The process of relapse entails much more than just a single event- it occurs as a series of steps in the direction of a return to addictive behavior. But along the way, there are opportunities to actively employ new ways of thinking and acting to reverse the process.
Relapse can happen for many reasons, and entertaining temptation or acting on triggers are often to blame. Moreover, at some point, after the change is made, the demands of sustaining it begins to appear to outweigh the benefits. We tend to forget that this is normal and that change is predicated upon resistance.
Common Triggers of Relapse
- The onset of withdrawal symptoms (anxiety, depression, nausea, vomiting, physical weakness)
- Post-acute withdrawal symptoms (anxiety, irritability, moodiness, sleep disturbances)
- Poor self-care
- Socializing with the wrong friends—people who use drugs or drink
- Going to or near places where one used to drink or buy drugs
- Things such as drug paraphernalia that remind one of using
- Uncomfortable, unpleasant emotions (H.A.L.T.: hungry, angry, lonely, tired)
- Relationships and sex, particularly if something goes wrong
- Isolation—too much time alone with thoughts)
- Pride and overconfidence—convincing oneself that the problem is handled or securely in the past
The Stages of Relapse
To understand how to implement relapse prevention, you have to be able to identify and understand the stages of relapse. An emotional/mental relapse often starts weeks or months before the physical relapse.
There are three stages of relapse: emotional relapse, mental relapse, and physical relapse.
Stage 1: Emotional Relapse
During an emotional relapse, you are not actively considering using. But your emotions and behaviors, however, are setting you up for future relapse.
Signs of emotional relapse include the following:
- Not asking for help
- Missing support meetings
- Poor eating or sleeping habits
The signs of emotional relapse are nearly identical to the symptoms of post-acute withdrawal. If you understand the post-acute withdrawal process, it’s easier to prevent relapse, because the early stage of relapse is the easiest to circumvent. In later stages, the pull of relapse gets more powerful, and the progression of events moves more rapidly.
Early Relapse Prevention
Relapse prevention means realizing that you’re in an emotional relapse and immediately changing your behavior. Recognize that you’re isolating and ask for help.
Take note if you are anxious and engage in relaxation techniques. Identify sleep and eating habits that are subpar and begin to improve self-care.
If you don’t alter your behavior at this stage and you subsist too long in an emotional relapse you’ll become exhausted and eventually will want to escape. This state will transition you into a mental relapse.
Practice self-care. The most critical thing you can do to prevent relapse at this stage is to take better care of yourself. Think about why you use—to escape, unwind, or reward yourself. Therefore, you relapse when you don’t take proper care of yourself and contribute to situations that are mentally and emotionally challenging that makes you long to escape.
Moreover, if you don’t take care of yourself and have poor sleeping or eating habits, you’ll feel drained and want to escape. If you don’t release your resentments and fears through some method of relaxation, they will grow to the point where you’ll start to feel uncomfortable in your own skin.
If you don’t ask for help, you’ll continue to feel isolated. If any of these situations linger for too long, you will begin to think about drinking or using. But if you practice self-care, you can prevent those feelings from building and avoid a relapse.
Stage 2: Mental Relapse
During a mental relapse, there’s a battle waging in your mind. Part of you desires to use or drink, but part of you does not. In the early stage of mental relapse, you may be just casually thinking about using, but as the stage wears on, you’re unmistakably thinking about it.
The signs of mental relapse are:
- Thinking about people, places, and things that remind you of use
- Glamorizing/romanticizing past use
- Lying or being secretive
- Hanging out with old friends who use
- Daydreaming about using
- Thinking about the possibility of relapse, and planning a relapse around other people’s routines
- Finding it harder to make the right choices as the pull of substance use gets greater
Techniques for Coping with Cravings and Relapse Prevention
When you think about using, the fantasy you have is that you’ll be able to control your drinking or drug use this time. But roll on with the story—one drink usually leads to more drinks. You’ll wake up tomorrow feeling disappointed and ashamed of yourself. You may not be able to stop the next day, and you’ll get wrapped back up in the same vicious cycle.
A common thought is that you can get away with using because no one will know if you relapse—for example, your significant other is away for the weekend. That’s when your addiction will attempt to convince you that you don’t have a significant problem and that you’re really in recovery merely to please others, such as your spouse, work, or society in general.
At this point, you must remind yourself of the serious consequences you’ve already experienced, and the potential adverse effects yet to come if you relapse again. Moreover, if you could control your use, you would have been able to do before now.
Tell someone close to you that you’re having cravings to use. Call a friend, a support person, or someone else in recovery. Tell them everything that you’re going through. The beautiful thing about sharing is that the minute you start to discuss what you’re thinking and feeling, your cravings begin to dissipate. They don’t seem quite as overwhelming as they once did, and you no longer feel so alone.
Use the art of distraction. When you start thinking about using, do something else to pass the time, such as talking to a friend, going for a walk, or even meditating. If you merely sit there with your cravings and don’t do anything, you’re giving your mental relapse room to continue building.
Wait for a few minutes. Most cravings only last for 30 minutes at most. When you have an urge, it may feel like an eternity, but if you can keep busy and occupied, it will be gone before you know it.
Remember recovery is one day at a time. Don’t think about whether or not you can stay clean and sober indefinitely. That’s a paralyzing and overwhelming though—even for those who’ve been in recovery for a long time.
Taking it one day at a time requires you to balance your goals with your emotional strength. When you feel strong and motivated not to use, then tell yourself that you’ll stay clean for the next week or month. But if you’re struggling and having cravings—and those times will likely happen often—tell yourself that you won’t use for just today or the next 30 minutes.
Navigate through your recovery in distances you can handle and don’t sabotage yourself by planning too far ahead.
Make serenity part of your recovery. Relaxation is an essential part of relapse prevention because when you’re anxious you tend to do what’s familiar and dysfunction instead of what’s new and right. When you are tense, you tend to repeat the same errors you made before. When you’re relaxed, you are more willing to embrace change.
Stage 3: Physical Relapse
Once you start actively about relapse and you don’t use some of the aforementioned techniques, it doesn’t take long to go from there to a physical relapse—going to get a drink or calling your dealer for opioids, cocaine, or marijuana.
It’s extremely difficult to stop the process of relapse at that point. That’s not where you should concentrate your efforts on in recovery. Rather, that’s attempting to maintain abstinence through brute force—it is not recovery. But, if you can identify the early warning signs of relapse, you’ll be able to catch yourself before you fall.
Our center offers evidence-based treatment and professional medical and mental health care staff who specialize in addiction. We help clients prevent relapse by ensuring safety and comfort in a warm, accepting, drug-free environment. You can regain your life!