Relapse Prevention Program

Addiction Relapse Prevention Program

For those who have been through rehab and suffered a relapse, the future may feel bleak. However, it must be understood that addiction is a disease that changes how your brain works. Rebuilding brain pathways will take time, focus, and self-care, especially to prevent relapse.

Relapse Is Common

Studies indicate that more than 75% of alcoholics will suffer some form of relapse during their first year after treatment. For those who detox from nicotine or heroin, the relapse percentages can run as high as 95%. In considering these statistics, it is important to note the difference between a lapse, a relapse, and a prolapse.

During a lapse, the recovering addict uses once, possibly accidentally. For example, you may order a non-alcoholic beverage and get the wrong drink. With the right mindset and support in place, you may turn this into a prolapse, or a choice to use this experience to reinforce the positive choices you learned during rehab. Such an experience may lead you back to counseling or to recommit to attending group meetings. 

A lapse can be managed and even turned into a good experience. The greatest worry after a lapse is a full relapse. During a relapse, the recovering addict returns to their pre-treatment level of drug or alcohol use.

Stages of Treatment Versus the Stages of Relapse

During detox, you suffer a hard stop or cessation of using drugs or alcohol. This change to the chemistry of your body and brain can be uncomfortable; you may suffer from extreme nausea, terrible mood swings, and a great deal of pain. 

After detox, you typically go through rehab. You learn to manage your emotions and you begin to build new brain pathways. You may also learn new ways to care for your body, such as through engaging in regular exercise, taking on a healthier diet, and practicing meditation and self-care.

During the stages of relapse, the emotional process is the first step. You may stop going to group therapies, meetings, or private treatment. You may isolate yourself and start to feel anxious or angry. You could stop engaging with your new community and spend a great deal of time alone.

The second stage of relapse is mental. You may remember the good times you had using and drinking with old friends. You may mourn the loss of these relationships or mourn the lost freedom and confidence you experienced when you were using. The deceit of addiction will have a strong hold on you during the mental relapse. You will not remember the bad feelings you had from drinking and using. You will not recall the damage that was done to your life by active addiction.

Finally, you may physically relapse. You will use or drink. This experience may send you back to therapy and to your group in a prolapse, or positive rebound. You might also fall back into full-blown addictive use.

Emotional Triggers

The emotional triggers that can move you toward relapse can be subtle; you may find yourself headed into a dangerous situation before you see the warning signs. You may come across a photo of a friend that you no longer spend time with because you used substances together. You may reconnect with a family member who enabled you and who has not done their own work around that behavior.

You may drive or walk by a physical location where you used or drank. During the early stages of emotional healing, it may be a good idea to relocate for treatment. White Light Behavioral Health, located in Columbus, OH, may be a better option for your healing than trying to undergo treatment in your hometown.

Stress and pressure push the brain into patterns that used to work but that no longer serve. If you used after a bad day at work or after a fight with your spouse, it may be time to look for another job or to consider a separation. You will be emotionally fragile at points in your life. Managing that stress before it pushes you back into the isolation that encourages you to use is a critical skill.

Manage Your Thoughts

When the mental need to relapse rears up, it’s time to get logical. You may choose to make a list of all the bad stuff that happened when you were using. Events such as “wrecked my car” or “went to jail” can be sufficient reminders of what happened when you were using to pull your brain away from craving.

As soon as emotions push you to use, it’s the logical part of your brain that can step up and push back. To engage it, use physical action. If you find a piece of drug paraphernalia or a bottle opener that encourages you to crave a substance, either discard that item or stash it somewhere far away, somewhere that will be difficult to get to. 

Next, put your body to use doing something else. Go for a walk, a bike ride, or a run. Clean your house while playing energizing music, and drink plenty of water to remind you of how great it feels to have gotten through the detox process.

After using your body hard enough to work up a sweat, be kind to it. Eat a healthy meal; treat yourself to a salad and some lean protein. Take a warm shower, and use your favorite lotion. Stretch out on a comfortable bed in a dark room. Focus on the good you have accomplished as you fall asleep.

If You Lapse

Addictive substances hijack our brains. We know it’s not healthy to smoke, yet cigarettes can be incredibly relaxing to an addict. We know that drinking to excess can be deadly, but one glass of wine with dinner or a beer with friends sounds quite pleasant.

Cravings are a cause of suffering. Anything that reduces the craving can seem to be positive, even if it’s deadly. As soon as you lapse, it’s time to contact a friend, your sponsor, or a counselor. There is no shame in lapsing or relapsing. There can be great joy in using a lapse to recommit to rehabilitating practices, such as meetings and therapy.

CBT and Relapse Prevention

Cognitive behavioral therapy (CBT) can be extremely beneficial to anyone undergoing rehab. During CBT, your therapist will help you to better understand the negative beliefs that are limiting your life.

For example, you may think that your life is too stressful to even think about cutting out drugs and alcohol. You may blame your addictive habits and cravings on genetics, your childhood, or your rocky marriage. Finally, you may believe that your drug and alcohol abuse have done so much damage to your body, brain, and relationships that there is no way to move away from drug use.

CBT pushes you to reconsider and question these negative thought patterns. Those undergoing detox may not be able to tolerate the mental flexibility that CBT requires. However, once the pressure of physical cravings is lowered, working with a CBT therapist can force a little daylight between those negative thoughts and your current situation.

Your CBT therapist may ask questions that seem ridiculous. The more locked down you are in negative thoughts, the harder it will be to unplug them from your brain and really study why you think the way that you do about yourself and the world around you. Therapy will take time and trust.

Loosening up your thoughts about yourself is critical to preventing relapse. If you believe that your job stress pushes you to drink or use, they will ask you about why you stay at that job and what else you could do for a living. You may come out of rehab and CBT with plans to go back to school or to learn a new trade. 

Abstinence Is Not Enough

There was a time when addiction experts believed that detox was enough. Once the drugs were out of the body and there was no justification for physical cravings, it was believed that all the addicted person had to do was not use or drink again to build a sober life.

However, modern addiction treatment is focused on more than just the cessation of physical cravings. Rehab therapies now include:

  • Private counseling to manage past trauma and untreated mental illness
  • Group therapies to improve socialization skills and reduce isolation
  • Physical support to rebuild bodily health and cleanse the brain
  • Tools to help you recognize that relapse is becoming more likely

Whether you choose to participate in a 12-step plan during and after detox and rehab or if you are seeking another treatment program, your focus needs to be on the life you will enjoy past the steps of detox and rehab. The mindset that led you to a life in which addictive substances were a positive choice must change for a long-lasting recovery.

Reviewed By:

Dr. Ryan Wakim, M.D.

Dr. Wakim is a board-certified psychiatrist with a passion for and expertise in addiction, mood disorders, trauma-related disorders and the subspecialty of interventional psychiatry. He obtained his medical degree from West Virginia University where he also completed his residency training, finishing as chief resident. Dr. Wakim co-founded and served as the CEO of Transformations leading to a successful merger with Shore Capital in May 2021. He is purpose driven towards improving the standard of and removing stigma related to behavioral healthcare. Dr. Wakim enjoys golf, traveling and time spent with his two dogs, Lulu and Rayna.

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