After a person has gone through an addiction treatment program, it’s important to implement techniques of relapse prevention.
Relapse prevention can come in many forms: From structured behavioral therapy to support groups, a person in recovery can find a technique that works for them.
It’s important to note that relapse is a very common part of the recovery process. If you or a loved one relapses, don’t give up hope. There are many ways to prevent and treat a relapse.
What Is Relapse Prevention?
Relapse prevention programs help recovering individuals abstain from the use of substances after they’ve gone through treatment for addiction.
This is a cognitive-behavioral approach that focuses on the physical, mental, and emotional aspects of recovery.
The National Center for Biotechnology Information (NCBI) states that relapse prevention reduces the likelihood and severity of relapse after a person quits using drugs or alcohol.
The NCBI defines relapse prevention as having two primary aims:
- to prevent initial relapse and maintain abstinence
- to provide lapse management if a relapse occurs
Why Relapse Prevention Is Important
Relapse prevention cannot exist without an initial treatment program, nor can an addiction program provide long-term success without relapse prevention strategies in place.
These are complementary programs designed to work in balance with one another.
During inpatient or outpatient addiction treatment, you’ll learn new coping strategies, work through trauma, create a system of support with family and peers, and much more.
But these skills must be cultivated outside the walls of a treatment facility if long-term sobriety is to be attained.
Especially if you’re returning to old environments and people, it’s much more likely that the issue will return without the continued support of prevention measures.
This is because it’s easy to forget the skills learned in classes, stop going to support meetings, and let go of the important progress made through therapy in your rehab program.
Programs focused on continuing the development of these skills and factors help to keep a person motivated to pursue sobriety and create a healthier life for themselves post-treatment.
Types Of Relapse Prevention Programs
Relapse prevention programs typically involve in-person treatment; however, some services may be available via telehealth if you need virtual treatment.
Here, we’ve broken down the primary forms of relapse prevention programs.
Therapy may be used by itself or incorporated into a larger program.
This is one of the most important steps of relapse prevention, as it offers the individual a healthy outlet to cope, discuss their roadblocks to recovery, work through emotional pain, and more.
Several therapies may be used, including:
- motivational interviewing
- cognitive behavioral therapy (CBT)
- dialectical behavior therapy (DBT)
- contingency management
- family therapy
For those recovering from opioids or another substance that causes uncomfortable withdrawal symptoms, medication-assisted treatment (MAT) may be beneficial.
MAT uses a combination of medication and behavioral therapy to take a whole-patient approach to recovery.
Medications help to alleviate the symptoms of withdrawal and reduce cravings, allowing the individual to focus on other aspects of recovery.
The program may last for a few months, years, or indefinitely, as you may use medications to assist in pain relief for as long as you need.
Peer Support Programs
Many relapse prevention programs involve peer support and mentoring. The goal of peer support is to provide a network of people who empathize with your situation and aid in acceptance.
These programs might include:
- Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings
- group counseling sessions
- SMART Recovery
- peer recovery coaching
Strategies Used In Relapse Prevention
There are also many evidence-based techniques a treatment program might employ. Below are three common strategies often used in relapse prevention.
Learning To Handle High-Risk Situations
High-risk situations can be defined as circumstances in which a person’s sobriety might be threatened.
These situations can include spending time with friends who abuse substances, experiencing stress, or visiting places that trigger a desire to use substances.
Relapse prevention addresses high-risk situations by focusing on:
- recognizing what a high-risk situation is
- how to address a high-risk situation
- how to avoid a high-risk situation
- managing your response to these situations
- developing skills for recovering from those situations
Enhancing Self-Efficacy In Relapse Prevention
Self-efficacy is a person’s attitude and beliefs about their ability to succeed in completing tasks to reach a goal. Low self-efficacy can significantly impact a person’s recovery process.
Many people feel powerless over addiction and incapable of stopping the behavior. Relapse prevention redefines this warped view of one’s abilities.
With this technique, recovering individuals learn that overcoming substance abuse has little to do with willpower and everything to do with skills acquisition.
One such way to enhance self-efficacy is to create smaller, achievable goals so a person has a better chance at accomplishing each task.
This provides a level of encouragement and motivation to push forward and apply the same ideas to other goals in life and addiction recovery.
Cognitive restructuring is used in cognitive behavioral therapy. This technique involves reframing thought patterns and behaviors.
Here are some common negative thought patterns many people have who abuse substances:
- “I am alone in this, no one can help me.”
- “I’ll never be able to get over this addiction.”
- “I don’t need help, I can do this on my own.”
- “Just one drink won’t hurt me.”
- “Rehab doesn’t work, it’s not worth it.”
- “I can’t get through today without a drink/drugs.”
In a relapse prevention program, treatment specialists work to restructure these ideas and replace them with better alternatives.
For example, a thought like, “I’m so alone,” or “I’ll never get over this,” might be replaced with something like, “I’m not alone, I can get through this with support from people.”
What Might Trigger A Relapse?
A relapse can be triggered by numerous internal and external factors. A person’s individual experience with addiction determines what those triggers are.
There are several physical, mental, and emotional triggers connected to substance abuse responses.
Physical Triggers Of Relapse
One of the most difficult parts of recovering from addiction is addressing the potential physical roadblocks to recovery.
Physical triggers include people, places, and other external situations that can cause relapse.
Common physical triggers that may lead to relapse include:
- withdrawal symptoms
- being in close contact with a substance
- seeing others use a substance
- visiting places you associate with the addiction, such as a certain neighborhood, hotel, bar, or club
- seeing people you associate with substance abuse
- spoons, needles, baggies, papers, bottles, and other paraphernalia that may have been used to abuse substances
- going to a friend or family gathering
- pressure from outside forces
- pain or medical issues
Emotional And Mental Triggers Of Relapse
A person might also experience mental and emotional effects post-treatment that can threaten their sobriety.
Some of the most common emotional and mental triggers are:</strong.
- lack of motivation
- low self-esteem
- meeting new people
- paying bills or debt
- times of celebration, such as a holiday or birthday
- being alone
- feeling happy, excited, or another positive emotion
- a lack of social support or community
- negative emotions, such as depression, fear, anxiety, guilt, or shame
- relationship issues
- problems at work, or with securing employment
- boredom, or a lack of stimulation
- feeling embarrassed
- internal struggles with trauma
- uncovering something difficult in therapy
- life changes
The Role Of Decision-Making In Relapse
Many of these triggers are what researchers consider seemingly irrelevant decisions (SIDs). That is, decisions that seem harmless but have the potential to elicit cravings and cause relapse.
For example, if a person knows that they’re most likely to drink when they’re alone in the evenings, deciding to spend the night in is a seemingly irrelevant decision.
But for this person, a night spent alone is not irrelevant or harmless, it has the power to overwhelm the progress they’ve made and induce a relapse.
So, it’s best to avoid this type of high-risk situation by putting barriers and support in place (for example, going to AA meetings in the evening time).
Signs Of Relapse
Relapse occurs in three stages: emotional relapse, mental relapse, and physical relapse.
The first two stages are what instigate a physical relapse. If you can recognize the early stages of relapse, you can take action before a physical relapse occurs.
Signs of emotional relapse include:
- emotional distress, such as depression or anxiety
- avoiding meetings, or staying quiet in meetings
- avoiding family and friends
- lack of sleep
- poor eating habits
Signs of mental relapse include:
- hoarding money to spend on substances
- spending or stealing money to get drugs or alcohol
- thinking about drugs or alcohol
- making a plan to get drugs or alcohol
- reaching out to people associated with the addiction
- seeking opportunities to relapse
- planning relapse
Signs of physical relapse include:
- buying drugs or alcohol
- using substances
- inability to control substance use
What To Do If You Relapse
This is where all of the tools of treatment and relapse prevention come in: If you relapse, you can rely on the support you built during these programs and continue your recovery journey.
In the event of a relapse, there are a few important steps you can take to get yourself back on a positive track toward sobriety.
Here’s what you can do if you relapse:
Reach Out For Support
The first step is to reach out to other people for help.
- seek help from a counselor or therapist
- attend an AA or NA meeting
- get together with your sponsor, if you have one
- meet with friends and family with whom you have a healthy relationship
- attend a detox clinic, if needed
- surround yourself with positive influences
Address Your Triggers
If any of the triggers in the list above resonated with you, sit down and create a mental or physical list of the triggers you need to address and avoid.
Take active steps to better prevent those triggers from happening, and create a plan of what to do if and when you run into those triggers again.
Attend A Rehab Program
If you’ve already been through an inpatient or residential rehab program, you might not have the ability to commit to another full-time treatment facility.
There are many other options for part-time support that you can attend.
- standard outpatient program (OP): This is the lowest level of outpatient treatment, and may only involve one to three hours of programming per week.
- intensive outpatient program (IOP): For a step above standard OP, an intensive outpatient program can provide further structure and counsel after a relapse.
- partial hospitalization program (PHP): As the highest-intensity option, PHP is best for those who need to spend the majority of their time in treatment to prevent drug abuse.
- individual and group counseling: Many outpatient programs offer individual, group, and family sessions, which can help to provide emotional support after relapsing.
Tips For Relapse Prevention
If you or a loved one are working on recovering from addiction, the most important things to consider are self-care and how to honor your needs during this time.
When you take care of yourself physically, emotionally, spiritually, and otherwise, you’re building your toolset to say no to old habits and begin better ones.
Here are a few ways you can prevent relapse:
- recognize, address, and avoid high-risk situations
- incorporate a healthy diet
- exercise or get active
- get quality sleep
- stay connected to people
- engage in holistic practices, such as yoga, meditation, or mindfulness
- practice visualization, imagining yourself successful in your health and sobriety
- address any underlying mental or physical health conditions
- place yourself in healthy environments
- if you’re in therapy or a relapse prevention program, try a new coping skill every day that you’ve learned
- stay in tune with your emotional state, journaling or reflecting regularly
- fill your schedule with activities, meetings, and time with people
- volunteer for a cause or organization you feel connected to
- National Center for Biotechnology Information — Addiction Relapse Prevention
- National Center for Biotechnology Information — Cognitive behavioral therapy
- National Center for Biotechnology Information — Relapse prevention
- National Center for Biotechnology Information — What Is the “Trigger” of Addiction?
- National Institute on Drug Abuse — Treatment and Recovery
- ScienceDirect — Relapse Prevention