So… You Had a Relapse.
Thank goodness it’s Friday. You’re watching anxiously as the clock ticks closer to 5 PM. It’s been a stressful week at work and you can’t wait to get a break. You’ve been trying to form plans but you’re not sure what to expect this weekend because your family relationships at home are still a little shaky. That’s when a few coworkers that you used to spend a lot of time around walk by and invite you to the bar tonight because they haven’t seen you in a while.
You just got to week five of sobriety after you completed the alcohol inpatient treatment program. You survived detox and rehabilitation and made significant strides in overcoming your addiction to alcohol. Yet while you’ve made these life changes and follow your plan for relapse prevention, your relationship with your family is still stressful and rehab didn’t seem to take away the stress from work or the depression. “What harm could one drink do?” you wonder. You decide to go tonight and take a load off, maybe it will do you some good.
The next morning you wake up nauseous and can hardly get up because of a splitting headache. That’s not even the worst part. You feel ashamed that you gave into the craving for alcohol. You feel guilty because you let down your family and close friends that helped you get clean. Above all, you feel discouraged because you thought this addiction was behind you… Apparently, it’s not.
Relapse Does Not Mean Your Treatment Failed
The first thing you need to know about relapse is that it does not mean that you have failed or that your addiction treatment failed. In fact, the National Institute on Drug Abuse reported that the relapse rate for people overcoming drug or alcohol addictions is 40-60%.1 You’re certainly not alone and there is hope for you to get better! At this critical point of decision, do not give up on yourself.
The unfortunate reality is that many people have multiple relapses during their recovery process before they finally achieve long-term sobriety.2 The fact that you had a relapse does not mean that it’s game over for you. Instead, focus on identifying the triggers, adjust your relapse prevention plan and rebuild. Think of relapse as a stepping stone where you learn and get better. This is a chance to figure out what went wrong and fix it, so you can be that much closer to long-term sobriety!
Difference Between a “Slip” and a “Relapse”
First, it’s important to identify whether your relapse was just a “slip” or a full-blown relapse. A slip is a one-time mistake that you immediately regret. Your response to this momentary lapse may be different than your response to a full-blown relapse where you might return to old habits and experience more feelings of hopelessness.3 In the event of a slip, you should learn from it and tweak your relapse prevention plan as accordingly. But, in the event of a full-blown relapse, you may need to return to an inpatient treatment facility. You should at least consider this as a serious option when you seek help from your sponsor and close family members or friends. However, if you simply have a one-time slip, you probably don’t need to return to inpatient rehabilitation.
Be Aware of the 3 Stages of Relapse and Warning Signs
A common misconception about relapse is that it happens in a single moment where a person finally gives in and restarts using their substance of choice all at once. However, relapse is a process, and it often takes a long time before someone finally gives into their craving.4 As you evaluate yourself, there are three stages of relapse to check for. Understanding your own process that led to experiencing triggers and cravings can help with preventing relapse.
1.) Emotional Relapse
In this stage, people may casually think about or remember when they used their substance of choice, but they don’t really consider using again. Relapse prevention is still a priority. However, a person’s emotions in this stage are warning signs that may be setting them up for the next stage of relapse. The warning signs for emotional relapse include:
– Bottling up emotions
– Isolating yourself from others
– Missing recovery meetings
– Going to meetings but not sharing
– Focusing on others and their problems
– Poor eating and sleeping habits
If you’re experiencing these symptoms, it is very important for you to take good care of yourself and address your needs to avoid transitioning into stage 2, Mental Relapse.
2.) Mental Relapse
People transition into the ‘Mental Relapse’ stage as a natural result from not taking care of themselves for a prolonged period of time. People in this stage might feel restless or discontent. The longer people feel this way, the more they will consider using again and the goal of relapse prevention begins to fade. Part of them wants to use again while another part of them wants to remain sober. The warning signs for this stage may only be recognizable by the person experiencing them. They include:
– Cravings for substance of choice
– Thinking about people, places and things associated with past use
– Minimizing the consequences of, or glamorizing past use
– Thinking of ways to control using
– Seeking relapse opportunities
– Planning a relapse
3.) Physical Relapse
You give into your craving and use your substance of choice again. The biggest thing to remember here is that relapse is not the end, you are not a failure. Since 40-60% of people relapse, it should be viewed more as a “stepping stone” to learn from on your path to recovery! Don’t give up on yourself!
Retrace Your Steps: Identify Triggers
Along with reviewing your own journey through the 3 stages of relapse, it’s important to retrace your steps and identify the triggers along the way that pushed you closer to relapse. Plans to avoid specific triggers should be included in your relapse prevention plan. There are some common triggers to be aware of:5
Stress and Hardship:
This is a common reason why people begin using substances to begin with. After treatment, people who experience stress and hardship may be triggered by the memory of when they first started using substances to cope. A way to avoid stress from work may be to try taking a lighter load. Coping with hardship can be a difficult trigger to avoid, but positive relationships and other good influences can make hardship more bearable so that substance abuse doesn’t have to be an option.
Feelings of frustration, confusion, anxiety, anger, worry, fear, loneliness. Many people initially used drugs or alcohol to cope with or numb these negative emotions. Therefore, when people experience these emotions again in the recovery process, it sparks a craving. Find alternative ways to vent like writing in a journal, exercising, or some other activity that helps you feel positive again without the substance abuse.
Hungry, Angry, Lonely, Tired. These are four basic triggers that are very common for most people recovering from addiction.
People and Places:
People can grow to associate their substance abuse with certain people, places or activities that they were around when they were addicted and actively used. The recommended method of dealing with these triggers is to altogether avoid the people, places and activities that spark cravings. It can be hard to feel like you’re leaving friends behind, but this is a situation where you need to think about yourself first.
Guilt and Shame:
Feelings of guilt and shame cause low self-worth, causing individuals to feel they have little reason to bother quitting alcohol or drugs. There’s not one perfect way to overcome this, but two excellent ideas include helping those in need or making amends with someone you may have wronged in the past.
This is not an exhaustive list of all the triggers that could possibly be a problem for you, but it’s a good start. Try to think of other specific circumstances or things that may be a trigger and include ways to avoid those triggers in your relapse prevention plan.
Relapse Prevention Tips and Trigger Responses
If you have already relapsed, then it could help to look back and try to pinpoint where you began to experience the symptoms of Emotional and Mental Relapse. This should help identify some triggers or turning points that pushed you toward relapse, so you can plan to avoid those things in the future. Once you have identified key triggers that might have pushed you to relapse, then it’s time to create a relapse prevention plan to help you be mentally prepared when you experience those triggers again. Three ideas to help in emergencies include:
– Call Someone. Expressing your concerns about any warning signs you see in yourself with a trusted family member or friend can allow them to support you and may even clear your head.
– Wait 30 Minutes. Forcing yourself to wait 30 minutes before acting impulsively can give you time to think about why you’re considering using and remember how hard it was to get sober. The waiting time can “talk you down.”
– Focus on Today. Don’t worry about tomorrow, next week or next month. Thinking about sobriety in terms of forever is intimidating but breaking it down into manageable pieces is much easier!
This is a short list that doesn’t include everything for creating a relapse prevention plan. However, these are some helpful techniques if you’re worried about relapsing again soon.
Do Not Give Up!
Although you had a relapse and you might feel discouraged, it’s not the end of the world and it’s certainly not the end of your journey to sobriety. The path from addiction to long-term sobriety is rarely straight or easy. It often has twists and turns and unexpected bumps in the road. That’s why your relapse should be seen more like a learning opportunity. It’s a chance for you to adjust your plan for preventing relapse in the future. Long-term sobriety might seem like an impossibility sometimes, but it is possible if you don’t give up on yourself!
The guilt and shame you might feel after relapsing don’t hold you back from becoming the best version of yourself possible. They are motivators to not mess up again!
Most importantly, remind yourself that the only true failure is giving up on yourself. Do not give up!