relapse prevention

Relapse prevention is key in successful, long-term recovery from drug or alcohol addiction. Before we get into detail regarding relapse prevention, let’s define the term ‘relapse’. A relapse is when an individual returns to the use of drugs or alcohol following a period of sobriety. It is common for recovering individuals to face a high risk of relapse. This is due to the structural and functional brain changes caused by chronic substance use. 

Relapse tends to occur as a process rather than an event. It can begin in less than detectable ways, while increasingly getting worse. Developing a relapse prevention plan for the recovering individual is crucial. But, to understand relapse prevention, one must first understand the stages of relapse. 

What is a Relapse Prevention Plan?

Relapse prevention means putting together a plan to help you successfully recover in the long run. Relapse prevention calls for some self-awareness. You must recognize that you’re undergoing emotional and mental changes that will be tested outside of treatment. Be honest with yourself about how you feel and don’t be afraid to ask for help. 

It’s natural to experience triggers and feelings of doubt during the addiction recovery process. The goal is to lessen the chances of a relapse occurring through a relapse prevention plan. 

The Three Stages of Relapse

The three stages of relapse are emotional, mental, and physical. Awareness of these three stages is immensely beneficial when creating a relapse prevention plan.

NJRC-Stages-of-Relapse-V2

Stage 1: Emotional Relapse

Emotional relapse is the first phase that puts a recovering individual at risk. During the emotional relapse stage, the individual is not actively thinking about using drugs or alcohol. However, their emotions and behaviors may be setting them up for a relapse in the future. It’s common for people to get stuck in their emotions and thoughts without realizing it. Relapse prevention helps by addressing this stage, helping people learn how to navigate through it. 

It’s also helpful to educate yourself on the warning signs of emotional relapse. Some of these warning signs may be:

  • Bottling up your emotions
  • Not attending recovery meetings
  • Social isolation from loved ones 
  • Unhealthy eating habits
  • Poor sleeping patterns 
  • Not addressing anxiety, anger, or other emotional issues in a productive and healthy manner
  • Defensiveness
  • Mood swings
  • Refusing to ask for help 
  • Not participating in sober activities/hobbies

Stage 2: Mental Relapse

If an individual chooses to ignore the warning signs of the emotional stage, a higher risk of transitioning into the second stage of relapse occurs. An important aspect of relapse prevention is understanding the symptoms of each stage and being honest with yourself about where you are. The mental relapse stage can feel like an internal battle going on in one’s mind. 

Individuals will feel tempted to use, while also hanging on to the motivation they have left to stay clean. Fantasizing about using is a common effect of this stage. As this stage deepens, cognitive resistance begins to lessen, while the urge to escape increases. It’s worth noting that fleeting thoughts of using are completely normal. Lingering thoughts, however, are potentially problematic.

Feeling triggered at times will happen and that is okay. Psychological relapse becomes a serious issue when these thoughts are not merely coming in and out of your head. Rather, it becomes an internal debate about whether or not one should begin using again.

Some of the warning symptoms of this stage include:

  • Cravings/temptations
  • Physical and psychological urges to use the chosen substance
  • Ruminating about people, places, and things associated with drug or alcohol use
  • Surrounding oneself with old friends who continue to use 
  • Minimizing the consequences of past use or glamorizing past use
  • Bargaining – This is when an individual starts to think of scenarios in which it would be acceptable to use. For example, they may try and rationalize using alcohol or drugs once or twice a year during the holidays or when visiting family.
  • Lying
  • Thinking of schemes to better control substance use
  • Imagining drug or alcohol use 
  • Planning your relapse

How Do You Stop a Mental Relapse? 

Having a relapse prevention plan is one of the best ways to avoid a psychological relapse. Those in recovery may feel that they are in the clear after an extended period of abstinence from drug use. Individuals can prevent relapse psychologically by understanding that substance use disorder is a lifelong condition that always needs monitoring. 

An actionable relapse prevention plan can also help avoid drug use in and after recovery. For instance, journaling can help recognize an emotional relapse. To prevent this from getting worse, that would be the time to cut back on responsibilities and increase the amount of self-care. While some may think of self-care as comfort food and shopping sprees, it translates into activities that help one stay grounded. Turn to exercising, eating well, sleeping enough, drinking enough water, and meditating to avoid relapsing mentally. 

Stage 3: Physical Relapse

Physical relapse is the final stage. This is when the individual gives in to their temptations and urges. After ignoring the warning signs of the first two stages, the individual will feel overwhelmed with the choice of substance use. This is why understanding the three stages is crucial to preventing a relapse from occurring. The more familiar you can become with the warning signs, the better you can be prepared to work through them. 

Preventing Relapse by Understanding Relapse Triggers 

Relapse triggers are what cause a person to crave drugs or alcohol, thus eventually leading to a relapse. Addressing triggers helps prevent a relapse from occurring. Each recovering individual will face triggers outside of treatment. This is not only normal but it is also expected. The key here is to plan and use your tool kit of skills learned in rehab to effectively work through the temptations. 

There are two main types of relapse triggers: 

Internal Relapse Triggers

Internal relapse triggers consist of feelings, thoughts, or emotions relating to addiction. They are often more challenging to address than external triggers. These triggers can lead to behavior that the individual will end up regretting after acting on heightened emotions. Internal triggers include:

  • Negative feelings
  • Normal feelings 
  • Positive feelings 
  • Stress

External Relapse Triggers

External triggers consist of people, places, activities, and objects that provoke thoughts or cravings relating to addiction. These triggers take on many different forms. So, recognizing the different types is a helpful tool in relapse prevention. Choosing to stay away from the dangers of external triggers is crucial. Relapse prevention means creating an action plan to avoid triggers that remind you of substance use. External relapse triggers take on the forms of:

  • People 
  • Situations 
  • Places
  • Objects

What Are the Components of an Effective Relapse Prevention Plan?

Aftercare planning helps prevent a relapse from occurring by creating a plan that can help the individual outside of the recovery center. Once the core components of treatment have been completed, the patient will transition back into their normal life. Preventing relapse can be effectively done through therapeutic services and continuing support.

Aftercare can take place in a variety of different ways, depending on the individual’s unique needs. In some cases, attending recovery meetings once a week gets the job done. In other situations, a step-down form of treatment is more necessary. Together, we’ll create an aftercare plan that’ll target relapse prevention. 

There are many different options when it comes to aftercare.

Some of the main options include:

  • Outpatient treatment: Outpatient treatment is the level of care with the most flexibility. Members will travel to our recovery center for treatment with the ability to return home after. If you have responsibilities outside of treatment such as work or taking care of a child, then outpatient treatment may serve your needs best. In standard outpatient programs, recovering individuals can create a treatment schedule that works for them. Together with our team, our clients can develop a personalized relapse prevention plan that suits them. This can mean attending treatment sessions once a week or it can mean going daily. 
    • An intensive outpatient program (IOP) is a more intensive option in outpatient treatment. Patients in IOPs will commit to about 9 hours of treatment weekly based on their scheduling needs. 
  • Group therapy: Recovering individuals in group therapy can openly share their thoughts and feelings, as well as develop social and coping skills in a group setting.
  • Individual therapy: Individual therapy consists of one-on-one sessions with a therapist. The exact type of therapy will depend on the individual’s needs and can include a combination of evidence-based therapies. 
  • 12-step programs: Recovery meetings such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) provide a judgment-free and supportive space for recovering individuals.

Additional Aftercare Components

There are a variety of aftercare components that are helpful to know. Each aftercare program will be created before the patient’s discharge. Aftercare can mean transitioning into a lower level of care or it can mean attending weekly recovery meetings. In either case, we will be here to support you from day one at our recovery center in North Jersey. 

Many aftercare plans will include:

  • Relapse prevention strategy created before discharge, as well as a rehearsal to build confidence
  • Consistently scheduled outpatient follow-up treatment sessions with an addiction counselor for continued therapy
  • Living arrangements post-treatment, such as sober living homes
  • Recommended or required drug testing

The Basics on How To Create a Relapse Prevention Plan 

Substance abuse and mental illness relapse happens to many individuals who think they have fully recovered. In fact, research indicates that the majority of those struggling with a substance use disorder will relapse at some point. That said, a solid relapse prevention plan can help maintain mental health and prevent drug abuse as a result. 

How do you create a relapse prevention plan?

Before relapse happens, it’s key to create a relapse prevention plan. The first step to avoiding substance abuse in the future is to do some deep reflection. Rather than work against your nature, recognize what caused you to turn to drugs and alcohol in the first place. Then, make sure to create a plan that can avoid alcohol and drug use in the future. 

Other components of an effective relapse prevention plan include: 

  • Recognizing what situations, scenarios, and people may make you want to turn to drug abuse. Do you have a friend that loves to party without any consideration for how it will affect you? Do you go to a grocery store that’s next to your favorite bar? Good relapse prevention plans avoid situations that can easily segway into substance use. 
  • Reach out to friends and family at low points. A robust support system is crucial to long-term recovery. Family and friends naturally care and want to help you overcome addiction in any way that they can. At moments that you feel emotionally unwell or that you may relapse, make sure to stay with friends and family that can help. They will be able to assist you in staying grounded and distract you from any emotional turmoil that may make drug use sound appealing in the moment. 
  • Check out support groups. While family and friends can help make up an effective support system, a support group has a strategy put in place to help guide individuals struggling with substance use disorder. There are 12-step programs, but also other support groups, like SMART Recovery. 
  • Have a plan in place if you do relapse. Despite one’s best efforts, relapse can happen. Instead of dwelling on it, figure out what to do if it happens. That may mean enrolling back in an inpatient program or a partial-hospitalization program. 

Learn More About Relapse Prevention Today

Developing a relapse prevention plan is a crucial part of the addiction recovery process. Following treatment, our priority is to set you up for long-term success. Together, we will work to develop an aftercare plan to lessen the chances of a relapse happening. No matter what stage you’re in, we can show you the potential you’ve always had.

We can guide you from beginning through the end of your treatment process, as well as your relapse prevention plan. If you have any questions, comments, or concerns, please don’t hesitate to reach out to us here at North Jersey Recovery Center. We’re waiting for your call!

Reviewed for Medical & Clinical Accuracy by Laura Riley

Laura-Riley-Cropped-Profile-150x150Medical Reviewer

Laura comes to NJRC with 23 years of vast clinical experience in hospital, residential, outpatient, and community outreach settings where she has worked, supervised clinical teams, and volunteered. She has provided substance abuse and mental health counseling, clinical coordination, and advocacy to individuals, families and groups, and specializes in co-occurring disorders for both adults and adolescents.