Managing Relapse Triggers
Part of staying clean and sober is learning how to identify triggers and, next, how to cope with them. Almost everyone has triggers, and it's nearly impossible to ignore them. However, if they are not properly managed, they can lead to a relapse.
This article covers:
What Is a Relapse?
The causes, or triggers, of a relapse are often similar regardless of the specific drug that was used.
According to the Substance Abuse and Mental Health Services Administration, triggers are events or circumstances that can lead to uncomfortable feelings such as anxiety, panic, anger or despair. 1
Triggers are likely to affect people in recovery sooner or later. But if the person doesn't learn to recognize them and develop an effective response to them, they can lead to a return to drug use or other destructive behaviors. 1
Any stimuli the user associates with drug use can serve as a trigger for a relapse, including people, places and things. But triggers can be classified into 3 general groups.
- Environmental triggers often include social events or circumstances that were once associated with using the drug.
- Re-exposure triggers include circumstances that bring the user into proximity with a drug of abuse, and this can reinstate the drug-seeking behavior.
- Stress triggers typically include such emotions as anger, fear, anxiety, and sadness.
These stimuli can cause a neurochemical response that induces an intense craving for the drug and may lead to a relapse. The feeling can be overwhelming and difficult to manage without the proper skills or support.
Triggers do not have to be negative, either. For example, you may be walking down the street and pass a bar. The sights and sounds may remind you of good times when you used to drink with friends. Or you may receive a promotion or a pay raise at work and feel compelled to celebrate by having "just one drink" or a "hit."
- Financial problems.
- Ending a relationship.
- Being yelled at or criticized.
- Family problems.
- Seeing drug use or alcohol commercials on TV.
- Feeling overwhelmed.
- The anniversary or a loss or trauma.
- Certain sights, smells or sounds.
- Being around certain people or in certain environments, such as bars or parties. 1
One way to deal with triggers is to make a list of your triggers and then come up with another list of actions you can take to deal with them. 1
Some actions you can take when you are faced with a trigger include:
- Call a sponsor in your 12-step program or another support person.
- Go for a walk or engage in another form of exercise.
- Do an activity such as playing an instrument or writing in your journal.
- Meditate or do a deep breathing exercise.
- Distract yourself with a book or a movie.
- Use self-talk to remind yourself of the negative consequences of drug or alcohol use.
You can also take proactive steps to deal with triggers, such as: 2
- Take a class in anger management or assertiveness training.
- Work with a therapist if you have experienced physical or emotional abuse.
- Make an effort to avoid people and places associated with drug use.
- Stay away from any abusive substance, even if it is not your drug of choice.
- Take good care of yourself by eating well, getting enough sleep and exercising.
Treatment programs and therapists will often use certain approaches to reduce the likelihood of a relapse. These approaches can be classified into 2 general categories:
- Medication therapy.
The purpose of medication therapy for drug addiction is to reduce the initial drug use, stabilize the user and prevent a relapse. Medication can help correct the long-term changes in the brain caused by prolonged drug abuse and reduce cravings. 3
Medications are available to help treat opioid, tobacco and alcohol addiction, and medications to treat stimulant and cannabis addiction are in development.
Some of these medications include: 3
Methadone and buprenorphine target the same receptors in the brain as heroin and morphine. They do not produce the same "high" as heroin, but they produce enough of an effect to help relieve withdrawal symptoms and lessen cravings. Naltrexone blocks the effects of opioids, but has also proven to be beneficial in managing cravings for alcohol. 3
Acamprosate can help reduce symptoms of alcohol withdrawal, while disulfiram produces unpleasant physical effects when someone consumes alcohol. The person may learn to associate the effects with alcohol use and refrain from drinking as a result.
Psychotherapy primarily deals with identifying relapse triggers and teaching coping skills.
- Cognitive behavioral therapy was developed to help prevent relapse in problem drinkers. It was later adapted to treat people addicted to cocaine and other drugs. The therapist helps the user anticipate triggers and develop coping strategies. The person may also be asked to consider the negative consequences of drug use and learn how to avoid situations that may trigger them to use. 4
- Contingency management reinforces abstinent behavior with a system of rewards and punishments. For example, contingency management often provides people with vouchers when they abstain from drugs. The person may then redeem these vouchers to purchase retail items. 4 The treatment can help reinforce positive behaviors instead of drug use.
Get Help for Drug and Alcohol Relapse Treatment
If you are concerned that you or someone you know may be at risk of a relapse, call 1-888-319-2606 today. If you are experiencing a relapse, we can help you find the right addiction recovery program to get you back on the road to recovery.
. Substance Abuse and Mental Health Services Administration. (2003). Action Planning for Prevention and Recovery
. Substance Abuse and Mental Health Services Administration. (2010). The Next Step...Toward a Better Life.
. National Institute on Drug Abuse. (2016). DrugFacts: Treatment Approaches for Drug Addiction.
. National Institute on Drug Use. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.