Rehab 4 Addiction

For people living with addiction, relapse is more often than not part of the recovery process. It’s not the end of the world if it happens. What is important is how you relapse and what happens next.

To start with there are different types of lapses. They occur after a period of abstinence from drugs or alcohol.

With alcohol as an example, the course of a relapse tends to follow this path:

  • A slip, where you might have a sip of a drink
  • A lapse, where you might spend an evening drinking
  • A relapse, where you start drinking again regularly

During a relapse, the person will return to the same level of alcohol that they were drinking before they became abstinent.

What makes it important to use the terms slip, lapse, and relapse?

Relapse

These terms are useful because they reveal the gravity of “backsliding” that has happened. Many people will give themselves a really hard time if they have a lapse.

This is entirely unhelpful. 

The reason for this is that when a person beats themselves up, they’re more likely to move from a lapse into a relapse. Whatever stage a person is at within a backsliding behaviour, it is always salvageable.

What makes people backslide into a relapse?

Withdrawal

One of the main reasons is withdrawal. This is where physical and psychological symptoms of the substance leaving the body are acute and uncomfortable.

Some substances (i.e. alcohol, benzodiazepines, and opioids such as heroin) create physical dependencies which mean the body starts to shut down when the substance leaves the body.

This is obviously very dangerous and why people require a clinically overseen detox period.

Withdrawal symptoms, depending on the substance, can last, at their longest, up to 18 months. Some people might be doing really well, having been sober for, say, 10 months and then lapse.

When this happens, it can be extremely dangerous. Users often think they can handle the same amount of the substance as they were taking before they became sober when their tolerance was at its highest.

If a person takes a high dose of substance after a long time being sober, it can be extremely dangerous. Fatal at worst.

Other people might lapse or relapse when faced with a new traumatic or distressing event, such as the loss of a loved one.

Accessing professional help and a healthy social support network is vital. Through doing this, people who use substances are better able to plan and prepare around cravings and triggering events.

What should you do if you relapse?

After Relapse

After you have lapsed or relapsed, you must try to exercise self-compassion.

The reality is that a relapse is not failing. It’s part of the process.

Many people in recovery have reached abstinence because of what they learned during relapses.

What really counts are your actions after a relapse.

This is a moment for honesty, self-reflection, and deciding how you’ll adapt in order to try and remain sober going forward. These actions are signs of self-awareness and a healthy approach to recovery.

Actions that turn your relapse into a helpful experience

  • Ask yourself what is one thing you have learnt from the relapse. If this isn’t your first relapse, look for a different lesson from what you learned before.
  • Focus on what is going well. Even if you can only think of one thing and that is that you’re still breathing, this is a positive. You might also be able to think of a person who is standing by you because you have been trying so hard.
  • Remember, living in active addiction mode is survival mode. You might want to return to the substance to handle the negative feelings that have arisen but to survive now, you need to be calm, focused and alert. Go to your relapse prevention plan to see what might help now. Alternatively, call a professional or helpline for guidance.
  • As soon as you acknowledge you have relapsed, try to stop it as soon as possible. The quicker you stop using, the less damage that might occur.
  • Remember that recovery is a time for learning. Part of this is where you begin to understand yourself and those things that lead you to substances use. Think back to what happened leading up to the relapse. Identify those signs that it was about to happen. If any of those signs are still present, distract yourself. Fill up your life with safe activities that keep you acting in healthy ways, no matter what they are!
  • Be kind to yourself. Rather than jumping straight in and self-criticising, set yourself a goal of remaining sober for the next hour, day, two days, or week. When you reach that goal, then allow yourself to think about what led to the relapse.

What is a relapse prevention plan?

A relapse prevention plan is usually developed between you and an addiction specialist. This might be a doctor, drug or alcohol worker, or counsellor. 

Some people are given them as part of an aftercare plan if they’re completed a residential stay at a private rehabilitation clinic. Others might have one from a worker they’re in contact with at an NHS-funded outpatient clinic.

The plan focuses on a variety of areas, but will most heavily focus on triggers and coping mechanisms.

Triggers

Substance use is caused by various triggers, cravings, and background factors. With a professional, you will discuss how the following influence you to get your next drink or high:

  • Who you spend time with and whether that affects your substance use.
  • Places you associate with drug and alcohol use.
  • Objects, recurring dreams, and other things that might trigger use.
  • Historic trauma and current highly stressful situations.
  • Issues in relationships with a partner, family, or friends.
  • Emotions including stress, anger, depression, boredom, and anxiety.
  • Isolation and lack of connection to others who understand your situation.
  • Low self-confidence and a lack of healthy coping mechanisms to replace addictive coping mechanisms.
  • Pain. When people experience physical and emotional pain, it can cause them to return to substances.

Coping mechanisms

In order to face cravings and triggers, you’ll need to identify healthy coping mechanisms that help you stay sober.

It can literally be anything to keep you distracted.

You don’t necessarily have to enjoy activities that help you remain sober. If a behaviour is healthy and stops you relapsing, that is the only reason you need to do it.

As bleak as this might seem to do things you don’t enjoy, it’s helpful to remember that it becomes easier to enjoy even the most simple moments as time passes and the substances leave your mind and body.

There are various coping mechanisms you can try, including:

  • Going for a coffee with a supportive friend who doesn’t use substances
  • Attending a 12 Step group
  • Gardening
  • Housework
  • Calling a helpline
  • Starting a collection of something you enjoy: flavoured teas, postcards, books
  • Exercise: running, swimming, yoga, tai chi (remember, there are free classes online)!
  • Creating art or music
  • Cooking or baking something new
  • Journalling

Honest self-reflection

If you do lapse or relapse, it’s really important to take time afterwards to self-reflect in the most honest way.

You ask yourself what happened leading up to the relapse. Take time to identify the signs that led you towards it. This could be things like:

  • A low mood
  • Not getting out of bed
  • Anger
  • Falling out with a friend or family member

It’s beneficial to ask yourself whether you used any of your coping mechanisms before turning to alcohol and drugs. After this, reflect on what you could have done differently and add this to the relapse plan.

Remember too that relapse is a point of learning, not failure, so look for that useful revelation you can take from it.

It’s really important to be open and honest when discussing your relapse prevention plan as it will make it more reliable. It will also be more protective in the case of any future relapses.

You can, of course, develop a relapse prevention plan of your own. It has to be said, though, that creating one with the support of professionals will bring specialist insight and new ways of thinking that will vastly improve your chances of success.

What helps people to avoid a relapse?

Research shows that are 5 “rules” in relapse that can support a person to avoid relapse and remain sober.

The 5 rules are:

  1. Change your life. Many people start by accessing rehab services and participating in groups and counselling. It also means making new social connections and developing new hobbies and interests. Creating a purposeful, safe and healthy life makes it easier to avoid substances.
  2.  Always be honest with yourself and others. No excuses or justifying certain actions. A huge part of recovery is being able to admit the truth and adapt to healthy behaviours.
  3. Ask for help. You are in recovery for a serious illness. You will need help at times and it’s important to acknowledge this. It could be through asking “safe” friends to spend time with you doing healthy activities to help manage cravings. It might be asking for a lift to the rehab clinic when you’re struggling with motivation.
  4. Practise self-care. Eating well, drinking water, being active, and a daily wash supports your mind and body and overall wellbeing.
  5. Don’t bend the rules!

Final thoughts…

Recovery is a long journey. For the majority of people who have addictions, relapse is a part of it.

It is beneficial to approach relapse head-on. You want to prepare and plan for it. If it happens, it’s best to directly address what has led to it and how to handle triggering events in the future.

Accessing rehabilitation services makes the chances of recovery much higher. Counselling, therapy, and support sessions, as well as healthy activities, offer lots of ways to tackle your healing journey in an uplifting way.

To find out about support for addiction in your local area, contact Rehab 4 Addiction. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/ 

boris

Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.