Preventing a Relapse
Preventing an alcohol or drug relapse is more than just saying “no” in the face of temptation. Prevention needs to start early and before temptation presents itself. In fact, a comprehensive relapse prevention plan accounts for social interactions, emotional triggers and the development of positive coping mechanisms.
Learn more about preventing relapse, including:
- The importance of seeking support.
- Relapse warning signs to watch for.
- How to develop a relapse prevention plan.
- Things to avoid in recovery.
Staying Sober Is Not a Solo Gig
Whether you are dealing with drug or alcohol relapse prevention, staying sober is not a solo gig. By its nature, addiction isolates the addict. Conversely, recovery requires a network of support. As you move through your recovery process, make sure to interact on a regular basis with other people who are able to recognize issues and offer moral support.
The many benefits of finding a support group include:
- Gaining assistance with alcohol or drug relapse prevention plans.
- Reducing stress or depression through appropriate social interactions.
- Developing positive friendships with individuals who will not encourage drug or alcohol use.
- Learning to empower yourself and develop control.
- Engaging with an anonymous source of support and communication.
According to studies conducted by the National Institute on Drug Abuse, men experience relapses more frequently than women do after completing treatment programs for drug addiction. The main reason for this difference seems to be that women are more likely to seek outside assistance in the form of group counseling.
Prevention Means Watching for Warning Signs
The best way to prevent relapse is to understand warning signs and risk factors.
In some cases, relapse can occur suddenly, and people struggling with drug or alcohol cravings can give in without reaching out for help. The best way to prevent sudden relapse is to understand warning signs of addiction and factors that commonly lead to relapse. Factors vary for each person and situation, but relapse causes include emotional triggers, social situations and physical changes.
Some specific situations that can lead to relapse include:
- Loss of a loved one.
- Major financial changes.
- Change in employment.
- Social pressures or conflicts.
- Change in marital status.
- Boredom with life.
- Health issues.
When you or someone you love is in recovery, especially the first year, it is important to continually check for the warning signs of relapse and get help right away if they begin cropping up.
Relapse Prevention Requires a Plan
An important factor in planning for relapse prevention is to understand that you cannot control everything. For example:
- You can’t dictate what other people will do and say.
- You can’t control every environment.
- You can’t hide in the safety of your home forever.
While you can make positive decisions to minimize relapse triggers in your life, you may have times when you must deal with strong cravings.
Experts recommend calling someone who is also in recovery as soon as you experience a craving or feel like you are unable to control your craving. This is the basis of the sponsorship structure popular with programs like Alcoholics Anonymous (AA). In order to make sure you follow through, writing your plan out as a reference point can be helpful.
Create a Relapse Prevention Plan on an Index Card
While you should tailor your plan to what will work for you, below is an example of a quick plan that may help ensure you turn to healthy actions during periods of temptation:
- Create an index card you can carry with you in a wallet, purse, or pocket.
- On one side, record the names and phone numbers for several people you can call as soon as you experience any sort of craving.
- Include sponsors and hotline numbers.
- Include contact information for supportive family members and friends.
- On the other side of the index card, write down 5 things you can do if you start to experience cravings, such as:
- Going for a jog.
- Engaging in a social activity.
- Attending a recovery meeting.
Avoidance Is an Effective Tool
According to a study published in The American Journal on Addictions, avoidance behavior is one of the most successful addiction relapse prevention tools. What this means is avoiding what some refer to as slippery situations, such as:
- Locations where your substance of choice is easy to access, such as: bars or clubs, homes of certain friends or family members who use, and events where drinking will be prevalent.
- Hanging out with anyone who abuses drugs or alcohol.
If you cannot avoid a situation where temptation may arise, consider using a buddy system by asking a close friend, family member, or sponsor to attend the event with you.
There is an important caveat: Certain things are not healthy to avoid. Do not avoid situations that must be dealt with such as:
- Relationship issues.
- Your physical health.
Making Progress Every Day
It may sound like relapse prevention will be a daily struggle for your entire life. Try not to be too discouraged, however. With each day and each small success, it will get easier, and your cravings will not always be so strong. The key is taking positive and appropriate action each time you struggle with your addiction.
Frequently Asked Questions About Relapse Prevention
What Are Relapse Prevention Strategies?
Relapse prevention strategies are tools to help you remain sober after you leave a treatment center. You can meet with a therapist during treatment to go over relapse prevention strategies.
By starting early on your relapse prevention plan, you can feel prepared to handle any urges or cravings you may have as you transition out of treatment. Depending on your preference, therapists may use different approaches.
The original relapse model was created by a researcher named Dr. G. Alan Marlatt.1 This model is based off of cognitive behavioral therapy, a type of therapy commonly used in addiction treatment. Dr. Marlatt and a team of researchers later developed mindfulness-based relapse prevention (MBRP).2 MBRP uses a mindfulness approach to help people learn how to combat cravings. Both strategies are used today to help prevent relapse.
If you are interested in learning more about these approaches, you can watch the following videos:
What Activities or Exercises Can Help Prevent Relapse?
During treatment, you will meet with a therapist to discuss activities or exercises you can do to help prevent relapse. Most strategies are based on cognitive behavioral therapy.
Your therapist may discuss how you can self-monitor situations. Self-monitoring is when you notice that you are in a situation in which you are likely to relapse. This could be a particular environment or group of people who make you feel like you want to use drugs or drink again (these are also known as triggers). Working with a therapist on how to recognize these feelings and manage them is a big part of relapse prevention.
Attending 12-Step Groups
The most common way people prevent relapse is by attending a support group meeting or a 12-step group. These are groups such as Alcoholics Anonymous or Narcotics Anonymous. You can share your experiences with addiction and recovery with other people who have had similar experiences.
These groups also offer a structured program of recovery that you can follow. It involves admitting powerlessness over your addiction, making amends to people you’ve harmed through your addiction, and accepting a higher power to help you in your recovery.
You are also encouraged to work with a sponsor. This person is another member of the group who is in recovery and can offer guidance as you work the steps. You can also call this person if you are experiencing an urge to use drugs or alcohol again.
There are also a number of non-12-step groups. These include but are not limited to:
Replacing Your Addiction With Something Else
Your therapist may suggest that you replace your current dependence or addiction with something positive. Your therapist can help you figure out how to substitute your addiction with something that you find gratifying or that you get enjoyment out of. Examples of substitution could be anything from eating chocolate to spending more time with your family.
Other exercises to prevent relapse may include:
- Creating a relapse map that lets you write down what your options are when you’re in a trigger situation.
- Holding an ice cube until the craving or urge to use drugs or alcohol passes.
- Splashing cold water on your face to “reset.”
- Doing deep breathing/belly breathing to calm yourself when you’re having a craving.
- Distracting yourself—calling someone on the phone, cooking, cleaning, watching TV, reading, or exercising—until the craving passes.
- Rewarding yourself—buying yourself small gifts or treating yourself to dinner at your favorite restaurant when you resist a craving.
How Do I Develop a Relapse Prevention Plan?
A treatment center should help you create a relapse prevention plan prior to discharge. When you are looking for a treatment center, make sure to ask the therapists and doctors whether or not they work with people to develop relapse prevention plans. Making sure you have the tools necessary to handle cravings will be crucial to remaining sober.
Are There Worksheets or Workbooks to Prevent Relapse?
Some people find that worksheets and prevention workbooks are useful tools to help prevent relapse. If you are interested in learning how to use these tools in your daily life, you can meet with a therapist for more information. Your therapist can offer suggestions on which worksheets or workbooks would fit best for your situation. They can also walk through the process with you and instruct you on how to use the worksheets. For example, some worksheets ask that when you have a thought about using drugs or alcohol you stop and write it down, record your emotions, and note the outcome.
Dozens of worksheets are online. Some examples include:
Although there are many resources on the Internet, the best way to learn how to prevent relapse using these tools is by working directly with a clinician, such as a therapist.
What Types of Drug Treatment Are Available?
Inpatient and outpatient are the most common types of addiction treatment programs.
- Inpatient or residential programs require that you live at the center for the duration of your treatment. Inpatient treatment offers 24-hour medical supervision and care. During inpatient treatment, you may attend individual and group therapy sessions in addition to learning skills that will help you lead a healthy life without drugs or alcohol. These programs typically last between 30 and 90 days. Inpatient treatment allows you to separate yourself from your home environment, so that you can focus on your treatment without distractions.
- Outpatient treatment tends to work better for addictions that are not as severe, since outpatient programs do not offer 24-hour care. During outpatient treatment you can live at home and take care of responsibilities such as childcare, work, or school.
Both types of programs may include forms of therapy, including but not limited to cognitive behavioral therapy, contingency management, motivational interviewing, and family therapy to help you address issues underlying your drug or alcohol addiction.
- Larimer, M. E. & Palmer, R. S. (1999). Relapse prevention: An overview of Marlatt’s cognitive-behavioral model. Alcohol research and Health, 23(2), 151–160.
- Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 211–228.