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Addiction Treatment

Relapse Prevention Plan

What is a Relapse Prevention Plan?

A relapse prevention plan is comprised of measures, techniques, and many different tools to avoid falling back into bad habits. A relapse is using drugs or alcohol again after a period of abstinence. Since recovery is not a linear process, it has its ups and downs, and relapse can be one of them. 

Relapse is common in the addiction treatment process. It should not be considered a failure, but after treatment, the goal should be to prevent relapse as much as possible. During treatment, you’ll utilize a relapse prevention plan template to help you develop a solid strategy to maintain recovery. 

Studies Into Drug and Alcohol Addiction Relapse Rates

Currently, studies show that relapse is more than typical among recovering individuals. Previous studies said about 40% to 60% of people tended to relapse. Now, recent findings state that this number went up to 85% just in the first year of recovery. More than 60% of people relapse about weeks to months after starting addiction treatment. Finding ways to prevent relapse is the ultimate goal of any relapse prevention plan. It will help provide direction in moving forward during your recovery. 

A recent study that was conducted in 2021 with a small group of 391 participants showed that those who stayed in addiction treatment for less than three months were 11.2 times more likely to relapse than those who spent more than three months. Additionally, those who engaged in more than two substance use disorders were 1.5 times more likely to relapse than those suffering from a singular addiction. 

Why Should You Develop an Effective Relapse Prevention Plan?

Creating a relapse prevention plan within your treatment program will be essential in helping prevent future relapses. As part of a recovery journey, you will be motivated to develop a list of triggers and coping strategies to add to your plan as well as a list of individuals to include in your support system. 

Early recovery is often difficult to navigate, but with a thoroughly developed relapse prevention plan, you can feel more confident about your ability to avoid drugs or alcohol and begin a new life. It’s also important to remember that you will get professional help during treatment in creating your written plan, so there’s no need to worry about missing a step. 

What is Relapse?

Relapse refers to a person’s breakdown in their attempt to manage and alter their substance use behaviors after already going through treatment and now in the recovery process. Relapse is a step back in someone’s attempt to change their thought patterns and physical reactions. This is usually caused by stressors and triggers. 

At this point, the medical community understands enough about relapse to know how it works – and how to best avoid it. Relapse triggers and chances differ from person to person. However, by understanding how relapse occurs, one can use many techniques to prevent it. A relapse prevention plan is precisely that, and different things work for different people. 

There are many things to consider when avoiding relapse. Each factor should be approached differently. All of the triggers and negative thoughts could require medications, therapy, or support groups. There are many treatment solutions to multiple situations. Individuals will utilize several solutions to stay on the path to recovery. 

Are There Stages and Warning Signs of Relapse?

A relapse is not a sudden event; it is a gradual process. Generally, a person will start experiencing some small symptoms or notice a few changes in behavior. Ideally, it is best to start looking into a relapse prevention plan as soon as possible. However, some people might not catch or notice these things early on. While it is still possible to prevent a relapse in later stages, it might require a more intense approach. 

The Three Stages of Relapse and Their Warning Signs

The three stages of relapse are emotional relapse, mental relapse, and physical relapse. Each phase leads to the next where physical relapse signifies using drugs or alcohol. 

To effectively create a solid relapse prevention plan, you must understand the three stages and the warning signs associated. During your addiction treatment, you’ll learn very intimately how to recognize these stages so you can prevent relapse while in recovery. 

Three stages of drug relapse

Emotional Relapse

This initial phase is much more subtle and harder to notice for some. Though most people are not aware of it, this is when you start engaging in behavior that might lead to relapse.  

  • Anxiety (in general, about anything) 
  • Intolerance and/or short temper
  • Easily angered, constantly angry
  • Mood swings, moderate or severe
  • Isolation in social situations, at work, and even amongst family
  • Defensiveness, primarily when the subject of relapse or getting help is addressed
  • Not asking for help when struggling
  • Not attending meetings or sessions for recovery
  • Changes in eating habits (eating either too much or too little)
  • Changes in sleeping habits (sleeping either too much or too little)

These are classic behaviors for those going through an emotional relapse. While one or another might be common to the recovery, too many can be a cause for concern. And after these, there are other signs to look out for in the mental relapse stage. 

Mental Relapse

Now, the actual thoughts of using start entering your mind. This might be the highest point of the internal conflict. You do not want to fall back into substance dependence, but you start missing aspects of consuming drugs. 

  • Romanticize/glamorize substance use, thinking only of the good times 
  • Think about the people you used with and places you’d go, missing it all
  • Lie about substance abuse-related thoughts and habits
  • Hang out with old friends or family members that are not sober
  • Fantasize about using drugs, imagining scenarios they could make happen to relapse
  • Plan a possible relapse around other people’s schedules

This could be considered the transition phase from thoughts to actions. Taking preventative action at this stage might be the difference between re-starting an addiction process and staying clean. But if you or a loved one experiences this, how should you deal with it, according to a relapse prevention plan? 

Physical Relapse

This is considered the final stage of relapse — the actual contact with drugs or alcohol. The first slip is enough to put a person on the wrong path. Just because they don’t start using heavily right away, doesn’t mean they won’t. By then, any action to stop yourself is not part of a relapse prevention plan. It is an actual remedial action toward relapse. 

Crucial Steps in Creating a Relapse Prevention Plan

A relapse prevention plan is not something set in stone, but rather, a list of possible measures. There are many proven, effective ways for each step. Nonetheless, having the right mindset is crucial for any of them to work. It might be hard, but the focus on recovery needs to be a priority. 

Identifying Triggers

Before anything, one of the most defining factors of relapse prevention plans is identifying triggers. You need to understand what is making you crave or abuse substances to avoid it. Substance dependence is the result of external stressors being too much to handle for current, known coping mechanisms.  

Some of the most common ones are: 

  • Experiencing withdrawal symptoms and wanting to make them stop 
  • Being surrounded by enablers 
  • Bad relationships, people who are not supportive 
  • Having drug supplies and/or paraphernalia around 
  • Feelings of loneliness and/or purposelessness 
  • Depressing events such as unemployment, deaths, breakups 
  • Places that remind you of using drugs or alcohol 

More often than not, there are deeper underlying causes of substance use disorder. These can be a trigger for relapse someone might not be aware of. This is one of the main reasons why therapy is of utter importance. Not just to help with recovery and for a relapse prevention plan, but to help you improve and understand yourself better for everyday life. 

Coping Skills for Relapse Prevention

There are also some other tips on how to deal with urges, both emotional and mental. By developing a list of what to expect and coping strategies your prevention plan can be more effective and specific to your needs. 

According to research, while urges can be strong, they might last about 15 to 30 minutes. When facing them, it might feel like an eternity, but having this in mind might help. Finding something to do and occupying yourself might be the best way to resist these urges. 

When thinking of substance use disorder, you need to remember the reasons why you quit. Though there might have been good times, you quit because addiction was significantly hurting you and others in your life. Maybe write these reasons as reminders, or have people remind you of it — anything to make you remember that quitting was the best decision. 

Find ways to reward yourself for steering clear of drugs and alcohol by providing incentives for yourself. Engage in self-care activities that will make you look and feel better about your recovery and how far you’ve come. A positive experience like getting your hair cut or getting a massage will help you realize there are much healthier ways to cope. Also, self-care helps boost your self-esteem adding to your personal growth. 

As part of your relapse prevention plan, you should have developed a list of people (like a family member) that you can call on to help you stick with your recovery plan. You should also have a list of support groups that you can reach out to (like alcoholics anonymous) in case you need additional support. Many treatment facilities offer different 12-step programs you can attend as part of your long-term recovery plan. 

Engaging in relaxation techniques like meditation, breathwork, and yoga will help you slow down your mind and refocus on the bigger picture. It is also an excellent way to practice self-care. Slowing down your mind will help you review your thought patterns and avoid old habits that led to negative experiences. 

When creating a relapse prevention plan, health professionals at your treatment center will have you develop a written document of all the people in your life that triggered your substance abuse. These are people that will not be positive for your recovery. It may seem difficult to cut people out of your life, but remember it is ultimately what’s best for you to manage. Moving forward in your life will often mean letting go of the past. You may not need to avoid these individuals for the rest of your life, but it’s best to do so in early recovery. 

Finally, one of the most important measures is to remember you are not alone. You should ask for help that is available to you because avoiding drugs is not easy. Calling friends and family who support you is a great way to keep yourself on track. Recovering alone is not only hard, but it can be painful, and to some, almost impossible. There is a way to make things easier, and there are many who can help while in recovery. 

Models of Relapse Prevention

There are several different views on relapse prevention just as there are different models of therapy and treatment. Relapse prevention models offer a variety of relapse prevention strategies. 

Known as an expert in the addiction treatment field, Terry Gorski is president of CENAPS and clinical director of its Relapse Prevention Certification School- which is a training program for addiction treatment professionals. Within his model of relapse prevention he lists the following nine steps to be important in developing a CENAPS model of relapse prevention, otherwise known as a Gorski relapse prevention plan: 

Self-control: Physical, psychological, and social stabilization 

Integration: Completing a self-assessment 

Understanding: Educating yourself on relapse signs and prevention methods 

Self-knowledge: Identifying early warning signs for when relapse is likely 

Coping skills: Managing these warning signs effectively 

Change: Reviewing the recovery plan 

Awareness: This is acquired through practice and personal growth 

Support Group: Getting loved ones and friends involved 

Maintenance: An extensive follow-up plan 

Dr. Gordon Alan Marlatt, a University of Washington Psychology professor, founded this relapse model centered around high-risk situations. 

Marlatt’s cognitive-behavioral model of relapse conceptualizes relapse as a “transitional process, a series of behaviors and activities that unfold over time.” This is unique to other models which view relapse as an end-point or “failure of treatment.” The addition of flexibility is a key advantage of these transitional models: they offer guidance and opportunities for intervening at various stages in the relapse process to prevent or reduce relapse opportunities. 

The basic ideology of Marlatt’s Model Relapse Prevention Therapy is a behavioral self-control program that is designed to teach individuals who are trying to maintain sobriety how to anticipate and deal with the problem of relapse. 

There are two basic goals to Marlett’s Model of Relapse Prevention: 

1.) To minimize the impact of high-risk situations by increasing awareness and building coping skills. 

2.) To limit the ability and likeliness of relapse by promoting self-care, healthy habits, and a balanced lifestyle. 

While the Marlatt’s Model was designed for working with clients struggling with alcohol abuse it has been applied to addictive and impulsive behaviors more broadly including eating disorders 

Get Help For Substance Dependence and Prevention at Sana Lake Recovery Center

Recovery is a rough road to walk through, full of turns and ups and downs. But in the end, that journey can be worth it, and much less dark than going down the path of addiction. Having the right people helping and supporting you can make the journey easier and much lighter. 

If you or a loved one need help to recover from substance use disorder or prevent relapse, we at Sana Lake Recovery Center can help. We provide services designed to improve mental health through behavioral methods. With programs including detox, inpatient treatment, outpatient rehab, and sober living, our goal is to give you all the tools to overcome alcohol or drug use and make it through the recovery stages. 

Whether you are still seeking help for substance dependence or if this is not your first time, our doors are open for you. 

We will give you an assessment to understand what will be the best course of action. Recovering can be difficult, but it is not impossible – and it can certainly be better with a team behind you. 

Larimer ME, Palmer RS, Marlatt GA. Relapse prevention. An overview of Marlatt’s cognitive-behavioral model. Alcohol Res Health. 1999;23(2):151-60. PMID: 10890810; PMCID: PMC6760427.  

Melemis SM. Relapse Prevention and the Five Rules of Recovery. Yale J Biol Med. 2015 Sep 3;88(3):325-32. PMID: 26339217; PMCID: PMC4553654.  

Picture of Ashley Murry LCSW
Ashley Murry LCSW
Ashley Murry, LCSW, is the Chief Clinical Officer at Sana Lake Recovery. She oversees clinical operations, ensuring effective treatment strategies and compliance. Before this, she was Program Director at Gateway Foundation, managing care programs and collaborating with state departments. Ashley has also served as Director of Clinical Services at Treatment Management Company, improving staff retention and clinical standards. She holds a Master's in Social Work from the University of South Florida and a Bachelor's in Social Work from Saint Leo University. She is licensed in Florida, Arizona and Missouri.
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