Relapse Prevention 101Anna Ciulla
Drug addiction is neither chosen nor curable, but a chronic illness like asthma, cancer or diabetes. While proper treatment can send symptoms into remission, there’s always risk they’ll come back.
The danger of recurrence—or “relapse” as addiction-disorder specialists call it—is greatest when basic health precautions are neglected. Yet even those who do everything right aren’t completely safe. Addiction changes physical brains in ways that impair self-control: in some circumstances, temptation may become literally impossible to resist. Rates of relapse for addiction are on the high side: 40 to 60 percent.
Yet there’s hope:
- Relapse into drug use (or any other active form of chronic illness) doesn’t mean treatment has “failed.” It simply indicates a need for fresh medical attention and reevaluation of treatment.
- One relapse incident needn’t mean sliding back into full-blown addiction. Prompt corrective measures can enable clients to regain their footing with a brief detox.
- If the average addiction-treatment client has a 40 to 60 percent chance of relapse, that means he or she also has a 40 to 60 percent chance of avoiding (The odds of symptom recurrence differ little from those associated with asthma, diabetes or hypertension.)
- Moreover, “40 to 60 percent” is only an average: individual odds may be considerably less. And anyone can take measures to improve individual odds.
The rest of this article will focus on specific hints for relapse prevention.
MANAGE STRESS EFFECTIVELY
Over three-fourths of relapses are triggered by stress or stress-related issues. While it’s impossible to eliminate all stress, much can be done. The key aspects of stress management are:
- Good general health practices. The healthier the body, the stronger the brain and the greater the self-control.
- A “relaxed” approach to life. It’s no coincidence that many treatments for insomnia—cognitive behavioral therapy, progressive relaxation, meditative prayer—are also effective in reducing waking-hours stress.
- Awareness and acceptance. Both reduce relapse triggers connected to worry, denial and false guilt. Try mindfulness meditation for preventing relapse.
- Healthy relationships. Positive, encouraging people are always less stressful to be around than complaining, controlling types.
- A sense of purpose. People who enjoy creative hobbies, find meaning in their work, and believe in a Higher Power are less stressed even in challenging times.
KNOW YOUR TRIGGERS
Stress management alone doesn’t make anyone relapse-proof: sometimes, the most dangerous triggers come when people lower their guard to enjoy themselves. (Rates of alcohol relapse may run as high as 90 percent, partly because alcohol is a socially accepted part of celebration and relaxation.) Staying sober around the holidays is a challenge for many people, and may necessitate tough measures such as declining an annual invitation and instead volunteering at a food pantry.
Celebration- or stress-related, the most common triggers for relapse are:
- Locations (or places that resemble locations) where drugs were used or bought
- Drug-using acquaintances (including social drinkers)
- Times of heavy responsibility
- Pay day (which the brain associates with buying drugs)
- Strong emotions such as guilt, anxiety or even euphoria
- Sights, sounds or smells associated with drug experiences
Not everyone is tempted by all the above. Know what’s a trigger for you, and do everything possible to avoid it.
HAVE A RELAPSE PREVENTION PLAN
Knowing personal triggers also plays a key role in relapse prevention plans, which no one should leave treatment without. Every plan should be written out and answer the following questions as specifically as possible:
- How will I keep aware of my sobriety motivations?
- What locations and people will I avoid? What will replace them?
- What triggers will I meet? How will I defuse them?
- What self-care skills will I practice regularly?
- What support groups will I attend, and when?
- Whom will I call in case of temptation?
- Do I know the early warning signs of potential relapse (depression, irritability, getting slack on relapse prevention, reminiscing about “good old days” of drug use)? How will I nip them in the bud?
- In case of a slip, what immediate actions will I take to keep it from becoming full-blown relapse?
- Who will hold me accountable for sticking to all the above?
CONSULT A DOCTOR
Support networks should include professional as well as personal contacts. Just as the success rates of addiction treatment are improved by opting for real treatment—seeking professional help instead of toughing out withdrawal alone—the best ally against relapse is often a primary care provider.
- A doctor provides patient-specific advice on insomnia, dietary needs and other general-health issues.
- A doctor can diagnose and treat mental illnesses that might increase relapse risks.
- If the addiction involved prescription medications and the original health issue still exists, a doctor can recommend alternate medications.
- A doctor brings professional perspective to controversial issues such as whether to provide methadone or naltrexone for opiate cravings. (Opiate relapse dangers present special concerns because some treatments can lead to new addictions, and because many opiate addictions originate with legitimate prescriptions.)
That said, some doctors would rather throw pills at symptoms than make time to discuss concerns in depth. Choose your provider carefully (the addiction treatment center may have recommendations).
KEEP A POSITIVE ATTITUDE
The most important points to remember are:
- Addiction is not destiny.
- Relapse is neither inevitable nor irreversible.
- A happier, healthier future is always
For related information on relapse prevention, see the following articles:
- Addiction Relapse Rates Compared to Those for Other Chronic Illnesses
- Addiction Triggers: How to Prevent a Relapse
- Coping with Negative Emotions in Addiction Recovery
- How Mindfulness Can Prevent Relapse
- How to Celebrate the Holidays While in Recovery
- How to Make a Relapse Prevention Plan with Your Loved One in Recovery
- Key Elements of Relapse Prevention
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