The process of relapse involves much more than just a moment of weakness—it occurs as a series of steps in the direction that is heading toward addictive behavior. Along the way, however, there are many opportunities to actively use new strategies and act to halt and reverse the process.
Relapse occurs for many reasons, and entertaining temptation and acting on triggers are often to blame. Moreover, at some point, the demands of sustaining change begin to feel as though they outweigh the benefits. People tend to forget that this is normal and that sustainable change is highly dependent upon resistance.
Common Triggers of Substance Abuse Relapse
- Withdrawal symptoms manifest upon cessation (anxiety, depression, nausea and vomiting, physical weakness, etc.)
- Post-acute withdrawal symptoms (mood swings, anxiety, irritability, and sleep disturbances)
- Poor self-care
- Continuing to socialize with people who use drugs or drink alcohol
- Going to or near places where one used to buy drugs or drink
- Seeing items such as drug paraphernalia (e.g., needles or pipes that remind one of using drugs
- Unpleasant feelings (H.A.L.T.: hungry, angry, lonely, tired)
- Stress related to relationships or sex
- Isolation—too much time spent alone with thoughts
- Overconfidence in one’s ability to regain sobriety after “normal” use of a substance
The Stages of Relapse
To understand how to implement a relapse prevention plan, you have to be able to recognize and understand the stages of relapse. An emotional relapse often begins weeks or months before the physical relapse occurs.
There are three recognized stages of relapse: emotional relapse, mental relapse, and physical relapse.
Emotional Relapse
During an emotional relapse, the person is not actively considering using. But emotions and behaviors, however, are positioning him or her in a mindset that could lead to future relapse.
Signs of emotional relapse include the following:
- Anxiety
- Depression
- Anger
- Defensiveness
- Moodiness
- Social withdrawal
- Not asking for help
- Not going to peer support group meetings
- Missing psychotherapy or counseling appointments
- Poor sleeping or eating habits
The signs of emotional relapse are comparable to the symptoms of post-acute withdrawal syndrome. If you understand the process of post-acute withdrawal, it’s easier to prevent relapse, because the early stage is the easiest to reverse. In later stages, the pull to give in grows more powerful, and related events progress at an accelerated rate.
Early Relapse Prevention
Relapse prevention requires you to realize that you’re in a state of emotional relapse and immediately change your behavior. Here, you need to recognize that you’re regressing emotionally and ask for help. If you don’t seek help, you’ll continue to feel alone.
If you don’t change your behavior at this stage and languish too long in an emotional relapse, ultimately you will likely become exhausted and eventually desire to escape. This state will transition you into the next stage of mental relapse.
During this time, take note if you are anxious or depressed and use relaxation techniques. If you don’t release resentments and fears through some means of relaxation, they may grow to the point where you’ll once again start to feel uncomfortable in your own skin.
You will also need to identify sleep and eating habits that are inadequate and begin to improve self-care. The most crucial strategy that you can use to prevent relapse at this stage is to take better care of yourself. People use substances to escape, unwind, or reward themselves. Therefore, they tend to relapse when they don’t take proper care of themselves.
If any of these situations persist for too long, you will probably begin to think about drinking or using drugs. But if you ask for help, learn to relax, and practice good self-care, you can prevent those feelings from accumulating and avoid a relapse.
Mental Relapse
During a mental relapse, there’s a war waging in the mind. Part of you desires to use drugs or drink, but part of you does not. Early on during a mental relapse you may be casually thinking about using, but if the stage continues, you will be unmistakably considering it.
Signs of mental relapse include the following:
- Glamorizing or romanticizing drug or alcohol use
- Thinking about people, places, and things associated with substance use
- Lying or being secretive
- Associating with old friends who use
- Daydreaming about using
- Considering the possibility of relapse, up to and including planning a relapse
- Finding it more difficult to make the right decisions as the pull of possible substance abuse gets greater
Techniques for Coping with Mental Urges
Remember that as you think about using, the fantasy will probably include the possibility that you’ll be able to control your substance use this time around. But if past behavior predicts future behavior, chances are one drink or one drug dose will lead to further abuse. You’ll wake up the next day feeling ashamed, and these feelings may prevent you from stopping again the next day.
Before you know it, you are trapped in the same vicious cycle you always were. A common belief that people in recovery have is that they can get away with using if it can be kept secret from others. This is when someone’s addiction attempts to convince them that they don’t have a serious problem and that recovery is merely to please others in one’s life.
At this point, you should actively recall the adverse consequences you’ve already encountered, and the potential effects yet to come if you relapse. Moreover, if you could keep your substance use in check, you should have been able to do long so before now.
Tell someone you trust that you’re having thoughts about using. Call a friend, a family member, or someone else in recovery. The wonderful thing about sharing is that the minute you start to discuss what you’re feeling, your cravings begin to subside and you no longer feel so alone.
Make use of distractions—when you start thinking about using, do something else to pass the time. Most cravings only last for about 30 minutes at most. When you have a craving, it may feel like an eternity, but if you can keep yourself occupied, it will be over before you know it.
Remember that recovery happens one day at a time—this requires you to balance your goals with emotional fortitude. When you feel strong enough not to use, then you can set goals to stay clean for the next week or month. But if you’re struggling, you can tell yourself that you won’t use for just today or the next 30 minutes.
Physical Relapse and Getting Treatment
Once you actively begin thinking about relapse and fail to use the aforementioned strategies, it doesn’t take long to descend into a full physical relapse. Moreover, it’s extremely difficult to stop the process of relapse at that point, and this is not where you should be focusing your efforts on during recovery. Rather, you would then be merely attempting to remain abstinent through brute force, and this is not recovery.
That said, relapse is not the end of the world. For many, it is part of the recovery process (although it is not recovery itself). The best thing you can do if you relapse is lift up your head, swallow your pride, and seek treatment as soon as possible before the situation gets even worse. Realize that relapse doesn’t have to send you spiraling to rock bottom, and you have the capability of turning your recovery around once again.
Recovery By The Sea offers partial-hospitalization and intensive outpatient treatment programs. These programs are ideal for those who have already completed residential treatment, but have relapsed and need additional support to re-establish sobriety.
If you have relapsed and feel you need further treatment, please contact us as soon as possible. Discover how we help people reclaim their lives and experience happiness and wellness, free from drugs and alcohol!