Relapse Prevention

Getting free from drug or alcohol use is a major accomplishment. Every day in recovery is a victory. Most people find that recovery gets easier as time goes by, but that's usually people who are doing something to strengthen their recovery.

The scary thing is that we can relapse at any time. That first drink or drug is often little more than an arm's reach away. Our recovery program - what we are doing to stay sober - is the only thing that stands between us and that first drink or drug that will take us back to the misery we lived before.

As an addictions researcher - and as an alcoholic and addict in recovery who attends a lot of recovery meetings - I have heard the stories of many people who have relapsed into alcohol and drug use. There are three things that jump out at me that seem to be a factor in almost every case:

1. people in recovery allow themselves to believe that THIS time they will be able to drink or use responsibly and control their drinking or using. This is known as the "insanity of alcoholism/addiction" (Click Here to read more about that),
2. people end up almost immediately right back where they were before, or worse. People express surprise that there was no build-up this time - they were right back to the same amounts as before, and
3. people who have many years of sobriety are also subject to relapse, if they stop doing the things they need to do to remain in recovery. They allow themselves to become convinced that they are "cured" and that they can now control their drinking or using.

Part of our relapse prevention is to learn from the experience of those who came before us. That means to accept that we are people who cannot control our alcohol or drug use (if we could we would have done so long ago), and that to attempt to do so will lead us to disaster.

Fixing the things that kept us drinking or using

Pure willpower alone seldom helps many of us. Statistics that have recently been reconfirmed and published by the U.S. National Institutes of Health tell us that 13% of people can't control their drinking or drug use.

For those who can decide one day to stop, or to successfully control their substance use, kudos to them. If you are not sure, try it and see if it works for you. There are some tests you can take to help you answer the question (Click Here). If you are not one of these people - I know I'm not - you will have to do more than just "white-knuckling" your way through recovery.

There are recovery programs that are designed to help us to address the things that brought us to our addiction and kept us there. Experience has shown that we can't just "do" the program and be cured. We need to be part of a program that provides us with the ongoing support and personal development that we need to keep our recovery in the forefront of our lives. If we don't, we risk relapse and losing all we have.


There are psychological processes that prevent us from achieving sobriety (see "I'm Overwhelmed!" - Click Here) or being mentally ready to face the challenge (see "Barriers to Recovery" - Click Here).

Recovery programs are designed to help us to overcome these things that stand in our way, and to lead us to directly address the problems behind our addiction. Chief among these recovery programs are the Twelve Step programs (Click Here) and SMART recovery (Click Here). Even if we attend an intensive rehab program we will still need to find an ongoing program to strengthen and support our recovery on an on-going basis.

Methods of relapse prevention

There are three techniques of relapse prevention that I recommend:

 

Technique #1: Beat our memory

Our memory is not like a video camera. It has quirks and flaws and is subject to many influences. In fact, our memory plays a major role in causing relapse. I won't get into the details here, but suffice it to say that our memory has a tendency to remember the "good" times in the past and squeeze out the bad times. Thus, we are more likely to think of drinking or using in terms of "fun" times that we had, and not the pain, misery, sickness, and loss that it caused us.

It is quite fascinating how our memory is affected by addiction to push us back to our drug or drink. Anyone who wants to know all about how that happens and why, and how to counter-act the process can learn more in my book The Alcoholic / Addict Within (see below).

Let's look at how we can counter-act this memory flaw that works against our recovery. By far the most effective way to do this involves a technique that I will borrow from the Twelve Step program.

The Twelve Step program has a slogan that goes: "remember when." A simple, two word slogan, but deeply effective in killing cravings. The idea is to think back to all the misery and pain we lived through in our drinking and using days whenever thoughts of "good" times start sneaking back into our mind.

It is especially effective if we meditate on this "remember when." If you don't know how to meditate, that's ok. It's nothing complicated, it just involves sitting or laying in a comfortable position, eyes closed, and relaxing the mind. Then we focus our mind on our "remember when".


We think back to what it was like to wake up - "come to" - each day and immediately be gripped by the obsession with where our next drug or drink will come from. Think back to the hurt we caused ourselves and others, the horrible things we were driven to do, the sickness of our hangovers and withdrawal, and how little else we had in life mattered to us besides our using or drinking. Meditate on the details. You only need to do this for 3 - 5 minutes at a time.

My own experience with this meditation was excellent. In early recovery I did this meditation daily, and it played a key role in taking away my cravings and desire to drink or use. Later in recovery, when the cravings and desire and obsession with drugs and alcohol are no longer there, I do this remember when meditation anytime I start thinking "this party would be more fun if I hit a rail first" or "why can't I just have a couple of harmless beers after work."

Try it!

 

Technique #2: change of venue

Another technique for avoiding relapse is to change the toxic parts of our environment as best we can. This is referred to as changing people, places, and things. We are much less likely to remain in recovery when we still have our using or drinking buddies coming over to hang out. Seeing us in recovery only makes them feel bad about their own using and drinking, so they will try to get us back into their world.


Many of them are not true friends anyway. A good friend of mine OD'd on heroine laced with Fentanyl during a "party". His "friends" did not help him, nor did they call an ambulance. They robbed him of his drugs and money and bank card, and left him there to die. Thankfully, a passerby found him and called an ambulance. He is with us in recovery now.

Our friends who are still drinking and using are still sick, as we once were. If they find recovery we will likely find true friends in them. Until then, they are poisonous to our recovery.

Likewise, if we keep going to the places and doing the things we did while drinking and using, we are exposing ourselves to powerful triggers to relapse.

We should surround ourselves with recovery. Spend times with people in recovery, and avoid places and events that will likely draw us back in.

 

Technique #3: don't stop doing the things we need to do to stay in recovery.

Another method of relapse prevention is to follow a recovery program and fellowship and stay with it for as long as you wish to remain in recovery. Make the program a part of your daily life. Do what they tell you to do, give in to the program. Be a part of the fellowship. Talk to other alcoholics or addicts in recovery every day. Embrace recovery.

I have two friends who were each over nine years in recovery in a program. Both thought that they were OK now, and no longer needed to have the program as a part of their lives. Both relapsed only a few months later. They are now back in the program - for life - but each one had a devastating relapse that cost them much.

Final Thoughts

They say it is much easier to stay in recovery than it is to get back in recovery. We have to work on our relapse prevention for this reason. Ours is a deadly disease, and many of us know people who relapsed and died. This is serious business.

Knowledge alone will not keep us sober, but learning as much as we can about ourselves and the disease of addiction certainly helps. Listen to the stories of those who have succeeded in recovery. Let them mentor (or sponsor) you. Read about alcoholism and addiction. Become "spiritual" - I don't mean religious - see what I mean by 'spiritual' in "Why Do They Call Alcoholism / Addiction a Spiritual Sickness?" (Click Here).  



To learn more about the science and psychology of addiction and recovery, and to understand why alcoholics and addicts behave the way they do, see the author's book The Alcoholic / Addict Within.

Available in print and e-book editions from amazon.com (Click Here).