What is Relapse and a Relapse Prevention Plan?

By
Sharon Farntrog
Medically Reviewed by
Dr. Jefferey A. Berman MD, DFASAM
Last Updated
August 1, 2023

Part of the complete guide to understanding addiction

Table of Contents
  1. Relapse Statistics
  2. Identifying and Addressing Relapse
  3. What is a Relapse Prevention Plan?
  4. How to Write a Relapse Prevention Plan
  5. Items to Include in Your Relapse Prevention Plan
  6. Create a Drug and Alcohol Relapse Prevention Plan for Long-Term Recovery

Relapsing to drugs and alcohol abuse means continuing to use drugs and alcohol after a period of abstinence. Since substance addiction is defined as a progressive, chronic, and relapsing disease, relapse is an incredibly common occurrence in the recovery population. According to the National Institute of Drug Abuse (NIDA), “Relapse rates for addiction resemble those of other chronic diseases such as diabetes, hypertension, and asthma.” Studies show that as many as 40 to 60% of recovering addicts will relapse at some point. Hence the need for a relapse prevention plan.

Many people in recovery find the prospect of relapse frightening, as it is an exhausting risk that hangs over their heads at every moment of every day. But the perspective on relapse is shifting, and people are beginning to recognize that it may be a natural part of the recovery process. Even if one does relapse, with the proper attitude, it can be utilized as a springboard for incredible growth. 

Relapse Statistics

Relapse is a far more common occurrence than most realize. According to the NIAA, approximately 35.9% of alcoholics will attain lasting sobriety. That translates into the reality that 65% will ultimately relapse, and likely within the first year of sobriety.

According to the National Library of Medicine, estimates from recent clinical studies suggest that over two-thirds of people relapse within months or even weeks of beginning treatment.

Studies conducted by the NIDA prove that up to 85% of individuals relapse within a year of treatment. After one year of sobriety, the likelihood of relapse decreases to 50%. After five years, that likelihood goes down to 15%.

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Identifying and Addressing Relapse

As we discussed, relapse is, unfortunately, a frequent occurrence among people in recovery, as their bodies and minds adjust to a substance-free life and they continually battle powerful cravings. Because of this, it’s critical to recognize the signs and symptoms of relapse so it can be pre-empted – in both yourself and others.

Common signs of relapse include:

1.       Changes in Mood and Behavior – Sudden changes in behavior, mood swings, and increased anxiety and irritability, may all be signs of relapse.

2.       Neglecting Self-Care – A relapsing individual might stop caring for themselves physically, mentally, and emotionally. This would include neglecting personal hygiene, abandoning hobbies and pastimes that once brought joy, and losing interest in school, work, and/ or socializing.

3.       Physical Signs – Any physical signs that accompany substance abuse would be an indicator that an individual may have relapsed. Signs include sudden weight gain or loss, bloodshot or dilated eyes, pinpoint pupils, or unusual body odor.

4.       Avoiding Support Groups – Another common sign of relapse would be when an individual in recovery starts skipping or avoiding AA meetings, therapy sessions, or follow-up appointments.

5.       Returning to Old Habits – If an individual in recovery begins returning to activities, relationships, or places with ties to their past addiction, that is a red flag indicating potential relapse.

6.       Loss of a Support System – As an individual moves closer to relapse, they may begin cutting ties with family, friends, sponsors, and other people who support their sobriety.

7.       Evasive Behavior – One of the primary characteristics of addiction is secrecy. If an individual is consistently evasive and deceptive about their activities, it may indicate relapse.

8.       Neglecting Responsibilities – Neglecting one’s duties and failing to meet expectations at home, school, and/ or work may also be signs of relapse.   

9.       Financial Difficulties – A perpetually empty bank account and constant need for more money can be an indicator of resumed substance use.

10.   Justifications – A relapsing individual will likely try rationalizing or “explaining away” their use of substances in certain situations.

It’s important to remember that relapse doesn’t happen from one minute to the next, and these symptoms may display themselves gradually and intensify over time.

If you or someone you know begins displaying any of these symptoms, seek immediate help from a healthcare professional, licensed counselor, or support group. The sooner a relapse is addressed, the sooner the individual can get back on track.

What is a Relapse Prevention Plan?

A relapse prevention plan is a personalized strategy meant to help individuals in recovery maintain their sobriety and prevent relapse. Relapse prevention planning is based on a proactive approach of pre-empting relapse before it occurs.  Relapse prevention plans identify potential triggers, list practical coping mechanisms, and provide resources to support an individual in their sobriety.

A well–developed, thoughtfully constructed substance abuse relapse prevention plan can be an invaluable tool in one’s recovery toolkit, and can significantly improve the chances of sustained sobriety.

An ideal relapse recovery plan will include certain key elements. They will ensure you:

·   Identify and avoid environmental triggers

·   Develop coping skills

·   Build a strong support network

·   Create an emergency plan to handle cravings

·   Continue to receive professional help

·   Practice Self-Care

·   Remember HALT

·   Celebrate Milestones

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How to Write a Relapse Prevention Plan

Creating a relapse prevention plan requires real self-honesty and a thoughtful, structured approach to identify triggers, develop coping strategies, and build a support system. Sit down with a qualified therapist (preferably one who knows you well and/ or who assisted you through your recovery process) and walk through the key elements together. Ensure you are well – aware of your triggers and personal signs of relapse and have a clear plan of action for when powerful cravings strike.

There are many templates available online that can be incredibly helpful as you go about designing your personal relapse prevention plan. Here is one such outline, and here is an example of another.  (Many more can be found when performing a simple Google search of “Relapse Prevention Plan Template”.)

Working off of a template provides the structure you need, and it’s then as simple as filling out the blanks in each section with the required information.

Remember to be transparent in all of your answers, regardless of how uncomfortable it makes you feel. The more honest you are, the more effective your plan will be. And lastly, be sure to review your relapse prevention plan consistently and update it as needed!

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Items to Include in Your Relapse Prevention Plan

As we mentioned above, certain key elements should be included in every relapse prevention plan. Let’s go into more detail about each.

 

1. Identify and Avoid Environmental Triggers.

Did you know that avoidance behavior is one of the most successful ways to keep from relapsing? Stay away from tempting situations where your substance of choice is readily available.
Some common examples of triggering environments are:

Ø  Bars and clubs

Ø  Homes of friends or family members (who are not part of your support network)

Ø  Events and celebrations

Ø  Being around people who abuse drugs/ alcohol

If you can’t avoid any of these situations, use the buddy system. Call on a supportive person to attend the event with you so that they can steer you away from temptation should it rear its head. This tactic is helpful when you are trying to stay sober during the holidays too.

2. Develop Coping Skills.

Although a lot of this work is done during inpatient rehab, entering early sobriety armed with solid coping skills gives your recovery the best shot possible.

Remember that each person is unique, and what proves effective for one person may not be helpful for you. Explore and discover the techniques that resonate with you, and add them to your personal “recovery toolkit”. Examples of effective addiction recovery tools would include meditation, mindfulness, breathing exercises, journaling, engaging in creative outlets (like art, music, writing, crafting, sewing, etc.), nutrition, volunteering/ commitments, and spirituality, to name a few.

3. Build a Strong Support Network.

It’s important to surround yourself with those that care about your recovery. That means staying in a supportive environment filled with people ready to assist at any moment. You should be in a place where harmful substances and triggers are completely avoided. Interact regularly with these providers of support so you can keep to your post-treatment goals. When returning to work after rehab, consider if your workplace is a supportive environment or a new job would be a better choice.

4. Create an Emergency Plan to Handle Cravings.

You can’t control everything around you, especially when it comes to facing triggers. You may experience momentary strong cravings. That’s why having a clear prevention plan in place will help. 

Substance abuse is a negative coping skill, so learning positive coping skills for relapse prevention is a good idea. Whatever this entails, write it on an index card as a reference. For example, you might have a list of names and numbers of people to call when a craving sets in, like sponsors, family, or sober friends. 

You could also make a list of alternative activities to engage in once you feel a craving set in, like jogging, going to the movies, meeting up with friends, or going to a recovery meeting. 

Remember that the relapse prevention strategies that you choose must be unique to you. What works for someone else might not work for you.

5. Continue to Receive Professional Support.

Even after treatment is completed, ongoing counseling sessions with a mental health professional remain an integral part of the recovery process. This is because counseling sessions offer a safe, non – judgmental space for sharing feelings and processing emotions and challenges. You can opt for group or individual counseling, or a combination of both.

Group counseling brings people with similar experiences together to learn from and grow with one another. Individual therapy offers one-on-one treatment with a professional that builds upon the progress already made. Continuing these sessions is an essential part of a relapse prevention plan and increases your chances of maintaining sobriety.

6. Practice Self-Care.

One of the primary characteristics of an addiction is the utter lack of self-care that its victims display. Those in the throes of an addiction are far too hyperfocused on their substance of choice to register anyone outside of their own existence, and even their own basic needs.

On the flip side, an essential part of recovery is practicing self-care and treating your body with the respect it deserves. Maintain good personal hygiene, remain mindful of your health, and see a doctor and dentist regularly. Eat well–balanced, nutritious meals, work out, get enough sleep, and indulge in the activities and hobbies that bring you joy! If you treat your mind and body well, they’re likely to reciprocate.

 

7. Remember HALT.

HALT stands for hungry, angry, lonely, and tired. These feelings often make people in recovery vulnerable to relapse. Relapse prevention techniques involve showing individuals these signs and helping them choose self-care over drugs or alcohol as an escape. The HALT method promotes eliminating uncomfortable physical and emotional conditions that might lead to a relapse. Take care of yourself right away if the craving is caused by any of these feelings. Practicing mindfulness in recovery can relax you, improve self-control and help you tackle cravings the right way. Consider adding a 10-minute meditation to your daily routine.

 

8. Celebrate Milestones.

Sobriety milestones are more than just another reason to throw a party. Marking your sobriety milestones gives you the opportunity to reflect on your journey and how far you’ve come, and internalize the power of the well of internal strength that you never realized you possessed.

Acknowledging your achievements reinforces the positive behaviors you’ve been practicing, and gives you the push to continue on – even when the going gets tough.

 

Create a Drug and Alcohol Relapse Prevention Plan for Long-Term Recovery

Addiction recovery isn’t easy; it is a lifelong process. That’s why it’s so important to place yourself in a supportive environment filled with mentors and friends ready to assist at any moment. Taking these important steps to create a realistic addiction relapse prevention plan will send you on the right path toward a successful and healthy future.

If you or a loved one are struggling with a substance use disorder or fear you are beginning to relapse, Avenues Recovery is here to support you. Leaders in addiction rehabilitation, our skilled team of treatment specialists will walk you through your treatment options and answer any and all questions you may have. Reach out today to begin your journey home!

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