The path to sobriety comes with its challenges, and many recovery journeys include a period of relapse into alcohol or drug use. Relapse is a normal (and dangerous) part of recovery. So it's best to have a solid relapse prevention plan in place. With hard work and the right attitude, relapse can be avoided. It can also be overcome if it occurs.
One of the most dangerous aspects of relapse is the increased risk of overdose. When people use alcohol or other drugs for a long period of time, they develop tolerance. That means they have to take higher doses of the substance to feel the same effects. Tolerance can begin to decrease after just a short period of sobriety. People who maintain sobriety for several weeks or months become much less tolerant than they were in the past. If they relapse and use the same dose that they used during active addiction, their risk of overdose is high. If an overdose does occur, it can be fatal.
Using drugs once during recovery doesn’t necessarily mean that a person has relapsed. A single use is usually referred to as a “slip.” Some people can slip without relapsing, but drinking or using does greatly increase the chance of relapse.
STAGES OF RELAPSE
Relapse usually begins weeks or months before a person slips for the first time. A person goes through numerous stages before fully relapsing.
During emotional relapse, people aren’t considering drinking or using. However, they aren’t practicing coping behaviors or proper self-care. In short, they’re setting themselves up for failure by (1) attending recovery meetings, but not actively participating, (2) distancing themselves from supportive friends and family, and (3) hiding their emotions. Poor self-care leads to feelings of unhappiness and increased levels of stress. As people continue to practice poor self-care, they transition into a mental relapse.
During mental relapse, people start to consider using alcohol or drugs. They know they shouldn’t, and they may try to practice coping behaviors, but their negative mindset often overpowers them. People in mental relapse may romanticize past substance abuse or minimize the negative effects of drinking or using. They may start to lie or look for opportunities to relapse. In some cases, they may even plan to relapse.
The final stage of relapse begins with a slip or use. If people who slip don't seek help, they often experience a physical relapse. A friend, family member or therapist may find out about the slip and help them access resources or find motivation to prevent relapse from occurring. If they don't get help, they may begin using obsessively or compulsively, leading to a downward spiral.
WARNING SIGNS OF RELAPSE
As people progress through the stages of relapse, they exhibit various warning signs. By recognizing warning signs that you or a loved one may be headed for relapse, you can take steps to prevent it from occurring. Signs that relapse is about to occur include:
- Romanticizing previous alcohol or drug use
- Thinking one slip will be OK
- Lying and being dishonest
- Isolating from others
- Skipping therapy or support group meetings
- Interacting with friends or other people who drink or use drugs
HOW TO PREVENT RELAPSE
In general, you can reduce the risk of relapse by:
- Obtaining steady employment
- Maintaining a safe and stable home environment
- Attending support group meetings
- Practicing coping and stress-relief techniques
- Finding a purpose in life.
CREATING A RELAPSE PREVENTION PLAN
People who attend therapy learn skills and strategies for preventing relapse. Rehab therapists will help people create easily accessible, realistic and specific plans for risky situations or times when they feel tempted to use drugs or drink alcohol.
A relapse prevention plan can be a list of reminders written on a note or mobile app. Or it can be a journal or workbook where you develop a comprehensive list of risky scenarios and the corresponding actions to take to maintain sobriety.
Relapse prevention plans should include:
- Someone to call
- A safe place to go
- A list of personal reasons for staying sober
- Examples of stress-relief strategies
- A schedule of local support group meetings
- Hotline numbers or crisis lines
- Locations of emergency services
Including others in a relapse prevention plan can help the plan succeed. Being open and honest about your recovery allows friends, family members and co-workers to support you when you need it.
WHAT TO DO AFTER RELAPSE OCCURS
The first thing you should do after relapse has occurred is find safety. That may mean calling 911 if you think an overdose is possible. If you don’t think 911 is necessary, contact a sponsor, therapist or loved one you trust who can get you help.
The immediate goals should be to remove access to alcohol or other drugs, shield yourself from negative influences including friends who drink or use drugs and begin to search for addiction treatment.
The intensiveness of treatment is dependent on the severity of relapse. Supervised detox may be necessary to safely overcome dependency and withdrawal symptoms. In less severe cases, outpatient therapy and support groups may be adequate.
Many people who relapse multiple times begin to lose faith that they can recover. They’re unsure how to quit relapsing. In some situations, they make the same mistakes repeatedly. For example, they may attend clinics that provide detox but not therapy. Therapy is crucial to recovery. Or they may attend therapy for only one to two weeks. In many cases, 30 days of residential treatment and multiple months of therapy are required to prevent relapse.
Some people return to high-risk situations after treatment. They live with spouses who use or drink, or they keep the same group of friends. In some situations, people must end relationships with others in order to fully recover and live healthy lives.
Relapse is not uncommon, and is considered one of the normal obstacles on the path to recovery. If used as a learning opportunity, it can be the last major hurdle on the road to a happy and fulfilling life.
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