Relapse Prevention

Relapse Prevention in Addiction Medicine

Monday, February 17, 2020 | By Cooper Samp

While relapse is often part of the recovery process, this does not have to be the case for everyone. There are steps that can be taken to help prevent a relapse from occurring.

What is a Relapse?

Relapse is often discussed as someone engaging in substance use after being sober. A relapse is not simply a one time use of substances, a relapse is a process that frequently begins before the actual use of the substances has started.

While a one time use of substances after being sober would be considered a lapse, a relapse is a process and use would occur more than one time.

There are a multitude of reasons or events that could potentially lead to a relapse. When working with clients who are engaging in substance use or have sought out treatment for their substance use, it is imperative as the clinician to develop a plan to limit the chance for a potential relapse. This is a collaborative process that requires effort and planning from both parties. Planning helps ease a sense of worry for the client about what to do when faced with a potentially stressful or triggering situation. Creating this plan is a multi-step process. 

Creating a Plan

The first step is identifying warning signs for the specific individual. These warning signs could include things like people, places, music and seeing certain objects in front of them. Before any of this can begin however, the client must possess the personal awareness to know what these warning signs are. Often times individuals know what their warning signs are however they choose in the moment to ignore them due to believing they are stronger emotionally and mentally than they truly are. This can create an opportunity for the client for introspection to discover certain situations they could see as potentially damaging for them and to then be able to sit down with their clinician to discuss some alternatives to these warning signs that would be beneficial for them. These would be the coping skills or strategies deployed when faced with tough stress-producing circumstances. 

Developing Coping Skills

Coping skills (coping strategies) are techniques that take time to develop. Coping skills have a wide spectrum in terms of their use and application and work for some but do not for others. If a client has a trigger it is important to determine the root of the trigger, what kind of situations in the past have developed it into a trigger, and possible strategy to combat this trigger.

An example of a coping skill that is often deployed is grounding. This is a mindful based technique used as a way to center one’s mind from outside distractions. This can look like having the client imagine a certain object, person, or feeling when they are stressed, sad, or angry. This can also entail having the client physically place their body centered to the ground such as standing or sitting straight to refocus their attention.

With coping skills, they are an acquired attribute to have. There are certain techniques that are beneficial for some that may be detrimental for others. To cope with something is to diffuse a situation appropriately that may be negative in nature through an action that is positive or beneficial in nature. Adversity will follow clients even once completed with treatment and for that reason having a positive natural support system is crucial in recovery and relapse prevention. 

Recovery and sobriety are often spoken about synonymously however they have separate meanings.

Sobriety is simply the act of abstaining from the use of drugs or alcohol. Recovery is a complex process surrounding the key areas of someone’s life and maintaining growth and improvement in all of these areas.

A connection is key when regarding recovery and preventing relapse. Having a group of individuals who can be called upon in the time of need or crisis is a critical component of relapse prevention. There may be times when clients both while in and out of treatment will face where guidance and/or advice is needed. This support system helps build the foundation for being able to ask for help and the trusting of others for the client. This group of people can be constructed with friends, family, co-workers, significant others, professionals etc. The people involved are determined by the person seeking out the support. It is important to choose wisely who is part of the support system as they will be counted on for accountability and safety when the client is in need or struggling. It is important for the clinician and client to discuss when constructing the support system for the client, which people are going to be non-judgmental and supportive moving forward regardless of the client’s circumstances and who does the client feel should no longer be included in the inner circle of support. There are going to be people almost certainly that the client used to consider as important people in their lives however moving forward it is important to evaluate with their new lifestyle who should be involved in it. 

Relapse prevention is an integral part of substance abuse treatment for all clients. This may be a topic they never felt the need to be discussed when first entering treatment because their behaviors had become normalized. One of the main focuses with relapse prevention is how can the client and clinician work together to identify potentially harmful past situations and prevent them from happening again to halt the need for substance use to be the “crutch” to ease the pain and worry. The conditioning of the new positive behaviors and people the client surrounds themselves with will certainly take time to develop and become habit however if the discussion is had throughout the clients treatment, this can provide the client with a new foundation for post treatment. The client with the new coping skills developed, positive support system, and trigger warnings known, there will be safeguards in place to potentially limit the chance for relapse and further substance use treatment down the road. Prevention is proactive and can limit impulsive decisions being made rather than reactive and having to fix a mistake or regretful decision that has been already made. 

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