Relapse happens. It doesn’t matter where someone is in their recovery journey, a relapse can feel like a failure that negates all the work they’ve put into their sobriety. Even though this isn’t the case, relapsing can still make someone feel like having to start all the way back from the beginning no matter how long they had maintained their sobriety beforehand.
If you have relapsed into using drugs or alcohol again, focus on getting sober and then have a relapse prevention plan to put in place. This will help lower the risks of relapsing and increase the chance of staying sober for longer.
It’s crucial to remember the following:
- Addiction is a chronic illness that does not go away after treatment but instead requires long-term management.
- Relapse does not equal failure and is actually quite common, with studies showing that roughly 40 to 60 percent of those in recovery from a substance use disorder will eventually relapse at least once.
- Relapse is something to be prepared for and, while it doesn’t mean that all your hard work was for nothing, it does mean that you need to step back and evaluate what aspects of your relapse prevention plan are not working and need to be retooled to be more effective.
While it isn’t possible to guarantee that you will never relapse, there are still several things in your power that you can do to help increase your odds of maintaining long-term sobriety. Taking the time and effort to create a practical, feasible relapse prevention plan based on what you and your addiction therapist or counselor know will work best for you can greatly decrease the risk of relapsing later and also help you bounce back faster if a relapse does occur.
What is Relapse?
Relapse is, quite simply, a deterioration after a period of improvement. In the specific case of addiction, it is when someone who has achieved sobriety returns to using drugs or alcohol.
Relapse can happen at any point in someone’s recovery, sometimes even years after they’ve stopped using. In that instance it is also particularly dangerous, as someone who has not used drugs or alcohol in many years will have lost their tolerance and, if they do relapse and take the same amount of whichever substance that they used to back when they were regularly using, there is a very high risk of experiencing an overdose.
There are many situations that can trigger a relapse in someone in recovery, or lead to negative emotional states that raise the risk of relapsing. Relapse prevention means not just learning the techniques and skills that help someone cope with these internal and external triggers, but also being able to identify these situations and then either avoid or prevent them before they become a problem.
Recovery treatment certainly helps to make managing addictive behaviors easier, but it is still important to be able to spot common situations or feelings that can leave someone vulnerable to a relapse.
Some Examples Include:
- Peer pressure, which might sound a bit silly, doesn’t stop when someone isn’t a kid anymore, and it can be a powerful trigger. Peer pressure can come in either a direct form, like friends urging you to drink at a party when you are in recovery from an alcohol use disorder, or indirect, such as being invited to a gathering where alcohol will be present, like an after-work happy hour.
- Negative interpersonal situations, whether the relationship in question is romantic or platonic. Feelings of conflict, disappointment, sadness, or guilt resulting from an important relationship in someone’s life can leave them extremely vulnerable to relapse.
- By extension, negative emotional states, in general, can very quickly put someone on the path to relapse. Feelings such as anxiety, frustration, depression, and more, whether they’re a reaction to something external or manifested internally, can all be dangerous.
- Positive emotions can also present issues. Recalling the good feelings associated with drug or alcohol use is one example, as are feelings of pride and confidence if they get too out of control and lead someone to think they don’t have to be careful when it comes to avoiding drug or alcohol use.
What are the Stages of Relapse?
Another key part of understanding and, by extension, preventing relapse is by recognizing that relapse is not, as many people might think, just a single event. In actuality, relapsing is a process that involves several stages.
The first stage of relapse is the emotional stage, which can begin before someone has even started truly considering going back to using alcohol or drugs. Largely mood-based, during the emotional phase of a relapse, someone can expect symptoms such as agitation, anxiety, depression, insomnia, and a loss of appetite.
Other behavioral signs that are frequently observed during the emotional stage include:
- Not following their personal rules for their recovery
- Isolating themselves from systems of support like family and friends
- Not dealing with emotions and, instead, bottling them up
- A substantial lapse in mental or physical self-care
- Noticeable change in eating and sleeping habits
If you recognize these behaviors in either yourself or someone else and can properly address them before things progress to the second stage, you can stop a possible relapse before it has the chance to happen.
The second stage in the relapse process is the mental stage. At this point, an individual will have the active, conscious urge to return to using drugs or alcohol and will be struggling between those urges and the desire to stay sober. This is when people in the process of relapse are at their peak vulnerability because if they do make the decision to use again, there is very little that can be done after this to stop them from following through.
Some Common Behaviors to Watch Out for That Point to Someone Being in the Mental Stage of Relapse Include:
- Lying to family and friends about being strongly tempted to use drugs or alcohol again
- Attempting to minimize the impact of past substance abuse or otherwise romanticize how life was when they were using
- Trying to make bargains like “I’ll only use or drink this once, and then that’s it forever.”
- Pointedly seeking out reasons or opportunities to justify a relapse.
The last stage of relapse is the physical stage, and it is this phase that is what people generally think of when they think of a relapse. If the behaviors of the mental stage of relapse are not identified and treated in time, then the physical stage will follow closely after, and then the person will relapse and return to using drugs or alcohol, breaking their sobriety.
While it is not certain that they will necessarily transition fully back to substance abuse, depending on the substance, strong cravings can make a comeback after a single use. And, this, inevitably, can increase the likelihood of a return to regular abuse. At this point, the relapse will have been completed, and the only thing that can be done for yourself or a loved one is to return to treatment as soon as possible.
If someone is unable to avoid a situation of feeling that leaves them vulnerable to relapse, a strong relapse prevention plan can still help stop a relapse-in-progress before it reaches the final stage. The prevention plan can help identify the behaviors associated with the first two stages and how to address them.
What Does a Relapse Prevention Plan Look Like?
For many people, the thought of having to remain constantly on alert for potential relapse triggers can feel like an overwhelming responsibility. Creating a relapse prevention plan can also often feel equally insurmountable, but it doesn’t have to be that way. A relapse prevention plan doesn’t need to be a huge, overly-complicated thing. In fact, the more complicated the relapse prevention, the less likely it’s going to be truly effective.
A solid relapse prevention plan can be broken down into five fairly simple to parse rules that can help you get a better grasp of what is most important to focus on during your continued recovery. This is not meant to be a quick or easy fix, but only a simpler way to think about relapse prevention that makes it less intimidating and more achievable, giving you the motivation you need to make your own plan and stay with it.
Rule One: Stay Honest
One major part of addiction is having to lie and keep secrets from your family, friends, employers, and often even yourself about the amount of damage your substance use disorder is causing. Being honest means holding yourself accountable for your actions, letting someone know when you need help, or being honest about your feelings. It can sound like a big change, but it can be done in small steps until it becomes a habit.
Rule Two: Make Changes
Changing your life post-treatment can sound like too much all at once, and if you do try to carry it out as an “all or nothing” task, then you’re setting yourself up to fail. Instead, break it down into pieces and make it practical. Look at the aspects of your life and behavior that contributed to your addiction and begin working to change or remove them one by one. Slowly but surely, it will make staying sober easier. Honesty, as previously mentioned, is a good place to start but it can even be something as simple as exercising more or taking up a positive hobby.
Rule Three: Don’t Forget About Self-Care
It often falls by the wayside, but self-care is an extremely important part of relapse prevention. Self-care helps to replace the motivation and reward system created by drugs or alcohol with a much healthier one. It also can help minimize the creation of negative emotions and thoughts. As with the first two rules, it doesn’t have to be anything major— a special dinner, a massage, a new video game—just something that helps you celebrate the hard work you’re doing and helps you keep working.
Rule Four: Ask for Help if You Need It
Like we mentioned in the first rule, you must be honest with yourself when it comes to needing help. No one can get through recovery alone; it just isn’t possible. Many people think that asking for help or support makes them weak, but the opposite is true: It takes a lot of strength to admit that you’re vulnerable and could use someone to lean on, whether it’s family, friends, or a support group of people who have had similar experiences to yours.
Rule Five: Follow the Rules
This might seem a bit redundant, but the rules of a relapse prevention plan aren’t worth much if they aren’t followed, or even if they’re bent. The emotional stage of relapse, as previously mentioned, involves a lapse in all of the good habits you will have worked to build. As we also mentioned before, no matter how long you’ve been sober, you always need to be actively working at staying that way, and following the rules of your relapse prevention plan is a critical part of that work.
Addiction recovery does not include one-size-fits-all treatment methods, so everyone’s relapse prevention plan is going to look different based on the strategies that they know will work best for them. There’s no template for a perfect plan, and there’s no guarantee that, even with a plan, someone won’t relapse. But having a relapse prevention plan still matters, as it will increase your odds of maintaining sobriety and being able to stop a relapse before it happens.
Creating a Relapse Prevention Plan
The idea of all that is involved in relapse prevention can often feel overwhelming, but there’s no reason that it has to be that way. A relapse prevention plan does not have to be something complicated and all-encompassing. If you try to take one that is too complex, odds are that it will not be terribly effective.
Instead, one useful way to create a relapse prevention plan is to make it as simple as possible, breaking it down into small pieces. One popular method is implementing five main rules to focus on during the long-term recovery process.
Rule One: Make Changes in Your Life
For many, the concept of having to change their life can feel like a whole lot all at once, but it’s not an “all or nothing” sort of rule. It just means looking at aspects of your life that have contributed to addictive or unhealthy behaviors and working to alter or remove them in order to make it easier to stay sober. One way to do this is to make attainable goals of changing one small thing at a time, even if it’s just waking up earlier or exercising more.
Rule Two: Practice Honesty
Lying and keeping secrets is a big part of active addiction. This is because people struggling with substance abuse are frequently in situations that require lying to family, friends, employers, and even themselves about how much harm their dependence is causing. Much like the first rule, this can be done in small steps, like being honest with someone about needing help, until it eventually becomes a habit.
Rule Three: Ask for Help
Speaking of being honest about help, anyone who believes that they can get through recovery alone without a support system is setting themselves up to fail. There’s nothing wrong or weak about asking for help. In fact, it takes a great deal of strength for someone to admit that level of vulnerability. Something as easy as joining a support group where someone can safely express themselves and asking for help from those with the same experiences can make all the difference.
Rule Four: Make Time for Self-Care
Self-care is a crucial element of relapse prevention therapy and addiction therapy in general, as it helps to avoid creating the negative internal emotions we mentioned previously. It also helps to create a new motivation and reward system to replace the one created by drug or alcohol use. Again, it doesn’t have to be anything big: a fancy meal, a relaxing bath, a special purchase, just something that allows someone to both acknowledge and celebrate their hard work.
Rule Five: Follow the Rules
While it might feel redundant, the rules of a relapse prevention plan won’t work if they aren’t followed or even if they’re bent. As previously illustrated, the first stage of relapse involves letting the good habits an individual has worked to build fall by the wayside. No matter how long someone has maintained their sobriety, they always need to be actively working at it and following the rules of the relapse prevention plan that they have set for themselves.