Using Diet, Exercise, and Sleep to Prevent Relapse
Relapses are a common part of the recovery process. But they aren't inevitable. Making certain lifestyle changes, and learning and practicing relapse prevention techniques, can lower the risk of relapse and increase the chance of a sustained recovery.
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Healthy Lifestyle Changes to Prevent Relapse
One of the most effective ways to prevent a relapse is to establish new, healthy habits in recovery - especially ones you are motivated to do and are excited about. You can make a number of changes to promote a drug-free lifestyle, including:
- Changing your diet.
- Starting an exercise program.
- Paying more attention to your mental health.
- Managing stress.
- Modifying your sleep habits.
- Spending more time around people who do not use drugs.
Many people in recovery neglected their diet while they were addicted. They may have developed nutritional deficiencies by not eating regular meals, not eating enough due to loss of appetite, limiting the bulk of their caloric intake from alcohol, or eating too much junk food.
Proper nutrition can promote recovery in a number of ways, including:
- Helping the body heal damage from addiction.
- Boosting energy levels.
- Improving mood.
Increased energy levels and improved mood can lower the risk of relapse. Recovering users may be more likely to reach for a substance when they are feeling tired or depressed.
A few dietary changes you can make immediately include:
- Drinking less caffeine. Caffeine (from coffee, soda, energy drinks) can disrupt sleep and lead to a crash, which causes people to drink more caffeine. It can also raise blood pressure and suppress appetite.
- Avoiding processed foods. It may be tempting to reach for a frozen dinner when you're on the run, but beware: These foods tend to be high in sodium and fat.
- Eating more protein and fiber. Foods high in fiber help you feel full, so you don't overeat. Protein can help rebuild muscles that have been weakened from malnutrition.
- Eating regular, small meals. This keeps your blood sugar levels up and can prevent unhealthy snacking.
- Watching your sugar intake. Like caffeine, sugar can lead to an increase in energy followed by a crash. Sugar can be tempting for people in recovery because it affects dopamine activity.
Exercise helps prevent relapse by:
- Curbing cravings for drugs and alcohol.
- Releasing endorphins.
- Reducing stress.
- Increasing energy levels.
- Improving self-confidence and body image.
The key to getting into an exercise routine is to find activities you enjoy. If you have a hard time getting motivated to exercise, find someone else to do the exercise with you, join a recreational sports team, or look for a local social group on Meetup that does sports.
Some forms of exercise you might try include:
- Team sports.
- Martial arts.
If you've never exercised before, or it's been a while since you participated in a sport, you might want to meet with a physician first.
Further, be careful about how much you exercise. Some people develop a compulsive pattern of exercising, which can cause injury and affect the person's life in much the same way as an addiction.
One of the triggers for a relapse is emotions. A number of emotions can lead to relapse, including:
Monitoring your moods and taking care of your mental health can help head off a relapse. There are a number of ways to do this, including:
- Making sure you are not spending too much time alone.
- Being aware of negative emotional states and taking steps to deal with them, such as calling a friend, family member, or sponsor to talk about the feeling.
- Becoming involved in activities that engage you and make you feel good, such as hobbies, spending time with friends, going to 12-step meetings, and finding a job you like doing.
- Getting assessed and treated for any serious conditions that require medication, and taking medications as prescribed.
- Attending support groups and/or seeing a therapist for mental health conditions.
Stress is also a big contributor to relapse. Similar to monitoring your moods, it helps to take a proactive approach to managing stress.
First, become familiar with the signs of stress:
- Muscle tension.
- Chest pain.
- Trouble focusing.
- Undereating or overeating.
- Trouble sleeping.
- Racing thoughts.
- Developing an exercise routine.
- Getting enough sleep (more on sleep in the next section).
- Reducing sugar and caffeine intake.
- Building a support network you can turn to in times of stress.
- Using breathing techniques, such as belly breathing.
- Participating in yoga.
- Practicing meditation.
As with exercise, find something that works for you and that you enjoy doing.
Getting enough sleep can help you feel more rested and alert, and less vulnerable to a relapse. The better you feel, the less likely you will be to experience a craving.
Here are some tips for how to get better sleep:
- Go to bed at the same time every night.
- Turn off all electronic devices at least an hour before bedtime.
- Don't eat or drink anything at least three hours before bedtime.
- Only use your bed for sleeping and sex.
- Avoid alcohol, nicotine, and caffeine before bed.
- Do a relaxing activity before you go to sleep, such as reading.
If many of your friends are still using, you can try to connect with other sober people through:
In general, make an effort to spend time around people who do not drain your energy and are supportive and positive.
Drug addiction has psychological and physiological components, both of which must be properly addressed in order to minimize the chance of a relapse.
Psychological methods of treatment help people to address the issues that may have caused them to become addicted to drugs. Psychologists and counselors generally encourage recovering users to live a drug-free and sober lifestyle. Some programs also encourage people to change any habits that make it difficult for them to stay sober.
Due to the high relapse rates among recovering users, most treatment programs consider the recovery process to be a continuous process that does not have a specific end date. Most rehabilitation programs also promote abstinence rather than moderation, particularly if the drug being abused is illegal.
Psychological Therapy for Relapse Prevention
The types of behavioral therapy commonly used to treat drug addiction and prevent relapse include:
- Cognitive behavioral therapy - helps users cope with situations that are likely to result in a relapse.
- Multidimensional family therapy - improves the user's ability to function within a family setting.
- Contingency management - encourages abstinence from drugs using positive reinforcement.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is the most common approach used to prevent drug relapses. Dr. Alan Marlatt describes the cognitive behavioral approach in his 1985 book, Cognitive Factors in the Relapse Process.
Marlatt recognizes the following psychosocial processes in addiction and relapse:
- Self-efficacy - the ability to deal effectively with situations that are likely to provoke a relapse.
- Outcome expectancies - the person's expectations about the effects of an addictive drug.
- Attributions of causality - the person's belief that a relapse is caused by internal factors as opposed to external ones. A person with internal attributions of causality is more likely to relapse when unusual external circumstances occur.
- Decision-making - making decisions that collectively result in a relapse. Marlatt also emphasizes that some decisions that recovering users make appear to be insignificant. Marlatt refers to these decisions as apparently irrelevant decisions.
The following is a common example of an apparently irrelevant decision. If a person in recovery from alcohol addiction encounters heavy traffic on the way home from work, he or she may decide to take an alternate route home. This decision may result in a high-risk situation if the person inadvertently drives past his or her favorite bar. People who are recovering from alcohol addiction who haven't learned coping skills may begin thinking about their craving for alcohol, increasing the risk of a relapse.
CBT Relapse Prevention Techniques
Cognitive behavioral therapy teaches recovering users a number of strategies to help prevent relapse, including: 1
- Identifying triggers. Therapists help users come up with a list of things that trigger them to use.
- Avoiding triggers. The therapist and the user discuss how the user can avoid triggers, such as staying away from bars or friends who use drugs.
- Distraction. The user prepares a list of activities he or she can do when experiencing a craving, such as going for a walk, exercising, watching TV, or calling a friend or family member.
- Self-talk. The user learns how to confront and reframe automatic thoughts that occur when he or she feels an urge to use. For example, a user might think, "I can't handle this craving. I have to use." The user then reframes this thought as, "The craving will pass. I don't have to use to get rid of it."
- Recalling negative consequences. When the user feels an urge to use, he or she thinks back to some of the bad things that have happened as a result of his or her drug use, such as a DUI, feeling hungover, hurting loved ones, and stealing.
Medical Therapy for Relapse Prevention
Medical therapy, or medication-assisted treatment, is most often used with people who have addictions to opiate or opioid drugs such as oxycodone, heroin, and morphine. It can also be used for people suffering from alcohol addiction.
Methadone and Buprenorphine
Methadone has historically been the primary pharmaceutical option for the management of opioid dependence. Buprenorphine is a more recent treatment that is available as a generic drug, or marketed under brand names such as Suboxone and Zubsolv.
These drugs mitigate the unpleasant symptoms of acute opioid withdrawal and help to reduce cravings for opiates. They are often used during the detoxification phase of a drug rehabilitation program. Methadone and buprenorphine can both be taken over a long period, which also makes them suitable for maintenance therapy and eventual tapering, should total abstinence be the end goal.
The drugs are most effective when combined with behavioral therapies and other supportive services. 1
NIDA reports that recovering drug users are usually able to retain their jobs and avoid the consequences of illegal drug use once they are stabilized on an effective dosage of buprenorphine or methadone. 1
Naltrexone is an opioid receptor antagonist, meaning that it blocks the euphoric effects of opiate drugs. However, it is also effective in the treatment of alcoholism. It diminishes the rewarding effects and can curb cravings for both alcohol and opioid drugs. It has no potential for abuse, and it is not addictive.
Naltrexone is best-suited for people who are highly motivated to remain abstinent and recently detoxed.
Medications for Alcohol Abuse
Besides naltrexone, other medications can be used to help prevent alcohol relapse, including:
- Disulfiram (Antabuse). Disulfiram causes the user to experience nausea, vomiting, dizziness, and other other unpleasant sensations when he or she drinks alcohol. If taken as prescribed, it can help to discourage someone from drinking.
- Acamprosate (Campral). Acamprosate corrects chemical imbalances in the brain that are the result of long-term alcohol abuse. It can help reduce cravings if taken regularly.
Get Relapse Prevention Help Today
The proper relapse prevention care can make a drug or alcohol relapse less likely. Call 1-888-319-2606 for information on how to prevent a relapse before it occurs or information on how to come back from a relapse.
. National Institute on Drug Abuse. (2012). Opioid Addiction.
. National Institute on Drug Abuse. A Cognitive-Behavioral Approach: Treating Cocaine Addiction.