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Long-term recovery from a substance use disorder requires strategies for preventing relapse that help you cope with various addiction triggers. These cues to drink or use drugs can be especially challenging to navigate during early recovery. This article will educate readers on common addiction triggers and how to avoid them, as part of a larger discussion of relapse and effective relapse prevention.
Relapse and Relapse Prevention
According to its more clinical definition as articulated in at least one study, relapse is “a setback that occurs during the behavior change process, such that progress toward the initiation or maintenance of a behavior change goal (e.g. abstinence from drug use) is interrupted by a reversion to the target behavior.” Put more simply, relapse is a return to drug or alcohol abuse.
This return to drugs or alcohol is clinically understood as a “gradual process with distinct stages,” according to another study published in the Yale Journal of Biology and Medicine. (In fact, each stage of recovery has its own risks of relapse, the same study explained.) The goal of treatment is therefore to help individuals recognize the early stages of relapse, when their chances of successful intervention are greatest. “Relapse prevention” is the name given to this objective.
Relapse prevention is also a psychosocial model for clinical intervention that, thanks to its evidenced recovery outcomes, is now an integrated component of most drug and alcohol treatment programs. Specific interventions to prevent relapse can include:
- Identifying (on an individual basis) high-risk situations and improving coping skills for these situations
- Increasing the client’s self-efficacy and self-advocacy
- Eliminating myths regarding alcohol’s effects
- Managing lapses
- Reframing perceptions of the relapse process
Common Relapse Triggers
During early recovery, various people, places, feelings and things can trigger the compulsion to use. And there are countless potential triggers, according to Dr. John Craven, a medical doctor, in a presentation on how to prepare for relapse triggers. Craven qualified this assertion by stating that most individuals with a substance abuse problem have one or two situations or people who are most dangerous to their recovery. In other words, effective relapse prevention identifies and targets these biggest personal triggers.
Common relapse triggers appearing on Craven’s list can include the following (which will vary from one person to another, depending on their addiction history):
- Walking into a pharmacy or bar
- Going out alone at night
- A friend who continues to use
- A difficult boss
- Certain feelings and emotions, like anger, shame, self-pity and fear
An article in Addiction Professional listed still other triggers to watch for, based on the clinical observations of an addiction therapist, Brian Duffy. Duffy laid out the top six triggers he has encountered in his practice. They are:
- Money, usually in the form of a fresh paycheck or visit to the ATM that triggers an urge to spend your money on drugs or alcohol.
- Romance and the common assumption in today’s dating world that alcohol and going out for drinks are the way you meet and/or date someone.
- Friends or family, especially those who may still be using and/or expect you to be part of situations where alcohol or other substances are readily on hand.
- Forgetting where you came from — Remembering your previous life through colored lenses and forgetting just how bad off you were because of the old habit.
- “Because I can” — Situations in which a previous constraint, such as a sober living environment, has lifted, leaving you open to the false notion that now you can get away with drinking or using drugs.
- Emotional highs and lows, especially during early recovery, when the absence of a substance can cause previously buried emotions to rise to the surface with greater intensity and unpredictability.
How to Manage Common Triggers
Identifying these common triggers is the first necessary step in preventing a return to drugs or alcohol. What follow are four other key steps for managing relapse triggers (and this article in Psych Central expands on them):
- Accept your triggers. After you have identified your triggers, you must accept them as part and parcel of what it means to be in recovery from an addiction. That means staying honest about the fact that these triggers can and will happen to you (as opposed to lying to yourself about your immunity to these temptations).
- Devise and practice a plan for dealing with your biggest triggers. Here working with a therapist or 12-Step sponsor can be of great help. You’ll need to write down a plan and commit it to memory. Then role-play what you will do when you begin to sense the onset of a trigger-related urge.
- Maintain a healthy plan of self-care. A nutritious diet, regular exercise, good sleep hygiene, and a daily spiritual discipline like meditation are helpful preventative health measures that make you more resilient to relapse triggers.You can also memorize the acronym “HALT,” which stands for “Hungry, Angry, Lonely and Tired.” These four states can become substance abuse triggers. The more self-aware you can become, the better equipped you will be to notice whether one or more of these four states is affecting you. Taking care of yourself thus involves paying attention to your inner state and meeting these inner needs promptly and in a healthy, constructive way. (This article in Sober Nation offers more tips on the HALT strategy for preventing relapse and how to apply it.)
- Do not test yourself by putting yourself in the very situations that you know are triggers for you. For example, if you know that the local gas station was where you used to stop for beer every day on your way home from work, only to binge drink the rest of the evening, you can safely assume that stopping for gas at the same gas station will be a dangerous trigger. You do not need to test this theory out. Instead, find another place to fill up your gas tank.