A relapse prevention plan is a written document that you can share with your support team – yourself, friends, family, and health professionals – to minimize a return to unhealthy behaviors, including drug and/or alcohol use.
Addiction is a chronic disease with relapse rates between 40% and 60%. [1] To prevent relapse it can be helpful to have a plan, recognize when old patterns or triggers come up, and learn how to manage them.
A concrete relapse prevention plan can help prepare the patient for the signs and symptoms that may indicate impending relapse so that the individual can intervene before they use substances again.
Relapse is often gradual. Recognizing dangerous behaviors before you pick substances up again can help to prevent a relapse.
Relapse is common with substance use disorder (SUD). It does not indicate failure, as it is often a natural part of the healing process. A relapse prevention plan helps to prevent a relapse or minimize the consequences of a partial relapse.
Relapse generally does not happen overnight. Some researchers consider it to have three distinct phases:[2]
A relapse prevention plan helps a person to identify the initial phases of a relapse – emotional and mental – before a physical relapse occurs.
When creating a relapse prevention plan, it can be helpful to work with a trained professional who understands SUD. The plan often works best if it is written down. It also often works best if the clinicians know the patient well and their individual situations, triggers, and strengths. It can also be helpful for family or friends to be involved.
It is helpful to know exactly what has caused a relapse before, and your own history of drug and alcohol misuse.
Know what you are aiming for and what you want in your life. Write these specifics down. They can include career goals, family goals, educational goals, spiritual goals, hobbies or activities you want to explore, and more.
It is vital to know what could possibly lead to relapse. Make a detailed list. Be as specific as you can, outlining potential scenarios or stressors.
Researchers define a “trigger” as something that sparks drug cravings.[7] Yours might include the following:
Think back to the days before your last relapse. How did you feel? Who did you see? How well were you sleeping and eating? You might spot patterns that could highlight triggers.
Knowing your individual triggers is critical, as once you’ve identified them, you can craft plans to avoid them altogether or deal with them if they appear.
Since relapse often starts with the emotional and then mental aspects, it’s important to recognize your own personal responses.
This is one of the most important parts of the plan. It should detail exactly what to do if you feel the signs of a relapse beginning.
Start with your list of identified triggers, and move through them one by one. Your plan might involve a list of the people you will call, the actions you will take, and what you will do instead of returning to substance use. Be as detailed and specific as possible.
Here are a few examples of appropriate responses to the triggers we identified earlier:
These are examples of strategies you might use in your personalized relapse prevention plan. Your tools and tips may look very different. Customize your approach and find something that works well for you.
Include your support people in your action plan, so they know how to best encourage you when needed.
Each relapse prevention plan will be personal and specific to you, but there are some general things that should be included, such as:
Research suggests that families learn a lot about SUD as they help people they love. They learn about how to get treatment, they determine how to use rescue medications like naloxone, and they become experts at caring for children left behind.[8] These experts are well-qualified to help with your recovery, and they should be part of a relapse prevention plan.
Tell your support system that you’re working on a relapse prevention plan, and ask for input. As outsiders, they may help you identify relapse triggers you’ve overlooked. They may also be eager to be contact points as you craft your trigger responses.
When your plan is complete, give your support system a copy of the document. Remind them you’re not asking them to police your behavior. However, they can help you stay accountable. For example, if they notice you’re staying out late every night and avoiding the rules you set about sleep, a gentle reminder could help you get back on track.
Everyone’s relapse prevention plan will look different, but here is a form you can fill out to create yours:[3]
While each relapse prevention plan is unique, there are several different models that help provide a template. Examples are the Marlatt and Gordon model and the Gorski-CENAPS Model for Recovery and Relapse Prevention.
This model explains how both things that are right in your face, which include high-risk situations, coping skills, and outcome expectancies, as well as factors that are more underlying, like cravings and lifestyle issues, can contribute to relapse. [3]
The model also details how both specific and global strategies can be used to reduce the risk of relapse. By identifying possible high-risk situations that are specific to an individual and designing coping strategies for managing them along with more generalized strategies that include lifestyle balance, relapse can be avoided or the effects reduced.
This model uses nine basic principles for relapse prevention planning. It couples each principle with a clinical technique or procedure to use for minimizing and preventing relapse: [4]
These are the questions we hear most frequently about relapse prevention plans:
Does a relapse mean the treatment didn’t work?No. Experts consider substance use disorder a chronic condition, and for many people, a lapse is part of the process of recovery. A return to drug use does mean that the person needs to talk to a treatment team and pick up skills that can prevent the next episode.[1]
Does everyone relapse?No. The National Institute on Drug Abuse says newer treatments are designed to help with relapse prevention.[1] Some people using these therapies don’t return to drugs.
Does a relapse prevention plan really work?A relapse prevention plan can help you identify triggers, develop coping skills, and understand who is ready to help you in a crisis. It only works when you follow it.
There are many worksheets, workbooks, and support group options that can aid in relapse prevention. Here is a sampling:
Your therapist, mental health professional, or SUD counselor will likely also have relapse prevention resources they can share with you. Generally, these resources are available as part of a comprehensive treatment program for SUD.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role . Read More
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