The importance of relapse prevention in addiction recovery

A relapse is not a random occurrence or event – it is a process that a person goes through during a period of abstinence before a relapse occurs.

Some of the symptoms associated with substance misuse relapse include:

• Intense or uncomfortable emotions (H.A.L.T – Hungry, angry, lonely, tired)
• Post-acute withdrawal symptoms (poor sleep, anxiety, mood swings, agitation)
• Personal relationship and intimacy problems (increased levels of stress if things go wrong)
• Isolating from others
• Negative self-care (poor sleeping and eating habits and poor stress management)
• Nostalgia over people (including addicts that the person once used with)
• Nostalgia about places (such as where the addict used)
• Intense withdrawal symptoms (nausea, exhaustion and anxiety)

Relapse Prevention

Since preventing relapse takes a cognitive-behavioural approach – the objective when it comes to relapse prevention is to identify intensely high-risk situations which often involve:

• Substance abuse
• Obesity
• Depression
• Obsessive-Compulsive Behaviour

Relapse means that a person goes back to using again after a period of sobriety.

According to the National Institute on Drug Abuse, 40 – 60% of people are likely to relapse after a period of sobriety.

One of the aims of preventing relapse is to create a new understanding of what triggers a person to want to use again and helps them to understand the kind of environments, people and situations that motivate and encourage them to use.

Everything and anything can act as a trigger for someone, and a former addict will likely come up with plenty of excuses for wanting to drink or to start drugs again.

Getting clean is one element to recovery. The other is staying that way – both are not easy processes. As a result, an addict may begin an internal bargaining process.

They may tell themselves that one drink won’t do any harm, or that indulging in porn today, won’t happen tomorrow. These are the kinds of bargaining statements that often lead a person to begin the stages of relapse.

How to stop relapsing

One of the first keys of relapse prevention is to recognize the stages of relapse:

• Emotional Relapse: This is the phase where a person may not be thinking about using. However, the behaviours and thoughts that occur during this phase are gearing the person towards relapse. These include a person suppressing their emotions. The person may even be isolating themselves. This stage often involves feelings of anxiety and anger.

• Mental Relapse: During this stage, a person may become nostalgic about their former life as an addict. They may reminisce about the good old days of using these may involve the people and places that were associated with the addiction. In this phase, an individual will see their former life as an addict through rose-tinted specs. Essentially, they are planning to start using again.

• Physical Relapse: It is in this stage that the person has started using again. It may start with one pill, one drink, one bet, and then, eventually, lapse back into regular use.

Several ways that an individual can stop relapsing include:

• Reminding themselves of the reasons they quit in the first place
• Seeking help from counsellors, support groups and 12 step programs including Narcotics Anonymous and Alcoholics Anonymous (A.A.)
• Distraction techniques – this may involve talking to a trusted friend, going for a walk, meeting someone for coffee or watching a favourite film
• Reward strategies such as having a relaxing massage or booking a day trip for each recovery gain
• Consistent self-care which involves getting enough sleep, eating a balanced diet and following a daily exercise plan
• Understanding triggers – this is a crucial element to stopping relapse as the person comes to recognize what led them to abuse substances and identify healthier ways of coping for the future

Relapse prevention plan

Recovering from addiction is rarely a smooth process. Therefore, addicts in recovery need to recognize just how tough recovery can be.

Alcoholics who relapse, for example, may punish themselves when they start drinking again. Although this self-loathing can only make things worse and continue the cycle of addiction.

Therefore the process of relapse prevention should begin with self-forgiveness. Once a person recognizes just how common it is for addicts in recovery to relapse, they set themselves on the path to long-term abstinence.

Recovering from addiction must have a tailored treatment plan. In this case, a relapse prevention model of some kind.

So far, we have established the three stages of relapse (emotional, mental and physical) and identified several ways that an addict can prevent themselves from relapsing in the future.

Let us look at some other helpful ways that a person can prevent themselves from a future relapse:

Lapse vs relapse

There is a marked difference between someone lapsing and someone having a full return to previous addicted behaviours.

Lapsing is considered a slip, something that happens in the spur of the moment. A lapse is a temporary blip, but one that does not compromise or prevent full recovery.

A relapse is a complete return to past behaviours, thoughts and addictions.

Knowing the difference between the two can be extremely helpful for addicts in recovery as this often limits the amount of guilt whenever a lapse takes place.

Mindfulness-based relapse prevention

G. Alan Marlett, PhD, coined the term urge surfing which he developed as a mindful practice to help curb the urges, cravings and impulses that are associated with addiction.

Marlett teaches those with addictions to view their urges like waves at the ocean’s edge, the waves follow a natural progression, then peak in intensity, before crashing and receding.

The aim is to bring about conscious awareness in addiction recovery, allowing individuals to observe their cravings and urges, accept them, be present, and ride them out as opposed to resisting them.

The duration of cravings usually lasts around 10-20 minutes before dissipating.

Urge surfing offers addicts in recovery the opportunity to observe their cravings without judgement and without becoming too attached or trying to repress them.

If a person can practice observing their urges for this short duration, the urges will eventually pass. Surfing an urge involves becoming consciously aware of any thoughts, emotions and physical sensations that might be attached to a craving.

By visualizing the urge as a wave whilst focusing on breathing, each breath becomes deeper and slower.

Intentional breathing such as exhaling and inhaling through the abdomen can help individuals to be fully present with their cravings and ride them like waves as they rise, peak and eventually subside.

Relapse programs

12-step programs are helpful when it comes to preventing relapse – many of the strategies often involved in relapse prevention programs include:

• Deep breathing and meditation
• Group therapy
• Exercise routines
• Rehab aftercare

Other beneficial therapies for addicts in recovery involve:

• Cognitive behavioural therapy (C.B.T.)
• Residential treatment
• Holistic wellness treatment
• Relapse prevention

If you think you might be showing signs of relapse, it might be time to contact a specialist who can help you get back on track. Contact the team at Tikvah Lake today and find out how we can help you through this process.