According to experts, a relapse doesn’t just happen, it happens in stages and is predetermined by certain factors. These three stages are: Emotional, Mental and finally, the Physical relapse.
To understand a relapse, it’s important to understand the common triggers:
When a person stops using, they usually experience withdrawal symptoms that may be severe depending on their drug of choice and the amount they were using. Withdrawal can be a dangerous trigger for a relapse.
Symptoms may include – nausea, anxiety and feeling physically weak and the unpleasant physical symptoms may increase cravings for the substance in order to feel better and take away the pain. The initial withdrawal symptoms may be followed by post-acute withdrawal symptoms such as: anxiety, irritability, mood swings and poor sleep.
Self-care includes maintaining a proper sleep schedule, eating healthy nutritious foods, practicing mindfulness and using tools such as meditation, yoga & CBT therapy to eliminate stress and reactions to stress. Neglecting ones’ self-care leads to stress and inability to cope.
PEOPLE, PLACES OR THINGS
In recovery, a core concept is avoiding ‘people, places or things’ that are triggering. It’s critical for someone in recovery to cut ties with old friends or partners who are still using, as well as dealers of course. It also means avoiding going to the same places they used to frequent when they were using. ‘Things’ can refer to anything symbolic that reminds one of drug use.
HALT refers to uncomfortable emotions and is an acronym for hungry, angry, lonely, tired. All of these things may easily lead to a craving and thinking about using.
Romantic relationships where there is conflict, or where another partner is using or also in recovery, can also make someone in recovery very vulnerable to relapse. Fighting and instability is a big concern. Painful breakups often lead to relapse. Alternatively, without a romantic partner, someone in recovery may feel as if they have no support system or are unable to deal with the grief, loneliness or pain. In treatment it’s always recommended that one should abstain from romantic relationships for at least the first year in recovery. However, this is not always possible for someone who is married or in a long-term relationship.
An addict may use a troubled relationship as an excuse to relapse and often make their partner responsible for their sobriety. i.e. “if you fight with me, or do this, I am going to use”. They play on their partners guilt.
When you isolate yourself in recovery, it’s easy to get stuck in your head and start to have obsessive thoughts about using. One may relapse out of sheer boredom and also lack of connection with other people and the outside world. Being in recovery can often be lonely – especially if you have had to cut out old friends or relationships. It’s therefore vital to attend meetings, surround yourself with others in recovery, and to reach out to friends and family who are sober and healthy for you.
EGO OR PRIDE
The ego kicks in when you believe that that you no longer have a drug or alcohol problem. Some addicts in recovery become overconfident. They may believe that they have enough “clean time” or have done their stint in rehab, and their addiction is behind them.
You may believe that you are able to be around others who are drinking or using, without picking up.
Others may believe that because a certain substance was not their primary drug of choice, they are able to use it without relapsing. You may find that an addict who is clean from cocaine, believes they may be able to still drink without relapsing on the drug. This leads them into dangerous territory, as a relapse can easily happen when intoxicated.
Some may turn to new addictions such as shopping or sex to take the focus off their substance craving. When an addict starts bargaining and saying things like “I’ll just have one drink, it won’t be a problem”, this is usually a red flag. Full abstinence is key.
A relapse usually begins on an Emotional Level. It is possible to relapse on an emotional level, without necessarily thinking about using, although your emotions and behaviors are setting you up for a possible future relapse.
An Emotional relapse can start weeks or months before an actual physical relapse.
What are the signs you can look out for in an Emotional Relapse?
- Mood Swings
- Not attending meetings
- Not asking for help
- Poor sleeping and eating habits
An Emotional relapse usually happens at the post-acute withdrawal stage. It’s important to understand post-acute withdrawal so it becomes easier to avoid a relapse. It’s easier to pull back from a relapse in the early stages. In later stages, the desire to relapse becomes stronger and the sequential events, happen much quicker.
PREVENTING RELAPSE IN THE EARLY STAGES
It’s important to know your triggers and to have made a list of them when you are still in treatment. Devising a “step-down” plan with a therapist or counsellor is vital.
REMIND YOURSELF WHAT YOU HAVE TO LOSE BY PICKING UP
Going to meetings or seeing your therapist, are healthy ways to remind yourself of how dysfunctional your life was when you were using, and the damage you caused to yourself and others. Remind yourself of the downward spiral your life was on and how much healthier your sober life is on all levels. A therapist can teach you coping skills and family and friends can listen.
Practicing self-care and following a routine at this stage is vital. It’s easy to slip back into old ways, so it’s important to get proper sleep, eat nutritious food, meditate, exercise and reach out to loved ones if you need help.
During this phase, the mind is working over-time and there is a war between using and not using. Thoughts of using start filtering into the mind, but during the later stage, one is definitely thinking about using. There is bargaining and idealizing past use. Saying things like “I can have just one drink” or “I can hang out with friends who are using and I’m strong enough to say no” are usually telltale signs.
At this point, the addiction is growing stronger and it becomes harder to make healthy choices.
A sure sign that you are in the midst of a mental relapse, is when you start to glamorize your old life – boasting and telling stories about your using, the people you used to hang out with, the crazy things you did, how much fun you had – these memories are all ego based. This indicates that one is also thinking about ‘people, places and things’ that were part of their destructive lifestyle.
It’s dangerous to believe that an addiction is under control without putting in the work, such as going to meetings, working with a sponsor & avoiding ‘people, places and things’ that are triggers.
A mental relapse can very quickly lead to a Physical one. This is why it’s so important to catch a relapse in the early stages and take necessary steps to change the thought process or distract yourself with healthy activities.
When you are feeling a strong urge to relapse, it’s important to remind yourself why you stopped using in the first place and the damage that your active addiction caused to your life on all levels. Figure out why you are having this urge and what you can do to change your mind. If you find yourself in a high-risk situation, then leave.
During this phase, one may start to lie. You may also plan your relapse around other people’s schedules. So if a family member or partner goes to work for the day and you are left alone, it can be a very easy opportunity to use.
It’s vital to have no contact with old friends that use. Whether it be on your phone, social media or physically hanging out with the person. The temptation is way too high. One may make excuses to hang out with old friends and lie to yourself and others by saying you are fine with people using around you without it being a trigger. It’s important to make a fresh start – delete old social media accounts, get a new number and only keep your important numbers such as others in the fellowship, family members and sober friends.
It’s important to be kind to yourself, realize recovery is a difficult process and acknowledge that you are doing your best.