Getting sober is a monumental first step, but what happens after rehab? One of the biggest fears going into addiction treatment is the prospect of facing life sober. Those fears aren’t entirely unfounded. According to statistics, 60 percent of relapses occur within the first six months of sobriety. Through a combination of therapy, peer support, and introspection, getting clean and staying that way is possible.
Relapse Prevention is an important part of Recovery
The difficult work of recovery begins after detox. Minds are clearer, and the body becomes stronger with each day away from drugs or alcohol. Through therapy, we’re able to dive deep and uncover the issues that led to addiction in the first place. With this knowledge, we can identify personal triggers and develop the skills necessary to manage stress. The goal is to leave rehab with the tools and confidence necessary to make healthier life choices.
Relapse prevention starts with a plan.
Goals of Relapse Prevention
Leaving a residential program may feel like flying without a safety net at first. It’s easy to stay sober within the safety of a rehab facility, but now the real world awaits. Emotions are raw and confidence is shaky. The age-old wisdom of recovery tells us to take it day by day.
A relapse prevention plan should be an evolving process that begins in therapy, is honed in group sessions through sharing experiences and feedback, and is put into motion by developing a plan of action. It can be a formal, written plan that’s fully outlined with steps and milestones, a verbal commitment to sobriety, or a combination of tools and actions for reducing cravings for drugs or alcohol and avoiding temptation.
The goals of addiction treatment and relapse prevention are to:
- Change destructive thought patterns and behaviors
- Identify and avoid triggers
- Manage stress and pressure
- Face challenges and cope with them more effectively
Counseling can help us objectively reflect on the mindset and environment that fostered dependence, whether it was a family history of substance use, a traumatic experience, coping with abuse, or an underlying issue like chronic health problems, an injury, or depression. Once these issues are confronted, we can learn to let to them go or devise plans to manage them in healthy ways. The tools are developed through cognitive behavior therapy, role-playing, and other practices that are designed to work when facing real-life situations.
Stages of Relapse
Whether it began with a single event or a binge, relapse is rarely something that happens overnight. It evolves slowly, beginning with a thought or emotion and ending in an action.
There are three stages of relapse, emotional, mental, and physical. Understanding what happens in each stage is the foundation of relapse prevention.
This involves a slow buildup of feelings. There may not be an intention to use, but those relapse triggers are waving red flags. This stage is characterized by feeling overwhelmed, followed by anxiety, and it leads to a mindset of isolation and despair. Understanding the nature of post-acute withdrawal will help neutralize the situation at this early stage and prevent a slide into old behavior patterns.
This may start with a wish to get high or it could be completely subconscious at first. There may some nostalgia for the “good old days”, which is often followed by rationalization, even minimizing how out of control life had become. This may be the most dangerous phase of recovery. Thoughts are often followed by actions without redirection and support.
During a mental collapse, the thought process may have jumped to “one drink won’t hurt” and other risky thoughts. Without a plan in place to divert this mindset, it’s a short hop to actually using again. One slip can lead to feelings of guilt and shame that snowball toward full-blown relapse.
Warning Signs of Relapse
The signs of a potential relapse can materialize at any stage. Part of relapse prevention is knowing the signs and how to implement your sobriety action plan. Some common signs to watch for are:
- Skipping support group meetings or therapy sessions
- Fantasizing about drug use or glamorizing past use
- Thinking about or socializing with people associated with past drug or alcohol use
- Actively thinking about using
- Planning a relapse around other people, such as waiting until a spouse goes to work to take a drink
Common Relapse Triggers and How to Avoid Them
It’s important not to minimize the warning signs of relapse. Learn to deal with them head-on. Personal triggers are different for everyone, but there are some common dangers like ending a relationship, employment issues, and financial problems. Even positive events like job promotions, having a baby, or other major life changes can trigger a setback.
In fact, the temptation to have a drink or get high to celebrate maybe even stronger.
There are things that can be done to diffuse and redirect.
- Practice self-care. Good nutrition, plenty of rest, and fitness are the foundations of emotional and physical stability.
- Avoiding withdrawal or isolation. There are times when we need to be alone. Being on the brink of relapse isn’t one of them. Reach out to program sponsors or supportive persons and tell them what you’re feeling.
- Distraction is a good way to avoid temptation. There are thousands of ways to redirect. Take a walk, start a new hobby, go to a support meeting, or call a friend.
- Wait. Try to overcome the impulse to use by waiting, The urge usually passes within half an hour. If it doesn’t, call someone or leave the immediate environment, even if it means just going into the next room and doing the dishes.
Elements of a Relapse Prevention Plan
- No relapse prevention plan is foolproof, but there are three elements that any plan should have that make success more likely.
- Practice mindfulness. Relapse begins in the head. Instead of dwelling on past actions, focus on the feelings that led to taking them.
- Use coping mechanisms. Therapy involves learning how to manage stress and make better decisions at the moment. When experiencing emotions or encountering a trigger that led to use in the past, envision a better way to deal with stress than using again.
- Get others involved. Actively engage in support groups and develop positive relationships. Sometimes calling someone who knows your struggle or just having coffee with a friend can help.
On average, 80 percent of teenagers and adults who successfully complete a treatment program begin using again within the first few weeks of recovery. These statistics aren’t meant to discourage, but to inform and empower.
Sobriety is a journey, not a destination. Relapse may be a bump on the road to recovery, but it doesn’t mean failure. There are stages of relapse and warning signs of trouble along the way. Knowing what they are and how to avoid the pitfalls will increase the odds staying sober for life.
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