Relapse Prevention Programs - Learning to Avoid Relapse after Drug Rehab
Anyone can quit… it’s staying quit that’s hard! That's why any addiction treatment program worth its salt spends a great deal of time teaching you how to avoid slipping back to your old ways.
You need to work to prevent relapse, and you do this by:
- Learning to identify situations, (physical, mental and environmental) that increase your risk of relapse
- Trying to prevent the occurrence of such situations
- Learning coping skills that help you to handle such situations when they do occur1
Relapse is common so relapse prevention efforts are vital. Read on to discover more about what you can expect to learn in drug rehab relapse prevention classes.
Does Relapse Just Happen?
Although on the day of a relapse it may seem like it just came out of nowhere, relapse is actually a process that begins long before you drink or use again.
The process of relapse begins when you start slip-sliding back into old habits of behavior and thought, such as:
- Getting overconfident – you stop trying to minimize your exposure to the people, places and situations that trigger cravings
- Letting stress and problems build up to a crisis point
- Failing to take steps to counteract negative emotions, such as anger, boredom or loneliness
- Forgetting to take care of your nutrition, get enough sleep or sufficient exercise
- Letting your recovery plan and activities slide2
You don’t have to relapse, but you need to understand that addiction is a chronic disease and that many people experience multiple periods of relapse and remission over a lifetime.
According to the National Institute of Drug Abuse (NIDA) drug addiction relapse rates range between 40 and 60% and of people that relapse, about 2 in 3 will relapse within the first 6 months of recovery3
So a significant percentage of people will relapse. Don’t feel discouraged, but accept that:
- You don’t have to relapse, and the best way to avoid relapse is to get treatment and to work hard on changing your lifestyle and on relapse prevention efforts
- If you do relapse, it doesn’t mean that your recovery process has to end; what it really means is that you need to get back to what was keeping you clean and sober before and that you likely need a refresher addiction treatment intervention
So treatment isn’t a magic cure to addiction, but if you pay attention and work hard, treatment offers you the knowledge and tools you’ll need to avoid backsliding.
But of course, tools alone won’t do much, unless you use them, every day.
What Causes Relapse?
According to the Substance Abuse and Mental Health Administration (SAMHSA), typical causes of relapse include:
- Lacking skills to deal with social pressures to use or drink
- Over-exposure to temptation and triggers
- Lacking skills to handle negative emotions or interpersonal conflict
- Testing your readiness to drink or use with moderation
- Lacking skills to manage recurring cravings4
So to avoid relapse you need to learn a few important skills; you learn these skills in relapse prevention classes.
Relapse Prevention Programs
A typical relapse prevention program consists of the following components:
1. Learning from Your History
If you don’t understand how you got in this mess, how can you expect to avoid repeating your past mistakes?
When looking back at your past you’ll focus on:
- Making a detailed history of your drug and alcohol use
- Listing the problems that caused you to seek treatment
- Listing reasons why previous treatment efforts or self-efforts at abstinence failed – what led to relapse? What situations got you into trouble?
- In past recovery efforts (if any), it’s important to identify which recovery exercises and tasks you completed and which you ignored or failed to follow-through with. It can be helpful if you can link your failing to complete a recovery task (like going to meetings) with your relapse.5
2. Learning about Relapse and Its Typical Causes
The more you know about relapse and its causes the better. A typical relapse prevention program will include education on some typical causes of relapse, such as uncontrolled anger or over-exposure to temptation, and an overview of some general protective strategies.
3. Making a List of Dangerous Situations
In your recovery plan you will need to prepare for high-risk situations, but before you can prepare you must first identify what threatens your recovery process.
By looking back at your history and by looking within you’ll develop a list of situations to avoid – and then later you’ll develop a plan for how you’ll deal with each situation, should it arise.
4. Learning about Warning Signs That Warn of Imminent Relapse
Relapse doesn’t come out of nowhere and the process of relapse begins some time before you drink or use.
Some example warning signs of imminent relapse include:
- Thinking you’ve got addiction beat and that you no longer need help or support
- You’ve started lying to those closest to you
- You stop making conscious plans for the future and for recovery success
- You start feeling really irritated with friends and family members and you start avoiding their company
- You start feeling resentful or self pitying
- You start entertaining ideas about drinking socially
- You stop trying to keep a structure to your daily activities6
If you can recognize relapse warning signs you can correct yourself before you stray too far off the right path.
To facilitate this, most relapse prevention programs teach daily or regular inventories, so you can make sure, every day, that you’re doing your healthy recovery activities and avoiding high-risk activities/situation/thoughts.
5. Learning and Practicing Coping Skills
- You will face cravings and difficult situations and you will have to deal with anger, frustration and stress.
- Since you know what’s coming, it’s a good idea to get ready
- You prepare yourself by learning and practicing coping strategies
Some examples of coping strategies you might learn include:
- Urge surfing techniques
- Getting involved with community self-help organizations
- Getting rid of drug and alcohol paraphernalia/reminders
- Limiting your contact with people you used to use/drink with. Changing your phone number
- Cutting up your ATM and credit cards. Having someone take control of your finances for you
- Trying new drug-free recreational activities
- Scheduling free time
6. Developing a Structured Recovery Plan for Dealing with High-Risk Situations
You make a list of personal high risk situations and warning signs that warn of imminent relapse and then you make a plan for what you’ll do, specifically, when you experience any of these warning signs or high-risk situations.
You match each warning sign or risky situation to a specific and appropriate coping strategy or activity.
- If I start entertaining thoughts of social drinking – I will go to an AA meeting and I will call my sponsor to talk about this option.
You also make a general schedule to integrate recovery activities into your daily/weekly routines. By sticking to your schedule you increase your odds of recovery and when you deviate from your schedule you’ll know that you’re increasing your odds of relapse.
7. Involving Close Family Members
Getting people close to you involved in relapse prevention planning and maintenance decreases your odds of relapse.
8. Making a Post-Relapse Intervention Plan
You hope and work for the best but plan for the worst.
The truth is, you may relapse – but not all relapses wreak the same destruction – not all people spiral back to full-blown out of control use.
With a post-relapse plan already made you won’t have to wonder about what to do after a relapse - you’ll already know - and by following the steps on your post-relapse plan, you’ll get back on the right track quickly.7
You may also work on a post-relapse plan with and for significant others, giving them instructions about what they need to do after a relapse. This way they’ll know what steps to take, without delay, and they’ll know they are following in your true best wishes.
9. Updating the Relapse Prevention Plan over Time
As your circumstances change throughout the early recovery period you need to keep-up by taking some time to regularly revisit and modify your relapse prevention plan, on an as needed basis.
Experts recommend updating your relapse prevention plan once a month for the first 3 months, once every 4 months after that for the first year, twice a year for the next 2 years and once per year after that.
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