Developing a Substance Abuse Relapse Prevention Plan

A relapse prevention plan is designed to promote long-term sobriety after treatment has ended. This program will include effective trigger coping techniques to avoid relapse and continue to resist drugs and alcohol. These healthy coping skills will be practiced to become habits. Then, these sober habits can be used to replace negative thoughts and actions associated with addiction.

Because so much hard work has undoubtedly been done for people struggling with addiction, relapse can be difficult to understand. This is especially true for those still in rehab, or freshly viewing the world through the eyes of sobriety. However, even with seemingly the best prevention program, relapse still happens.

In fact, according to the National Institute of Drug Abuse, relapse rates are roughly 40-60% for individuals leaving professional treatment facilities. That’s why creating a relapse prevention plan is so important.

Just as addiction had been able to mutate and grow more aggressive as time went by, so must the ability to resist substance use. Throughout the course of life, there will be many unexpected elements that can arise, and some may threaten sobriety. A relapse prevention plan must function for both the present and future triggers, in order to be effective.

Some of the most common reasons include:

• In order to relieve uncomfortable or painful withdrawal symptoms
• Peer influence or enabling
• Development of relationships that prove to provide little support
• Possession or temptation of abusable drugs, alcohol, or paraphernalia
• Feeling void of meaningful purpose
• Loneliness, boredom, or isolation
• Break-ups or unhealthy romantic relationships
• Loss of job or financial assistance
• Death or injury of a loved one
• Injury of oneself and temptation of drug supplies in the form of medication
• Skewed enjoyable memories of substance abuse
• Lack of planning when drugs or alcohol present themselves
• Anything that may negatively impact your overall mental health

Unfortunately, there are many more factors that can contribute to substance use disorders. Yet the most important takeaway is understanding the difference between sober thoughts, and thoughts of addiction. While MAT may be available, it may not benefit everyone on their individual path. Because of the potential risks of MAT for some, a more holistic approach may be necessary. Many holistic practices can be implemented into a plan, to better cope with triggers.

Ideally, a well-constructed and solid plan could lead to taking precautions before the first stage begins. This is not always the case, though. The good news is that all three stages exist.

Understanding what each tier includes doesn’t only mean stopping relapse in its tracks, but physical sobriety can hopefully remain intact. Whether you are experiencing emotional, mental, or physical relapse with active addiction, it doesn’t mean the journey is over. However, the further into the stages of relapse a person goes, the more difficult the road back will be. Because of that, the sooner warning signs are noticed, the sooner and more likely an addict can get back on track.

If you or someone you know is in danger of relapsing, talk with them about getting help. It’s never too late to reinforce or even add to a plan. Whether it means reaching out for help through a support group or rehab professional. If you’re unsure about whether you are in danger of relapsing, examine the following stages. And most importantly, be honest, and ask for help to resist drug use and maintain control over the recovery process.

Stage One: Emotional Relapse

This first stage may be difficult to identify, even for those experiencing it. This is because it revolves around mostly unconscious behaviors, such as isolation or feelings of sadness, anger, or anxiousness. Outwardly, many will not be able to notice the signs unless they know you well. This means it may be up to the addict themselves to get back on track, and often back into treatment.

However, just because emotional relapse is difficult or even unconsciously sneaky doesn’t mean it’s left out in creating your plan. This is practicing the lesson of awareness and becoming conscious of when these emotions occur. During rehab, or specifically during cognitive behavioral therapy (CBT), individuals can do the work to break out of these addictive trends. By first identifying these emotions or isolating tendencies, and then replacing them with healthy thoughts and habits. To either prevent or treat this stage, CBT is effective.

Signs of Emotional Relapse

Recognizing the first stage is important for two reasons. First, it’s the initial stage. While still in the first stage, the individual will have the opportunity to recognize warning signs and prevent these thought patterns. Awareness of the symptoms allows the opportunity to adjust or take action to correct factors that could dangerously progress further.

Second, this is the first stage that threatens recovery, and there is enough time to get help. It’s not too late, and it doesn’t mean that advancing into stage two is inevitable. By getting involved in a support group or outpatient program early, and restructuring of a written plan offers success in maintaining sobriety.

Outpatient programs often don’t require as much time to be spent within the facility as would residential programs. This makes it possible to continue applying the relapse prevention program to everyday life while making the necessary corrections.

Symptoms of Emotional Relapse

Those who are experiencing this stage often become confused as to what’s considered normal reactions to making lifestyle changes. However, those who have suffered this first stage reported experiencing:

• Feeling anxious, nervous, or overwhelmed
• Mental health issues, mood swings, agitation, intolerance of others, or angry
• Becoming isolated or withdrawn from family, friends, or co-workers
• Forwardly defensive of recovery, sobriety, or addiction
• Refusal of meetings, lessons, group therapy, or addiction help
• Inconsistency or changes in self-care, sleeping, or eating habits

Realistically, navigating life sober for the first time after rehab can be unfamiliar. This is what makes this written document so essential. In order to avoid, manage, or correct these emotions, relying on the plan will help. However, if symptoms of persist, it’s crucial to long term recovery to get help.

Stage Two: Mental Relapse

This is the beginning of an internal debate or conflict revolving around thoughts of substance abuse. Yet essentially there’s an understanding, or at least enough of one, that rejects turning back to addiction.

This stage typically consists of reminiscing about times when active drug or alcohol abuse was taking place. However, just like with any memory, it’s usually the enjoyable times thought about instead of aspects that caused harm. The same is true of memories during this stage. Unfortunately, this sometimes leads to making visits to old friends or places that once correlated with abusing substances. This in itself is a dangerous trigger.

When creating a relapse prevention plan, acknowledging how people, places, and things are associated with addiction adds awareness. Additionally, part of the process to create the plan requires socializing with new sober friends in group therapy. This goes along with filling up extra time with healthy practices and activities, leaving less chance to indulge thoughts of old habits during active addiction.

Signs of Mental Relapse

Reaching this second stage is going to be treated much more seriously in a rehab setting. This is because it brings the individual much closer to alcohol or drug use, which can be devastating to recovery. Some of the symptoms experienced by a person include:

• Sentimentalizing or glorifying memories from active addiction
• Missing or longing for people and places associated with substance use
• Denying or lying about entertaining thoughts of addiction
• Begin social situations with individuals who aren’t sober, have relapsed, or not in recovery
• Daydreaming or considering how and when to use drugs
• Synchronizing plans around active users in order to attempt using drugs

Stage Three: Physical Relapse

Just as it sounds, this stage is when there is actual action taken toward substance abuse, including active use. This is when it’s certain that relapse has occurred and a person is no longer sober. It means the relapse prevention plan wasn’t followed, nor was there sufficient dedication to it. This, however, is not when relapse started and not where recovery ends.

It’s usually at this point that becoming overly confident has contributed to neglecting the relapse prevention plan. Physically relapsing doesn’t have to consist of heavily using again, nor does it have to involve the same substance. It’s simply the point in time that repeating detox and rehab become fully necessary to again establish sobriety.

Once reaching a point of using drugs or alcohol, it’s likely that both emotional and mental relapse have already occurred. The best course of action is to get involved with a rehab professional and begin treatment as soon as possible. During treatment, the individual will have the opportunity to reevaluate their relapse prevention plan.

Resisting relapse isn’t as easy as it sounds. This is particularly true for those that attempt to detox and rehabilitate without the help of professionals. The accountability factor that is enforced within the facility promotes the reinforcement of making sober choices moving forward. By utilizing a relapse prevention plan as the first, second and third line defense, the risk of relapse declines dramatically. However, this takes practice, education and dedication.

In order to fulfill the intention of a relapse prevention program, addiction treatment centers will make education a priority. This means ensuring that each individual receives essential lessons and opportunities to strengthen sobriety and understand relapse.

Choosing to live and remain sober is what it means to be in recovery. It will always be the constant act of choosing to avoid high risk situations and develop healthy habits free of substance abuse. The purpose of a relapse prevention plan is to compile the methods and lessons developed in addiction treatment. Then, by determining the most valuable ways to approach and avoid triggers, they can be applied to everyday life. An effective and well-rounded plan is one of the most important relapse prevention strategies you can learn in addiction treatment.

When first getting started on developing your plan, many treatment centers will have a relapse prevention plan template to help you get started. This will provide you with examples of common triggers, behaviors, and methods of coping. It should help guide you in writing a plan that is individual to your needs.

Relapse is a serious issue affecting the recovery community. In the U.S., as many as 40% to 60% of addicts have successfully completed treatment but have resumed active drug abuse. As troubling as these rates are, it does suggest one very important action to be taken.

Essentially, the more developed, practiced, and easily implemented a relapse plan is focused on during treatment, the better it works. This is why a great deal of importance is placed on lessons and training during rehab. The more often a routine is repeated, the more likely that it’ll become a habit. The goal is to make sobriety less of a choice and more of a natural way of living.

After admissions, assessment, and detox, individual therapy and addiction education will begin. It will be at this point that you’ll be identifying triggers. Using an accumulation of knowledge, gained from therapy, lecture, and during active addiction, a relapse prevention plan takes shape.

For some, this is the first time they’re developing their relapse prevention program. For others reevaluating after relapse, it will be time to determine where the gaps were in preventing relapse. To do this, each individual will need to take a self-assessment of their signs during each stage. Then within each area, or the area lacking effectiveness, focus can be given to strengthening their plan to prevent relapse.

Medication-Assisted Treatment for Relapse Prevention

For those that can’t seem to manage cravings or manage withdrawal symptoms, medication-assisted treatment may be available. The use of certain drugs can lessen the urges and pain of withdrawal and promote a healthy recovery. However, it may not be the best option for everyone. This is determined on a case-by-case basis and is subject to change throughout the rehab curriculum.

Essentially, the medications that are available for medication-assisted treatment (MAT) can’t completely exclude the risk of dependency and abuse. Most importantly, MAT shouldn’t be solely relied on in place of a relapse prevention plan. However, it may be included for encouraging and adjusting to recovery.

Although coping with triggers may be more difficult, there are helpful habits to rely on when confronting them. In fact, incorporating them into a relapse prevention program can reduce the stress of triggers, and add to the quality of life.

Some of the helpful hints associated with relapse prevention plans include:

• Relying on your support system. Having others (like family members) around that support and celebrate your accomplishments holds you accountable and provides encouragement to succeed.
• Regularly attending support groups and sober meetings. Regular reinforcement, as well as open peer conversation, allows for a judgment-free space to vocalize feelings and accept the past.
• Getting healthy and moving. A relapse prevention plan encourages moving forward toward self-care. Get involved in a gym, sport, or club where you can meet new people with similar interests on the right track.
• Learning and practicing relaxation techniques, reflection, awareness, and grounding. Meditation and yoga are fantastic ways to build confidence and remain centered and focused on your new life.
• Speaking to yourself with kindness. It’s okay to remind yourself of the progress you’ve made and how well you follow your relapse prevention plan. Be kind to yourself and forgive yourself. Understand that by actively making changes to remain in recovery, you are succeeding.

These are some helpful ideas to reinforce your relapse prevention plan. It’s important to remember that you’re never alone and that many others support your sober success. If you feel as though you are getting close to any stage of relapse, reach out to a close friend or family member before it progresses. When in doubt, turn to the lessons and coping mechanisms that make up your relapse prevention plan. And remember, rehab is designed to help at any stage of addiction and relapse, allowing recovery to remain indefinitely possible.