Researchers estimate that in a given year, 47% of adults will struggle with an addiction (3), making it an extremely common condition. Addiction is considered a “chronic” disease because of the high rate of relapse for those in recovery. 85% of people who stop using relapse within the first year of recovery, and two thirds of these occur early on, within weeks or months of starting treatment (2). Those who are able to make it to the one year mark will continue to be at high risk for relapse for several years.
Luckily, there are things that people can do to reduce these risks and help protect their sobriety against relapse.
Addictions to drugs or alcohol often result in catastrophic damage to a person’s physical and mental health, their relationships, careers, and many other important areas of their lives. In some cases, these damages can even be fatal, illustrated by the 750,000 overdose deaths that have occurred in the past two decades (4).
The vast majority of these deaths are attributable to what is being called the “Opioid Epidemic”, which refers to the high rate of people addicted to prescribed opiate pain medication, synthetic opioids like Fentanyl, and heroin. Because of these statistics, finding strategies to reduce the risk for relapse has literally become a matter of life and death.
Luckily, research done over the past few decades has helped to identify a number of strategies to help build up “protective factors” which guard against relapse and to minimize “risk factors” (1).
Early on in treatment, a person recovering from addiction should create a “relapse prevention plan”, which includes a number of different individualized strategies to avoiding relapse, which will be explored below.
Identifying Early Signs of Relapse
The first and one of the most important steps to take in early recovery is to identify the early warning signs of relapse. These vary from person to person, typically consisting of subtle, but noticeable changes in a person’s thoughts, feelings and behaviors.
Some of the more common warning signs for relapse include (1):
- Less involvement in recovery groups and activities, including 12 step meetings, calling a sponsor, or attending therapy.
- Isolating oneself from friends, family, or other supportive people.
- Being less careful about avoiding people, places and things that are triggers for using.
- Beginning to be more secretive, telling white lies or making excuses.
- Having frequent dreams, memories, or thoughts about drug or alcohol use.
- Experiencing strong urges or cravings to use months after stopping.
- Neglecting your physical or mental health, being less consistent with self-care.
- Wanting to “test” yourself by exposing yourself to an opportunity to use.
- Fantasizing about using or scheming about how to not get caught.
- Minimizing past drug or alcohol use or the problems it caused.
- Blaming others or feeling resentful for being “forced” to get sober.
- Considering trying again to “moderate” drug or alcohol use, or thinking this time would be different or that your addiction is “cured”.
- Using or considering using another substance other than the one you were addicted to.
Identify Triggers for Relapse
Early on in recovery, your willpower to resist drugs or alcohol will be low, and you will be less confident in your ability to refuse them.
For these reasons, most people find it important to avoid these triggers (when possible), at least early on. In order to avoid them, you have to identify what they are and where/when you are most likely to encounter them.
Common triggers include:
- Specific people that you used to use with, who are unaware you are in recovery or who enabled your use in the past.
- Specific places where it is likely you would encounter, be offered, or be able to easily obtain drugs or alcohol.
- Stashes of drugs or alcohol you might have in your home, or prescriptions of a family member you know you could access.
- Situations you associate with drug or alcohol use like parties, concerts, or situations where drug and alcohol use was the “norm”.
Plan Ahead for Success
A successful recovery is usually one that has been planned ahead of time. Planning ahead and taking steps to prepare for your recovery often helps set you up for success, as well as guarding you against failure.
You will always have an easier time making smart decisions ahead of time, rather than in moments when you are tempted or have an option to use. For this reason, a lot of the planning you should do involves ways you can make it easier to make good choices and harder to make poor choices.
Some examples include:
- Get rid of any stashes of drugs or alcohol in your home.
- Leave your wallet, cash or debit card at home to avoid making an unplanned stop.
- Delete the number of people you drink or use with or purchase drugs from.
- Tell the people closest to you that you are planning on stopping, and anything they might be able to do to help you be successful.
- Enroll in a treatment program that has random drug screening.
- Bring a “buddy” to help you stay accountable when you have to go to a place where you know drugs and alcohol might be available.
Build a Support System
Research has proven that people who have a support system are more successful in maintaining their sobriety.
Sometimes, you may need to make amends, apologize, or make things right with people in your life who you have hurt or pushed away. This can be hard, but is an important step in moving forward and committing to them that you are going to get help.
It may also be helpful to build a support network which includes other people who also struggle with an addiction, like joining a local SMART recovery or 12-step group, getting a sponsor, or enrolling in substance use groups. Professionals can also be supports, and include people like counselors and addiction specialists, or even a peer support professional.
Find New Coping Skills
Most people who struggle with an addiction to drugs or alcohol report using these substances to help them cope with stress, difficult emotions, or even an underlying physical or mental health condition.
Because drugs or alcohol has likely become the primary method of coping, people in recovery will need to be prepared to find new, healthier ways of coping.
Coping skills can include spending time with people you care about, activities that relieve stress, or skills to overcome sadness, anger or anxiety. Coping skills aren’t one-size-fits-all, but some that you might consider include:
- Getting professional help from a counselor or from an outpatient or inpatient rehab.
- Exercise, including biking, walking, or joining a gym.
- Journaling about feelings, experiences or cravings.
- Tracking progress in recovery (like days sober) on a calendar.
- Starting a yoga, mindfulness or meditation program (try an app!).
- Asking a person close to you to be available once a week to talk or listen.
- Creative projects like art, music, photography or writing.
- Gardening or spending time outside.
Work on Repairing and Rebuilding
Because drug and alcohol addiction can impact you and your life in so many ways, part of recovery should also be about doing the work on repairing and rebuilding.
In many ways, an addiction to drugs and alcohol puts your goals and dreams “on hold”, so recovery should also be about revisiting these. If there are important relationships that you neglected or damaged, work on repairing these, but understand it may take time.
You may also need to rebuild your health, your confidence, your career or your savings. Addiction was all about the “right now” but recovery is also about your future.
Final Thoughts
There is no way to completely “relapse proof” your sobriety, but there are several ways to reduce your risk and increase your protection. Becoming more aware of warning signs and triggers, planning ahead, finding new coping skills, and focusing on goals, will help set you up for success.
Recovery is an ongoing process, but it can be one that helps you find parts of yourself you lost to addiction, and to rebuild a life you want to stay sober for.
Sources:
- Melemis S. M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale journal of biology and medicine, 88(3), 325–332.
- New findings on biological factors predicting addiction relapse vulnerability
- Prevalence of the addictions: a problem of the majority or the minority?
- CDC, National Center for Health Statistics