rules of recovery are well-proven, and if you choose to go your own way, you may relapse hard and never recover. If you are serious about ending substance use, it makes sense to stick with the relapse prevention plan created for you.

Relapse Prevention Starts with You

Relapse prevention involves learning and understanding the problems behind the substance use disorder. It includes introducing you to the tools and knowledge you will need to stick to your relapse prevention plan. Relapse does not mean addiction treatment failed or that you are a failure. It means your relapse prevention plan needs adjusting.

Sources

American Psychiatric Association. (2017 January) What Is Addiction? Parekh, R. M.D., M.P.H. Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

Merriam-Webster. Relapse. Retrieved from https://www.merriam-webster.com/dictionary/relapse

American Society of Addiction Medicine. (2015, May 13) ASAM Continuum. What are the ASAM Levels of Care? Retrieved from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/

NIDA. (2020, July 10). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

verywellmind. (2019, November 18) Relapse After Addiction Recovery. How to Respond to a Relapse Positively. Hartney, E. BSc., MSc., MA, Ph.D. Retrieved from https://www.verywellmind.com/what-is-relapse-22106

Psychology Today. (2012, October 19) Why Relapse Isn't a Sign of Failure. Sack, D. M.D. Retrieved from https://www.psychologytoday.com/us/blog/where-science-meets-the-steps/201210/why-relapse-isnt-sign-failure

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