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Relapse and Relapse Prevention
by Darlene Albury, LMSW

Relapse and Relapse PreventionOne of the most important problems in recovery for alcohol and substance abuse is Relapse and Relapse Prevention.  One must always realize and be aware that relapse is a distinct possibility which can happen to anyone who is and have been an abuser.  Prevention from relapse is an ongoing process requiring both abstinence and changing your thinking patterns behaviors, attitudes, and lifestyle.  The purpose of this article is to help the individual, and family to understand relapse and relapse prevention and how it relates to their particular situation.

Relapse refers to the process of returning to the use of alcohol or drugs after a period of abstinence.  Relapse is possible regardless of how much time you have been sober, and part of one’s recovery plan should include learning about the relapse process and coming up with a plan to help prevent one from relapsing and knowing the warning signs.

There is the relapse before the relapse, meaning it builds over a course of time a period of hours, days, weeks or even months.  Many who have addictive personalities have reviewed their relapse experiences and identified signs which precedes the relapse, and which indicates they were headed back to using.

Clues or warning signs may relate to changes in behavior, attitudes, feelings, thoughts or a mixture of these.  This does not mean that what you are experiencing are indications that you may be in a relapse, it means that you should be aware when these changes occur.  What is important to remember is that changes or a combination of changes could indicate that your relapse process is in motion.

There are high risks situations that may make you feel that you could relapse.  Once you have identified your possible high risks relapse factors, you can then plan relapse prevention strategies to help you handle these feelings without using alcohol or drugs.  The list is as follows:

  1. Anger expression problems (holding in anger; expressing anger inappropriately or violently).
  2. Anxiety or nervousness
  3. Boredom or lack of constructive leisure interests.
  4. Denial
  5. Depression
  6. Excessive or impulsive behaviors
  7. Exhaustion or fatigue
  8. Fears that seem unreasonable
  9. Feeling helpless or hopeless
  10. Guilt

These are just some of the risks factors involved with turning back to using alcohol or drugs.  In the early stages of recovery it is normal to experience urges and cravings to use alcohol or drugs.  Urges and cravings can occur at any time even if you are actively involved in a recovery program.  They differ in frequency and intensity with each person.  It is important to be aware of trigger signs to regression, (the urges or cravings) and physical and psychological signs, and positive coping strategies.

Cravings and urges can be triggered by things you see in the environment which may remind you of using alcohol or drugs or getting high;  There is internal discomfort such as anxiety or anger, or by things which you don’t seem to be able to identify.  Physical signs include tightness in the stomach, feeling nervous throughout the body; Psychological signs may include increased thoughts of how good you would like to feel from using alcohol or drugs, or feeling a need for them.

During recovery, particularly the early months, it is common to experience urges or cravings to use alcohol or drugs.  An urge or craving may occur at any time even if you are actively involved in a recovery program.  Urges and cravings may differ in frequency and intensity with each person.  It is important to be aware of things which may trigger an urge or craving, physical and psychological signs, and positive coping strategies.

Urges and cravings can be triggered by things you see in the environment which may remind you of using alcohol or drugs or getting high; internal discomfort such as anxiety or anger, or, by things which you don’t seem to be able to identify.  Physical signs may include increased thoughts of how good you would like to feel from using alcohol or drugs, or feeling you “need” alcohol or drugs.  Think of times when you have experienced what you would consider an urge or craving for alcohol or drugs and take note so that when these situations arise you are aware of the triggers. An important issue, especially in the early stages of recovery when you are not so used to handling urges or drugs are being used.  Successful recovery will require you to be aware of how you might be affected by these various social pressures and what you can do to deal with these pressures without using alcohol or drugs.  Think of these social pressures in terms of how they will affect both your thoughts and feelings.  Think about what you can do to help you cope with the social pressures without using.  Other recovering alcoholics and drug dependent persons have used a number of practical methods to help them survive urges or craving, talking with other, redirecting your activity, changing your thoughts and avoiding threatening situations.

One of many issues recovering alcoholics and drug dependent persons state is difficult to cope with is anger.  Many attribute regression to an inability to constructively handle anger.  Mismanaged anger can pose a threat to sobriety; it can also lead to problems in relationships with others.  Problems with anger may occur for several reasons.  In some instances, much of your difficulty with anger is related to the self anger you have.  This may occur as a result of problems your addiction has caused in your life.  What may happen is that you direct your anger at others or blame them for your feelings.  Recognize angry feelings; be aware of when you are angry, how does your anger show, look for anger clues.  Physical signs may include such things as headaches, tension in your stomach or rapid speech.  Psychological signs may include revenge fantasies, increased thoughts of using alcohol or drugs, or feeling depressed.  Decide first if your anger is really justified.  It may be an overreaction to a situation or a result of self-anger which you misplace on others.

It is important to have a specific sobriety plan to follow after, this plan involves identifying specific steps you will take to not use alcohol or drugs, changes you need to make, and recovery resources you will use to help you.  It is important to accept the fact that recovery is a long term, painful process requiring you to take a close look at yourself (Daley, Dennis C., Relapse Prevention).

Darlene Albury, LMSW

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