There’s an old axiom often heard in recovery circles – “Relapse happens”. While that’s true, it doesn’t HAVE to happen. Once you have regained your sobriety, it is NEVER all right to return to drinking or using drugs. But it’s important to face reality – relapses CAN and DO happen to people at every stage of recovery.
How Likely Is a Relapse during Recovery from Addiction?
The National Institute on Drug Abuse reports that relapse rates for people with substance abuse disorders are quite similar to those for other chronic illnesses:
- Addiction – 40% to 60%
- Asthma – 50% to 70%
- Type I Diabetes – 30% to 50%
- Hypertension – 50% to 70%
Each of these diseases is incurable, but a person suffering from any of them can successfully manage how the disease progresses in them. Adherence to a physician-recommended regimen, dedicated lifestyle changes and diligence, and, where necessary, medication assistance are all keys to living with a chronic disease.
How are a “Relapse” and a “Slip” Different?
While both terms refer to a return to the use of intoxicating substances after achieving or regaining sobriety, they are not precisely interchangeable. The difference between a slip and a relapse lies primarily in the duration.
- A “slip” is when someone very briefly returns to using drugs or drink – for one night or for a weekend, for example. When a person slips, they realize almost immediately that they’ve made a dangerous mistake.
So, they once again stop using/drinking and resume their sobriety. Often, they “go back to the basics” and redouble their efforts – going to more 12-Step meetings, for example.
Usually, a slip results in very minimal damage to the rest of the person’s everyday life.
- A “relapse” is more serious, because it means that the person has totally abandoned their efforts at recovery and has instead returned to active addiction.
A relapse can begin as a slip and rapidly worsen. The damage from a relapse has the potential to be severe, because the person can break the law, lose their job, harm someone else, overdose, or simply never return to sobriety.
Does a Relapse Mean That My Recovery Has Failed?
Absolutely NOT. Again, let’s compare addiction to another chronic disease – diabetes. If a diabetic were to stop complying with their diet and nutrition plan and, thus, see a return of the symptoms of their disease – high blood sugar, neuropathy, etc. – the assumption would not be that they were beyond help or that they could never return to health. But it WOULD mean that they would once again have to re-dedicate themselves to a hearing with their doctor-recommended plan of recovery – taking their medication as prescribed, losing weight, avoiding certain foods, exercising, avoiding stress, and so on. It’s the same way with addiction. When a slip or a relapse occurs, it simply means that the recovery plan needs to be adjusted – more preparation, greater vigilance and support, a new treatment approach, a different medication, etc. But it DOES mean that there was something missing in the recovery plan – vigilance, preparation, a specific treatment protocol, medication, support, etc.
Four Facts You Need to Understand about Relapse
You already know three critically-important things about relapses – (1) they are more than possible – they are probable, and (2) they can happen to anyone, at any stage or duration of recovery, and, (3) they are preventable. We know relapses are preventable because of a fourth fact – they are predictable. Relapses don’t usually “just happen” – there are relapse warning signs that alert you to the need for immediate action. Most people who relapse do so because of:
- Pain – physical or emotional
- Ongoing or unexpected conflict
- Unresolved Trauma
- Peer Pressure
Each of these can lead to renewed or increased cravings for alcohol or drugs, as a familiar coping mechanism. This Is where having a Relapse Prevention Plan comes in handy.
Creating Your Personal Relapse Prevention Plan
Creating a Relapse Prevention Plan this necessitates honesty and self-awareness from you if you want to be able to recognize the “red flags” indicating a potential impending relapse.
- Stay in touch with your sponsor – Anytime you feel like you might return to drinking or using, your sponsor should be your FIRST telephone call – night or day.
- Have your support system in place – Write down a list of sober family members and friends that you can call when you are in danger of relapsing.
- Participate in outpatient or aftercare programs – Communicate and work with your counselors.
- Get to a 12-Step meeting – Your peers at Alcoholics or Narcotics Anonymous are people who have felt like you feel and have been where you are, and they can be an invaluable source of strength, inspiration, and support when you are feeling overwhelmed.
- Perform a self-evaluation – Learn your personal feelings, thoughts, and behaviors that have in the past preceded alcohol or drug use. Look out for dangerous or negative:
- Emotions – frustration, anger, worry, anxiety, loneliness
- Thoughts – suspicion, poor self-esteem, regret, defeatism
- Behaviors – driving by bars or liquor stores, skipping AA/NA meetings, canceling therapy appointments, lying, hiding or stealing money
- Physical symptoms – headaches, insomnia, tremors
- Situations – around holidays, preceding court dates, after arguments or breakups, following a bad day at work etc.
It’s Not Enough to Know about Relapse – You Have to DO Something about It
If you start to recognize any of these thoughts, emotions, or behaviors yourself, you need to be proactive and prevent a relapse before it happens. Here’s what you SHOULD and SHOULD NOT do: DO:
- Call your sponsor and talk it out
- Distract yourself by socializing with sober friends – prepare a list in advance of healthy activities that don’t involve drinking or using
- Go to extra 12-Step meetings – as many as you can between
- Keep a journal as a means of processing your emotions
- Skip meals – hunger pangs can be misinterpreted as drug/alcohol cravings
- Isolate yourself – engage your support system
- Keep it all in – talk to someone about what’s going on in your head
- Quit taking your medications
When you are trying to protect yourself against a possible relapse, don’t forget one of your most valuable resources – the rehab program that helped you recover in the first place. As part of their aftercare program, they will most likely offer relapse prevention advice that can help you maintain your sobriety. Relapse happens – but it doesn’t have to happen to YOU.