Preventing Relapse

Relapse prevention seems so simple to an outsider looking in: "Here's how to stay sober: don't drink alcohol. Don't use drugs." If only addiction and recovery were that simple. It's hard to fault the outsider, though: there's no way the human eye could spot the hijacked reward pathways inside our brains or the years of negative self-talk or any pressing external circumstances that elevate our stress levels and reactivity. Still, none of those make good excuses for a relapse. Especially when we can make a plan to manage and cope with those stressors.

Preventing relapse can't be boiled down to "just don't use," but it can be simplified: proactivity and healthy emotional regulation are some of our strongest assets for staying sober. So what do those words really mean? In this piece we'll discuss what exactly relapse prevention involves and provide some great exercises and resources for crafting a reliable relapse-prevention plan that suits you.

What is Relapse Prevention?

Relapse prevention is the use of coping skills, recovery tools and mindfulness exercises to diminish the likelihood or re-occurrence of relapse. Relapse-prevention plans can be individualized based on our preferences. If one person likes to meditate and walk in the park for stress relief and grounding, those can and should be used for preventing relapse. Anything that helps us healthfully manage and process our emotions is a great inclusion in a relapse prevention plan.

Ultimately, relapse prevention isn't only about not drinking or not using drugs. Relapse prevention is about learning new skills and modalities for regulating our emotions and behaviors, and replacing unhealthy behaviors with better habits.

How to Replace Unhealthy Behaviors with Better Coping Habits

When we begin to craft a relapse prevention plan, we ought to look at our habits. If specific cues tend to trigger us or create negative emotions, we can create new, healthier habits around them. For example, if we grow anxious whenever the mortgage payment comes due, it would be beneficial to replace whichever negative habits we had (like drinking or using other drugs, or even just behaving irritably) with healthier ones that calm us. Generally, there is a sequence to habit forming:

• Cue/Reminder: the trigger that initiates the behavior
• Routine: the reaction to the cue/reminder, and
• Reward: the benefit gained from doing the routine or behavior

By paying attention to the cue or reminder, we can begin to respond with new routines. Whereas before we responded to the mortgage payment with drinking or irritability, we would now replace it with a new routine like calling our sponsor or going for a run. The benefits and rewards of healthy routines will naturally arise and reinforce our new behavior. If we cannot find the benefit or reward, it's time to look at a new response or routine. Over time, these habits will quicken our calm and support our sobriety.

It might be worth making a list:

• The activities that I engage in that trigger me (work meetings at a bar, mowing the lawn, etc.)
• The things that often happen to me that trigger me (bills come due, social anxiety, etc.)
• The recovery behaviors that strengthen my emotional and spiritual resolve (meditating, walking the dog, reading)

Then we can attach a desired behavior or routine to the things that trigger us. Every time we confront a known trigger, we will thereafter have a hot cup of tea and read a book (or whichever routine you like most). This way, we can create grounding rituals and coping routines for each of our stressors and triggers.

Mindfulness-Based Techniques for Addiction and Recovery

Research has shown that mindfulness-based techniques have an incredible effect for those of us in recovery, reducing cravings even more efficiently than treatment.¹ And that's a large part of preventing any relapse. By reducing our cravings, focusing on the present and engaging in activities that restore some level of calm or bliss, we can completely rewire our brains.

Mindfulness-based therapy and techniques are all about the present. We sit quietly and pay close attention to the thoughts and feelings that we're experiencing this moment without any judgment. We don't try to act upon them or solve them. We simply accept them. These thoughts are a part of our lives: we shouldn't react to or dodge them, but allow them their space to come and go.

When we practice mindfulness and grow familiar with the reoccurring thoughts that trigger us, we can make a game plan around them. If we sit and listen to our thoughts and notice a strong reaction to specific feelings or thoughts, we can now add those to our trigger list. And we can plan to respond with our grounding techniques.

If you'd like to learn more about mindfulness-based cognitive therapy or relapse prevention techniques, you can always reach out to a recovery expert for guided instruction.

Warning Signs of a Potentially Impending Relapse

Drug or alcohol relapse doesn't come from nowhere. It happens in definable, recognizable and preventable stages with telltale emotional patterns and other indicators. With some effort and practice, we should be able to detect the smallest and earliest signs of a potential relapse. Then we can address the issues as they arise and find a healthy way forward.

So what are some warning signs of an impending relapse? Below we've provided a few stages in thought and attitude that could suggest a relapse is coming:

• At first, we undergo a shift in attitude and thought that others might notice even before us.
• Then we return to old patterns of behavior, like being quick to anger or slow to respond to responsibilities.
• We then slowly withdraw from AA or other recovery support groups.
• And finally, we experience an emotional crisis and a return to use (relapse).

Relapse Prevention Means More Than Abstinence

The importance of a strong relapse prevention plan cannot be overstated. Preventing relapse sounds like a secondary goal, but it's a powerful tool in any recovery. For those times when we find ourselves alone, we need to have a plan. Ultimately, even if our sobriety isn't at risk, these tools will flesh out our recoveries and add color, meaning and emotional grounding to our daily lives.

If you or someone you know is struggling with maintained sobriety, please reach out to Hazelden Betty Ford for answers and help at 1-866-831-5700. You don't need to manage the situation alone. Substance use disorders of all varieties are common and treatable, and there is no shame in needing help with addiction. We're here for you.