Addiction is a chronic disease that affects your brain by rewriting how you process drugs and respond to stress. Long after your body has purged itself of the addictive substance on which your brain was dependent, the effects of addiction will continue to linger. Addiction is chronic and there is no cure, but it is a treatable disease. However, it takes a life-long commitment to recovery as you continue to seek support and insight into how you can deal with cravings and triggers in different situations throughout your life.
Neglecting your recovery journey, even after you’ve completed treatment, can lead to relapse. In fact, studies show that you’re about as likely to relapse back into addiction as someone with diabetes is to relapse into symptoms. Approximately 40 to 60 percent of people in recovery relapse after treatment. Relapse can even happen after years of successful sobriety, which can be especially dangerous. When someone uses again after a long period of sobriety, they will have lost their tolerance and risk overdose, depending on the drug.
However, you shouldn’t take that to mean that a relapse is definite. Just like a diabetic can make lifestyle changes to help ensure that they don’t experience dangerous diabetes symptoms, you can make changes in your life to ensure you live a life free of addiction. Techniques that help you avoid this are called relapse prevention strategies, and they can significantly increase your chance of lifelong recovery.
THE THREE STAGES OF RELAPSE
Before brainstorming relapse prevention strategies, it’s important to understand how relapse works. Most people think of relapse as one, singular act that ruins everything you’ve worked towards; however, relapse begins well before you actually start using again. In fact, there are three phases to a relapse, and relapse prevention aims to provide techniques to deal with it at all three stages. Most importantly, if you apply healthy coping mechanisms at the first sign of relapse, you’re more likely to resist. But, the first step is recognizing the signs.
The three stages of relapse follow the idea to use from trigger, to inception, and then to action. Here’s how the process can be broken down:
The real first stage of relapse begins before the thought to use even enters your mind. Withdrawal begins with a basic emotion. Depression, anxiety, or frustration are the embers that start it all. For instance, if you’ve had a rough day at work and come home to an empty apartment, stress can lead to depressive feelings. Stressors and challenges are facts of life, but your emotional response to stress can make a huge difference. Through addiction, your brain was trained to deal with stress by causing you to seek drugs or alcohol. In recovery, you have to retrain yourself to catch these emotions and cope with them in a healthy way.
Once a negative emotion begins, if you don’t have a healthy coping strategy, your thoughts may begin to make matters worse. The second stage of addiction begins to play a role: your thoughts. For instance, when you begin to feel stressed because you are late to work, you may begin a process called catastrophization. That means you take one source of stress and snowball it in your mind thinking, “I’m late so my boss will fire me. If I’m fired, I won’t be able to pay my bills. If I can’t pay my bills, I’ll end up homeless.” It doesn’t always happen in so many words. You can catastrophize in an instant. One moment, you’re five minutes late in traffic and the next you’re living on the street–in your mind. As you snowball your stress, your brain will remember how you used to deal with stress, by using. Your mentality may shift to begin justifying using drugs again thinking, “I need this, I’ve had a rough day,” or “I can just do it once, and then never again.”
Only in the third and final stage does relapse take the form people generally think about: taking physical action. You’ve experienced stress and a lack of healthy coping skills has led to negative emotions, those emotions have led to unhealthy thoughts that justify giving in to drug cravings, and, finally, you seek out and use the drug. This domino effect was defined by psychologist Alan Marlatt, and understanding it is the foundation of the cognitive-behavioral model, which is one of the most recommended therapies in addiction treatment.
WARNING SIGNS OF RELAPSE
The warning signs of relapse can be seen at each stage of the relapse process. Recognizing these signs is the first step in successfully coping with relapse triggers and what Marlatt calls “high-risk situations.” Here are the typical warning signs at each stage of the relapse process:
Emotional triggers can be outborn, or stress that comes from an outside source, like your boss yelling at you. But they can also be inborn, like the low feeling you get when you return to an empty home. When these stressors trigger an emotional response, there are a few signs you can keep in mind:
- Not feeling up to normal tasks
- Not finding joy in things you normally enjoy
- Isolating yourself from family and friends
- Repressing emotions and not dealing with them head on
- Neglecting self-care (mental and physical)
- Neglective recovery goals
Mental triggers are typically caused by negative emotions and they can take a variety of forms. However, they do tend to follow some basic patterns that you can look out for:
- Lying to loved ones and your support group
- Justifying drug-use
- Downplaying the consequences of drug use
- Romanticizing past times that you used drugs
- Bargaining with yourself
Physical signs of relapse are some of the most clear-cut. Once you start to see these signs beginning to occur, it will be harder to prevent the coming relapse. Recognizing the signs of relapse as early as possible is the most important part of prevention. Still, if you can’t yourself at physical signs, a relapse may still be avoided:
- Seeking out addictive substances
- Contacting known dealers
- Using “just once” despite consequences
WHAT IS A RELAPSE PREVENTION PLAN?
A relapse prevention plan is all about creating a strategy to avoid relapse before you enter a high-risk situation and applying healthy coping mechanisms if you do find yourself in one. Avoiding high-risk situations altogether is ideal. For example, if you feel depressed when you get home from work to an empty house, take a gym bag to work and go straight to exercise afterward. Getting your blood pumping can elevate your mood at the time of day you need it most.
Other high-risk situations are unavoidable, and that’s when you need strategies to cope in a healthy way. According to a study in the Yale Journal of Biology and Medicine, there are five basic rules for implementing an effective relapse prevention plan:
1. Change your life. Making a healthy change in your behavior and lifestyle is more effective than simply not-using anymore.
2. Be honest. Addiction often leads to users lying to themselves and others. Being more honest with yourself and others can help you become more accountable to yourself and the people in your support system.
3. Ask for help. Many people want to handle addiction on their own, but it’s incredibly difficult. Reaching out to friends, family, mentors, or counselors means you’ll have more help along your recovery journey.
4. Practice self-care. Addiction often forms as a way to relieve stress or deal with trauma. Through self-care, you can relieve the negative emotions that may initiate a relapse.
5. Stick to the Rules. Relapse requires you to break your own rules and forsake your recovery goals. Be strict about them; don’t let yourself justify breaking the rules.