Staying sober is hard work. Temptation is everywhere. It could be an old circle of friends calling to hang out, a stressful day at work or a difficult day dealing with withdrawal. It could be something as innocent as a family gathering, an office party, or a friend’s birthday.
Fighting the temptation to use again is the goal of everyone in recovery, but sometimes people succumb to temptation and relapse.
Why Do Relapses Happen?
Relapses fall into one of three categories: emotional, mental, or physical.
- An emotional relapse is triggered by great emotional strain. This could be a breakup, the death of a family member or the loss of a job.
- A mental relapse occurs from the belief that a certain task cannot be accomplished without substance use. For example, a student believes she can’t study without a pill, or a writer can’t write without marijuana.
- A physical relapse is directly tied to withdrawal. A person thinks he can’t sleep without his pill or needs a hit to perk up during the day.
Factors for Determining a Relapse
There are no set criteria that predict a relapse. It is a matter of an individual’s biological and psychological makeup and how he or she deals with the stresses of withdrawal.
The first factor is biology. This includes family history of addiction, drug sensitivity and the physical severity of withdrawal factors. Personality is important, too. This includes self-esteem, perception of the recovery progress and expectations for the future without drugs.
The second factor is environmental. Environmental triggers can cause a substance abuse relapse after a period of abstinence. Some of these are situational, including lack of support, availability of drugs and alcohol, and life events, such as a wedding, job concerns and the death of a loved one.
The drug of choice is a third factor. Not all drugs affect the brain in the same way. Heroin and cocaine are second only to nicotine for addictive potential, and alcohol has the worst withdrawal symptoms for the top-five used substances.
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What Is a Slip?
A slip is a one-time drug uses that causes regret and is recognized as something that will happen only once. A slip is not necessarily the first step to a relapse. An alcoholic might accidentally drink something they thought was alcohol free or someone recovering from a sleeping pill addiction might take an aspirin that contains a sleep agent. Mistakes happen. What happens after the mistake is the difference between a slip and a relapse.
The best way to prevent a substance abuse relapse is to have a plan in place for risky situations or times when you feel tempted to use drugs or alcohol.
- Take things one day at a time: Make it a rule to take things one day at a time. Part of having a plan to prevent relapse is understanding that while today may be bad, there is always tomorrow.
- Join a Support group: Support groups will encourage you when you hit hard times and hold you accountable for your actions. Having support group connections will also give you someone to call when potentially dangerous situations arise.
- Create a schedule: Keeping the mind busy allows you to focus on the task on hand — not your addiction. Make a detailed schedule so you’ll always have something to do. The focus is now on getting to the next task and not on drugs.
- Use an index card for emergencies: Create an index card that can fit in a purse, wallet, or pocket. You may include pictures, words of encouragement from loved ones, sponsors’ phone numbers, or activities to distract you from the urge to use.
Relapse Warning Signs
Warning signs that someone is heading for a relapse fall into two categories: psychological and social.
Psychological Warning Signs:
- Romanticizing the days when they were using: If the person makes the days when they were using sound better than those of sobriety, it could mean they are longing for those times and are susceptible to a relapse.
- Acting the same as if they were using: If someone currently recovering from addiction is beginning to act as they did when they were using, it may mean they have relapsed.
- “Just one more won’t hurt”: One of the benefits of rehab is the confidence it gives recovering individuals. This confidence can be a double-edged sword when the person thinks they have enough control to use their substance “just one more time.” Confidence is a positive thing, but only if it’s under control. Some people in recovery have years, sometimes decades, of sobriety under their belt, and they still aren’t strong enough to have “just one more.”
Social Warning Signs:
- Making excuses for not going to support meetings: Someone in recovery might not make it to every support meeting, but missing multiple meetings is a problem. Someone relapsing will feel guilty around a group of people successfully maintaining their sobriety. Finding excuses for skipping meetings is a sign of an impending substance abuse relapse.
- Going back to their old circle of friends: If the recovering individual has removed themselves from the people who encourage their sobriety to go back to an old circle of friends, it could mean they are getting ready to use again.
- Shutting down their support system: A support system is essential to maintaining sobriety. People in recovery need the encouragement of family and friends to stay sober. If they start shutting out members of this network, it’s a sign they may be using again.
What to Do After a Relapse Occurs?
If you’ve relapsed it doesn’t mean all hope is lost, only that an inpatient program in a controlled environment may be necessary. Try to uncover the causes of the relapse and understand how you can prevent it from happening again. Regardless of the cause, it’s important to stay healthy after you have completed your inpatient treatment. Remember: mistakes happen, you aren’t a failure, and even though you took a step backward, you will beat your addiction, and your loved ones will help you do it.
- Drug War Facts. (2008, January 9). Addictive Properties of Popular Drugs. Retrieved from http://www.drugwarfacts.org/cms/Addictive_Properties#sthash.mUS6WXGu.UPfiNA34.dpbs
- Hendershot, C. et al. (2011, July 19). Relapse prevention for addictive behaviors. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163190/
- Jin, H. et al. (1998, November). Predictors of relapse in long-term abstinent alcoholics. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9811085
- Marlatt, G. A. & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press.
- Moos, R. & Moos, B. (2006, February). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1976118/#R1
- Sinha, R. (2011, October). New Findings on Biological Factors Predicting Addiction Relapse Vulnerability. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674771/