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Relapse Prevention ~ The "Big" Plan

What Is Relapse?

Relapse is a process that begins when you start slipping back into old behaviour patterns. A relapse begins long before you take your first drink, drug or gamble. Some things that can lead to relapse include:

  • Feeling that you have the problem under control and taking a chance to use or gamble again

  • Not working out stresses and problems at home, work or school, and when these build up or a crisis happens, you go back using or gambling

  • Not dealing with stresses such as problems with your finances, with your health, or with the legal system

  • Not handling negative feelings such as boredom, loneliness or anger

  • Giving in to cravings or urges to use or gamble when under stress you don't see any other way to cope other than to use or gamble

  • Not working on your recovery plan or letting it slide (e.g. not going to self-help meetings)


To avoid Relapse:

1. Handle day-to-day feelings and problems as they happen. Your plans should involve handling feelings and problems as they happen. This way, pressure and stress do not build up. The stress you may already feel will only get worse if you put off dealing with problems with family, friends or work.

2. Keep your life in balance... a way to reduce stress. It is important to find ways to balance work and relaxation. Having fun with family or friends, without including alcohol, drugs or gambling, can be challenging. Be kind to yourself. Give yourself simple rewards that give you pleasure - a walk, time with a hobby, a chance to read a book. Writing out a plan for your day may help you find a balanced routine. Fill in free time with a variety of activities. Try a few new ones; you will find some you enjoy. What you eat can affect how well you cope with pressure. Lots of good basic foods like fruit, vegetables, cheese, whole grain cereals and breads, fish, and meat help cut down stress. Food rich in B vitamins helps to reduce craving for alcohol and to keep stress manageable. Caffeine (coffee, soft drinks), nicotine (cigarettes, cigars) and too much sugar can make you tense.

3. Gain support and trust. Family, friends, your boss, a co-worker, a support group or a counselor can talk with you about the pressures you are feeling in recovery. They can watch with you for the warning signs of relapse and help you handle the stress. Let them know your goals and your plans so that they can help you out.

4. Identify and plan for high-risk situations. Everyone faces high-risk situations at some time - you will find yourself in situations where you are more likely to drink, use drugs or gamble. These situations can be handled more easily if you know ahead of time what they will be. Have at least three ways to handle them, so that if one does not work, you do not give up. Practice what you will do or say, so you do not worry about what to do under pressure. You can stay confident and in control. 

Here is an example: At a dinner party with friends, alcohol is served. You want to relax and enjoy yourself, but you do not want to drink. With relapse prevention plans, you might:

Carry a non-alcoholic drink with you to avoid being pressed to drink alcohol.

Have an answer ready, such as:

"No thanks, I don't drink anymore."

"No thanks, I'm driving."

"No thanks, I'm on a diet."

"No thanks, I'm an alcoholic."

Agree with your spouse ahead of time that you will leave if you feel uncomfortable.


Abstinence: The Feeling

What Feelings Do You Have About Abstinence?

Emotions I have had in the first few months after stopping drinking/using drugs or gambling:

What Are the Advantages and Disadvantages of:

Using alcohol/drugs or gambling:

Not using alcohol/drugs or gambling:


Can you identify with these statements?

In the beginning, abstinence:

is confusing and disorienting,

is nothing like the way I believed it would be,

can be lonely and overwhelming.

These negative feelings are usually worse when a person is under stress or is tired. The symptoms gradually go away.  Because there is confusion and fear in the first few months, people are more likely to relapse. These are uncomfortable feelings, and it's hard to resist taking the easy way to get out of dealing with them: a drink, drugs, or a bet. To help you  "wait it out"  you can:

Talk about it

Get plenty of sleep

Eat well, exercise regularly

Actively reduce stress

The following information can help you recognize stress in your life and suggests ways to help reduce that stress.


Managing Your Stress

Stress is a common part of everyone's life. We deal with most of our stressful experiences successfully. It's the small percentage that we have difficulty managing that causes problems. Because stress is a part of life, it makes sense to develop a variety of ways of handling it. There are many ways - the following are some basic, common sense methods:

Organize yourself. Take better control of the ways you're spending your time and energy.

Control what and who is surrounding you. Stay away from people who cause you to doubt your decisions.

Develop a supportive network of caring people around you. Feeling alone or apart from others builds stress. Being in touch and talking to others reduces it. Family, friends and self-help sponsors can help.

Build up your strength. If you're in good physical condition, you'll be better able to stand up against your stress.

Find ways to laugh each day. Laughter is one of the purest and most total releases of tension.

Learn to relax. Do something relaxing for 20 minutes each day. You will think more clearly and will be better prepared for decision-making.


Managing Your Cravings

When you quit using alcohol, drugs or gambling, you are likely to experience cravings. Cravings are a normal part of recovery. They will lessen over time. Cravings may be stronger in high-risk situations. An important part of relapse prevention is learning how to cope with these urges. One way to minimize these temptations is to focus on specific actions or thoughts in dealing with them. Examples of specific actions might include:

Talking to someone who understands, carry a list of phone numbers of people you can call,

Writing down your thoughts,

Distracting yourself, do for a walk, work out, clean the house,

Removing yourself from the situation,

Trying relaxation techniques,

Keeping a record of how you have coped in the past.

Examples of thoughts that might be helpful include:

Thinking of the negative consequences of using/gambling (remembering how bad things were when you were using),

Thinking of the reasons why you do not want to use/gamble any more,

Reminding yourself that cravings are a normal part of recovery,

Visualizing the craving as a wave that you are simply going to ride out

Using positive self-talk or picturing a STOP sign in your mind.


Resources:

Because stress affects the whole person, good stress management skills allow you to manage all parts of your life. The following list is things you can do to help keep stress under control:

Get Physical: Build up your strength and stamina.

Relax: Develop a list of activities you find relaxing and do them regularly.

Eat Well: Eat good basic foods such as whole grain cereals and breads, fish, meat, fruits and vegetables. Avoid too much caffeine (coffee, soft drinks), nicotine (cigarettes and cigars), and sugar.

Take Care of YOU: Treat yourself kindly. Don't push beyond your limits.

Exercise: Learn to get the benefits of regular exercise.

Use Your Mental Skills: Use your mind to help cope with stress more effectively.

Manage Your Time Well: Pause to think about what is really important and give time to those things.

Organize: Seek order. Don't let things pile up.

Problem Solve: Address issues as they come up. Don't hesitate to ask others to help.

Build a Support Network: Develop a network of resources and people that you can count on.

Use Family and Friends for Support: Your family and friends may help you solve problems and reduce stress.

Keep Life in Balance: Make sure you set aside time for home as well as work commitments.

Enjoy Time with Others: Spend time with those you care about, doing things that everyone enjoys.

Settle Conflicts: Look for solutions where all sides win.

Getting Along with Others: It's important to build relationships that will help you in dealing with stress in your life.

Try New Things: Discovering healthy new ways to have fun is a great way to reduce your tension level. Try new recreational activities and find new hobbies.

Stay Open to Change: Try new approaches.

Believe in Yourself: Trust others. Share and show feelings. Share your burdens with your family and friends. Be direct about your wants, needs, and feelings.

Learning: Take a class. Exercise your mind.

Enjoy Music: Play an instrument. Join a choir.

Work: Volunteer for something worthwhile.

Get Away: Spend more time alone. 

Play: Go out with a friend.

The easiest way to add to your methods for handling stress is to develop one new habit at a time. Remember you have the power and ability to decide to deal with stress.


Personal Stress Management Plan

You may want to draw from the stress management ideas outlined below when developing your own Stress Management Plan.

1. Maintain a Healthy Stress Level:

While some stress is good - it pushes us to learn and grow - too much can be dangerous to your health. The trick is establishing a healthy level of stress and maintaining that level. Identify the kinds of stress in your life.

2. Deal with pressure:

Stress is not pressure from the outside, as some people think. It's the physical reaction within your body that prepares you to meet that pressure - and to fight back.

What is causing you trouble?

Analyze the area of pain - where is it coming from?

Who is involved?

What are you doing that contributes to the problem?

How can you minimize or get rid of it?

3. Identify your Values and Goals:

Define your goals - specifically, what do you want to change and when?

Assess the importance of each goal.

Identify blocks to goal achievement.

Identify risks and/or consequences of each action.

Are others involved? Can others help?

4. Have a Plan of action:

Establish specific steps to reach your goals.

Identify resources that can help you.

Assess your progress - set a date to evaluate your success.

Make an alternate plan if needed.

Take time to reflect on your success - what have you learned?

Can it work for you in other ways?

You may find it helpful to make a stress management plan with the assistance of a friend or counselor.


Are These High-risk Situations for You?

High-risk situations are those situations where you are most likely to relapse. Check off the danger areas that apply to you:

when I pass a pub, lounge or place I used to gamble,

when I'm with others who are drinking, using drugs or gambling,

when I feel no one really cares what happens to me,

when I have to meet people

when I feel depressed when there are problems at work,

when I feel I am being punished unjustly,

When I feel afraid

When I'm on holidays

When I feel happy with everything

When I have money to spend

When I remember the good times when I was drinking, using drugs or gambling

When there are hassles and arguments

When feel resentful

When I feel irritable or tired

When I'm at a party

When I start thinking I am not really hooked on alcohol, drugs or gambling

When I feel myself getting very angry

When there are special occasions like Christmas, birthdays, etc.

When I start feeling frustrated and fed up with life

When I feel disappointed that other people are letting me down

When I feel lonely or bored

When I feel pressured by debt or lack of money

When I remember the excitement of a "big win" or a "great high"


Reasons for Relapse

The following are major reasons for relapse:

Not handling negative feelings such as boredom, loneliness, anger,

Difficulty in handling social pressures to drink, use drugs or gamble, or just being around people who are engaging in those behaviours,

Not resolving conflicts with others,

Having urges or temptations to use alcohol, drugs or gamble,

Difficulty in handling positive feelings,

Problems dealing with withdrawal symptoms or health conditions,

Testing to see if drinking, drug use or gambling can be controlled,

Not keeping life in balance (not eating well, not sleeping regularly, not keeping active, spending too much time at work).


When Do Relapses Occur?

Consider the following information:

Approximately 2/3 of all relapses for any addiction (alcohol, drugs, gambling, smoking, diets) occur within the first 90 days. The reasons for relapse are the same whether the addiction is to alcohol, other drugs or gambling. During the first 90 days after withdrawing from alcohol, drugs or gambling people may experience some periods of poor memory or concentration, or they may overreact to stress. This may lead to relapse. The longer a person is abstinent, the better these things will get, but handling stress as it comes up is an important way to prevent relapse. Not coping with stress is a major reason for relapse.


Recognize the Danger Signals

A return to alcohol, drug use or gambling does not just happen. There is a process leading to the return. When you begin to backslide or "slip," you go through changes that could lead to a possible relapse. Some of the danger signals might be:

You begin to isolate yourself from others and feel bored and lonely much of the time.

You find yourself easily irritated and relationships become strained.

You doubt your ability to stay abstinent.

You act impulsively under stress, which causes even more stress.

You think you will never use alcohol, drugs or gambling again, so you don't need a recovery program - you don't attend support groups or counseling, and you reject offers of help.

You try to impose abstinence on others.

Your eating and sleeping patterns are disturbed and you cannot get things done.

You cover up your feelings of unhappiness and helplessness.

You frequently feel sorry for yourself.

You begin to think that you can handle alcohol, drugs or gambling again and it will help you feel more at ease.


There are also other danger signals. What are yours?

High Risk Situations

A. Figure out the high-risk situations that might lead you to start drinking, using drugs or gambling.

1. What days are you most likely to start to drink, use drugs or gamble?

2. What times of the day are you most likely to start drinking, using drugs or gambling?

3. In what locations are you most likely to start to drink, use drugs or gamble?

4. Who are you most likely to start drinking, using drugs or gambling with?

5. What moods or feelings are most likely to lead you to start drinking, using drugs or gambling?

6. What positive things do drinking, using drugs or gambling do for you?

7. List some high-risk situations that may result from the above. 


Creating a Plan to Deal with High Risk Situations:

B. For each high-risk situation, think of three things you can do to handle the situation so you won't start to drink, use drugs or gamble to feel good. Here is an example high-risk situation - Staff party where there will be drinking.

Plan 1. Order a non-alcoholic drink before joining the group.

Plan 2. Arrange to leave the party early.

Plan 3. Have three responses ready for when you are asked if you want a drink.


Handling Relapse

Sometimes you just cannot control everything in your life, or handle every situation the way you plan to. There is a possibility that you might relapse and start drinking, using drugs or gambling again.

Think about how you would feel if you relapsed. Some people have overwhelming feelings of guilt, anger, shame, or fear. These feelings could drive you to continue to use or gamble after a slip. How would you deal with a relapse? It is important that you do not give up. You have other choices.

There are ways you can regain control and prevent a slip from becoming a full relapse. If you relapse, you could talk to a counselor or friend about it. You can learn from the situation and find different ways of handling the pressures that led to the relapse.

If you use a relapse as a learning opportunity rather than viewing it as a failure, you can prevent it from happening again.

Plan to stop a slip from becoming a relapse. Don't let a slip be an excuse to keep on drinking, using drugs or gambling.

  1. Figure out how you feel about relapse ahead of time. Record your feelings.

  2. Figure out the best way for you to handle those feelings and how you would stop drinking, using drugs or gambling. Record your ideas.


Relapse Prevention Is Important Now

The first months after you stop drinking, using or gambling are filled with change and unfamiliar feelings. Withdrawal causes feelings of confusion and tension, which may leave you feeling incapable of handling problems. Throughout your recovery you will be faced with many situations that will be difficult to deal with. This is why it is important to make a Relapse Prevention Plan now. You can successfully negotiate the road to recovery. Planning for a flat tire or a thunderstorm does not decrease the chance of either happening, but if it should happen, you'll be ready! You are vulnerable. Protect and care for yourself.

Deal with your problems and feelings as they come up.

Build a balance in your daily routine to reduce stress.

Talk to friends, family or a professional counselor. Let them help.

Think through ways to handle high-risk situations.

Plan and work for success!


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