ARTICLE SUMMARY: The secret to preventing relapse is to be engaged in the therapeutic process. If you’re seeing a professional counselor, you can begin to understand what drinking or drug “do” for you. And take hope. Relapse isn’t all bad; it can be a part of this process. In fact, relapse should not block you from moving forward.
ESTIMATED READING TIME: 10 minutes.
TABLE OF CONTENTS
- Relapse Rates
- Why People Relapse
- Is Relapse Bad?
- The Secret to Preventing Relapse
- Relapse Management Planning
- What to Avoid
- Extra Tips
- Your Questions
Are you afraid that you would not be able to maintain sobriety? You are not alone. Many addicted people fear relapse. In fact, the fear of failing can be one reason why people avoid treatment in the first place. So, how many people relapse back to drinking or drugs?
The National Institute of Drug Abuse states that:
“Relapse rates for drug use are similar to rates for other chronic medical illnesses. If people stop following their medical treatment plan, they are likely to relapse.”
This JAMA study published in 2000 compared addiction relapse to type 2 diabetes mellitus, hypertension, and asthma.
So, an estimated 40-60 % of people return to drugs after treatment. Alcohol relapse rates can be even higher. This chapter on Alcohol Craving and Relapse Prediction references a 2005 medical study that summarized:
“Among alcoholics up to 85% of all patients relapse, independent of whether they have been treated as inpatients until complete remission of physical withdrawal symptoms.”
For some addicted individuals relapse feels like the end of the world. But guess what? There is a way to prevent relapse! Want to learn how? Continue reading and perhaps you can avoid a setback.
Why People Relapse
There are many reasons why people relapse, most related to the environment that they return to after treatment. Plus, treatment of chronic diseases involves changing deeply rooted behaviors. Risk of relapse is even higher if you’ve been in jail due to a drinking or drug problem. For former inmates, NIDA lists multiple challenges (that we think can be broadened to include many of us):
- Educational and employment problems
- Family difficulties
- Limited social skills
- Medical issues
- Mental health disorders
This 2016 study published in the Journal of Addiction may help explain further. Researchers looked at relapse for heroin, opiate, and opioid users in India, and of nearly 150 people found that chances of increased relapse were related to a person’s police and imprisonment history as well as drug use patterns. The longer the duration of abuse (or the stronger the effect on the brain)… the more likely a person was to relapse.
This points to the phenomenon of drug craving and triggers.
Addiction is a tricky disease, it has physical and psychological aspects which are not easy to overcome. When we quit drinking or taking drugs, cravings hit hard. But what is a craving?
According to this 2012 medical review on the “Clinical significance of drug craving“, despite the diversity of craving theories, most researchers assume that craving is a subjective experience of wanting to use a drug.
Indeed, craving is not necessarily pleasant. Cravings for drugs can be defined as unexpected, surprising and stressful experiences. A craving can be both physical and mental, with peaks and valleys that occur multiple times per day. A craving is like an obsession paired with deep despair. And craving is a very real phenomenon. It often intrudes into your daily life, at times dominating your thoughts and generating considerable distress.
This 1993 study into the brain craving phenomenon distinguished between hedonic or pleasant drug effects (“liking”) and the craving for such a positive effect (“wanting”). In other words, craving is a true need for a drug. Cravings drive us to seek out past experiences that we know work: drinking or using drugs. The trick is to move through them and allow them to pass. This can be done through:
- Relaxation breathing
- Snapping a rubber band on the skin
- Visualization of new situations
- Calling someone
Substance abusers sometimes fail to stay sober regardless of their efforts. Some experts theorize that relapse occurs as the results of strong brain patterns that are unconsiously put into motion by “triggers.” So, what is a trigger?
A trigger is a cue that sets off a certain behavior. Triggers can be situations, places, or people associated with the drinking or drug use that reminds us of our previous substance abuse. Triggers often produce craving.
Triggering cues primarily activate cortical regions in the brain related to a broad range of functions, including:
- Executive controlmemory
- Interoceptive integration
- Processing of reward
- Regulation of action
In other words, a trigger can set us off balance and have us reaching for a drink or a drug like a zombie. Cravings might become so strong that we reach for the booze or drugs again. The trick to triggers is to first identify and anticipate them. Because they are often subconscious, bringing them into the subconcious can help us avoid them. If we do encounter a trigger, we then learn to cope with the craving.
Want to learn more?
This SAMHSA PowerPoint presentation does a good job explaining both cravings and triggers.
Is Relapse Bad?
No, relapse is not bad.
However bad the feeling of relapse makes you feel, it is not a failure! On the contrary, they are a normal and common part of almost every addiction recovery. The National Institute on Drug Abuse (NIDA) sees it like this: Recovery from addiction means that we have to learn new ways of thinking, feeling, and dealing with problems.
But, why is preventing relapse so difficult?
The following obstacles might get in the way of preventing relapse:
1. Failing to control triggers
2. Inability to recognize the early warning signs of drug addiction
3. Lacking a relapse prevention plan
The Secret to Preventing Relapse
The secret of preventing relapse is to get professional help.
You might promise yourself that you will stay away from drink or drugs for your own sake. But who will guide you in the process of change? Who can help keep you accountable?
Talking about your urges, cravings, and wanting to use with someone you feel close to can help you move past them. This person might be a friend or a family member. However, they are not trained in the best practices of behavior change. Instead, we recommend that you talk with:
- A Licensed Clinical Social Worker
- A Pscyhologist or Addiction Counselor
- A Psychiatrist
Talking through about the range of emotions you are experiencing will help you feel accepted. Talking can also help you become more aware of underlying stress issues. When we are aware of problems, we can work towards solutions. And working with a professional on relapse prevention can help you engineer a better future for yourself.
Relapse Management Planning
Better preparation can help you get through tough spots. Here are some important elements that should be in place as you consider creating a relapse management plan:
1. Accepting relapse as a normal experience.
Both you and your support system family and friends can view relapse as an opportunity for learning how to avoid further lapses. Every day of recovery brings new chances for knowledge, self-awareness and self-control, you only have to give it time, patience and perseverance.
2. Work with a professional for up to a year after rehab.
Once you’ve completed rehab, you’ve just started a new life. So, when you’ve come this far, why throw all the effort away? Maintaining sobriety requires work over time. This is why most reputable rehabs refer to outpatient programs for 6 months to a year after initial treatment begins.
3. Learn to identify risky situations (internal and external).
Anything that might remind you and make you nostalgic for your drug-of-choice needs to be aired out. Addiction triggers cloud our awareness and can lead you into temptation to reach for booze or drug again. It is very helpful to know which behaviors help protect you from relapse…and how you can bring subconcious cues to the surface.
4. Develop coping strategies and skills to avoid triggering situations.
One way to cope with high risk situations is to learn alternative techniques to handle difficult situation. Here are some suggested tools to avoid triggers:
- Learn anger and depression management.
- Use meditation as an effective and healthy way to relive stress and relax.
- Reduce your list of daily responsibilities and obligations.
- Engage in hobbies, sport or other activities which you find enjoyable.
- Establishing control over your mindset and way of thinking.
- Encourage yourself with positive self-talk and try to use affirmative language such as: I can, I will try… etc
What to Avoid
The top 5 things we think you should avoid to prevent relapse include:
1. Avoid seeing relapse as something negative. Accept it as a normal part of your recovery.
2. Avoid communication or interraction with substance abusers. Instead, focus on socializing with new people, or keep contact with people that support you.
3. Avoid looking back, focus on the present moment and on all the things you CAN DO.
4. Avoid situations that might lead you to stress, anger or other out of control behaviors. Learn stress and anger management.
5. Avoid being alone when cravings stricke. Build a strong supportive network.
Here are two helpful reminders to keep in mind regarding preventing relapse:
TIP# 1: Revise your relapse plan together with your doctor or addiction counselor. Regular check ups are important so that you can be sure you’re continuing to do well.
TIP# 2: In order to prevent relapse you need to prioritize your recovery and well being. Avoding the chance to surrender to relapse means constantly reminding yourself of the purpose of your recovery and the benefits of LIVING A LIFE WITHOUT DRUGS.
We hope to have answered your questions and given you ideas about avoiding relapsing situations. But in case you have any additional questions or simply want to share a personal experience regarding relapse prevention feel free to use the comment section below. We always try to provide you with a personal and prompt response.