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Relapse Prevention Plan

John Schaffer, LPCC

Medically reviewed by

John Schaffer, LPCC

February 11, 2019

Learning about how to stay focused in recovery and avoid relapse is important while you navigate your sober journey. Take time to understand and implement coping skills while addressing and adhering to a positive and fulfilling life free from substance addiction.

According to the National Institute on Drug Abuse, addiction is a disease of the brain that involves an overpowering compulsion to drink alcohol or use drugs. Addiction affects much more than just the physical body; it also alters the neurotransmitters in the brain which affect behavior, emotions, and thinking processes. The connections between the physical body and mind are the reasons why so many people tend to live in and out of drug use.

Whether someone suffering from addiction attempts to reduce or stop drug or alcohol use on their own or within a rehab program, relapse is the roadblock to true and lasting success at abstinence. It is often what keeps those suffering from addiction from progressing in their struggle to build a higher quality of life. However, it IS possible to get over a relapse. It is possible to recover from addiction and achieve long-term abstinence through various treatments, therapies, and support outlined in this guide.

What Exactly Is Relapse?

According to the National Institute on Drug Abuse, the term relapse describes the return to drug use or alcohol after someone decides to quit using. Addiction is a disease that affects your entire life and most often is not cured after the first time you decide to stop using a drug or consuming alcohol.

People recovering from addiction often relapse at least once on their journey. When someone relapses, they often end up in a downward spiral back into dangerous drug use or drinking and will need treatment and support to help them get back on track. It is the constant pattern in and out of relapse that can hold someone in the perpetual state of never truly recovering from addiction.

If you or a loved one is struggling with addiction and abstinence, it is important to understand the risk factors that often lead to relapse so you can avoid them in order to start building the higher quality of life you deserve.

What Are The Risk Factors That Often Lead To Relapse?

The severity of addiction, access to social support, and other factors are what affect the probability of someone relapsing. The most common causes of drug or alcohol relapse are stress, negative emotions, anxiety, drug-related pressures, temptations, boredom, and a lack of support and positive environment in one’s job, friends, and family.

According to the U.S. National Library of Medicine, studies have found that higher levels of withdrawal symptoms, including distress, irritability, drug cravings, sleep issues, and cognitive problems that occur during the early stages of abstinence contribute to a higher risk of relapse. Personal trauma is also an associated risk of relapse, along with depression. However, relapse happens gradually, long before someone takes a sip of alcohol or uses a drug.

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The Warning Signs And Stages Of Relapse

The stages of relapse can be broken down into a few categories, as documented by the U.S. National Library of Medicine, to help you understand just how addiction affects an individual and how relapse is brought on.

Stage One: Emotional

During this phase of relapse, the addicted individuals may not be thinking about using the drug or alcohol, but their emotions are stirring thoughts and behaviors that are setting themselves up for a relapse in the future. Self-denial is often a part of this emotional stage of relapse since the individual may not be thinking about using the substance.

The primary stages of emotional relapse include bottling up emotions, isolating oneself, skipping treatment meetings, attending meetings but keeping to oneself, focusing more on other people’s issues, and poor eating and sleeping habits. The common thread throughout the emotional relapse phase is poor self-care. When an individual neglects vital self-care, they may become so uncomfortable in their own body and their daily life that they think about using drugs or alcohol again to relieve their emotional discomfort.

Stage Two: Mental

Once someone enters into the mental phase of relapse, they are often at war inside their own mind. They want to use drugs or alcohol to relieve their symptoms and negative emotions, but they don’t want to use at the same time because they don’t want to “fail.” The stages of mental relapse include a craving for drugs or alcohol, focusing on experiences in their drug past, glamorizing past use, lying, thinking about how they can control their use, and looking for opportunities for relapse. Once someone gets deep into this phase, they often inevitably relapse to escape the mental war being waged inside.

Addiction treatment is critical during this phase to help the individual realize and avoid high-risk situations that can lead to relapse. Many times, patients haven’t yet identified their high-risk situations and don’t believe them to be high risk.

Stage Three: Physical

The final phase of relapse, the physical stage, is when someone actually uses drugs or alcohol again. This phase is often broken down into two parts: “lapse” for the initial use of drugs or alcohol, and “relapse” as the onset of uncontrolled use.

Individuals struggling with addiction often don’t realize how much of a substance they have had during the “lapse” phase and don’t understand how it can quickly lead to uncontrolled use. Many physical relapses occur due to the individual believing in a window of opportunity for use without getting caught. A necessary part of addiction treatment is helping them create and rehearse healthy exit strategies to avoid this.

Relapse Prevention And Addiction Treatment

One of the most successful methods for preventing relapse is to help the individual struggling with addiction understand and recognize the warning signs of relapse, so they can avoid them or seek help. Abstinence and withdrawal should not be solo experiences because the risk of relapse occurring is almost guaranteed. An individual wanting to recover from addiction should find a treatment program to help them recognize the risk factors for relapse and develop the coping skills needed to remain drug-free and build their confidence.

Addiction treatment can teach the patient what self-care is and why it is important to make a priority to prevent a relapse. Individuals can find more information on drug and alcohol treatment programs through or on the Substance Abuse and Mental Health Services Administration’s website.

The Steps Of Relapse Prevention

One of the most important steps for relapse prevention is cognitive therapy, which has been found to be successful at shifting people’s negative emotions and thinking to develop healthy coping skills. Negative thinking is most often all-or-nothing for individuals struggling with addiction and eliminates all possible positives of treatment and recovery attempts.

Cognitive therapy helps individuals in treatment to break their negative thinking habits and teach them how to create healthier, positive ways of thinking. According to the National Institute on Drug Abuse, cognitive and behavioral therapies are a crucial part of a successful addiction treatment to address a patient’s motivation and behavior. This style of therapy also helps because many patients suffer from co-occurring mental disorders along with their substance abuse.

Overcoming Fear

The fear of failing and relapsing, not knowing if a recovering individual can truly remain drug-free, not knowing who they will become if they stop using drugs, and not knowing if they’ll lose those closest to them are all common negative thinking patterns that stem from fear. Cognitive therapy helps the individual to understand that recovery from addiction is not some special skill or willpower that only some people possess, and that it is based on developed coping skills.

Redefining Fun

Many clinical studies have shown that those struggling with addiction tend to glamorize their past use of drugs or alcohol when they are under stress. They will think about their substance-using past longingly and will think of it as a time of fun and enjoyment. Cognitive therapy is aimed to help people remember all the positives they have experienced through treatment, and to understand that recovery isn’t easy but that it is worth it compared to a life living with addiction.

Learning From Mistakes And Setbacks

An individual’s ability to handle setbacks and discouragement affects their experience in addiction recovery. Examples of setbacks maybe someone not setting healthy boundaries, not reaching out for help, not avoiding high-risk situations, and not making time for self-care. Many people in recovery see setbacks as failures, even if they didn’t end in relapse, and usually experience negative emotions. Setbacks along with resultant negative thinking can lead to a dangerous cycle which eventually leads the person to relapse when they feel they’ve been confirmed in believing that recovery is not possible for them. But setbacks are normal in recovery and are not failures; cognitive therapy helps individuals to realize this and work through their setbacks.

Living With Being Uncomfortable

Many individuals in recovery tend to have harsher feelings put on themselves than they carry for others who do not suffer from substance abuse. They assume that non-addicts don’t feel or deal with the same emotions and setbacks, and then they justify the need to escape their feelings with drug use. Cognitive therapy works to help individuals see that their negative feelings are not signs that they are failures and are a normal part of life.

The Steps To Long-Lasting Recovery From Addiction

Recovery from addiction is a continuous process that will be different for everyone trying to refrain from drug or alcohol use. While the length of time and experience of recovery differs from person to person, there are a few primary stages that everyone goes through.

Transitioning To Abstinence

Someone in recovery transitions into the abstinence phase from the moment they stop using the drug or alcohol, typically lasting for about 1 to 2 years. This phase of recovery mainly focuses on the need for the person to deal with their cravings without turning to substances. A few of the primary focuses in this phase include the acceptance of the addiction, practice of honesty, development of coping skills, activity in peer support groups, practice of self-care, cutting ties with drug-using friends, and understanding the stages of relapse.

Dealing with withdrawal is another key component of the abstinence phase. It requires medical supervision, support therapies, and sometimes medication when appropriate, with examples listed in this document by the National Institute on Drug Abuse, to control the unpleasant symptoms of withdrawal, which can include nausea, insomnia, aches and pains, mood swings, and depression.

Early Recovery And Repair

The second part of addiction recovery is repairing the damage done to the body that was caused by the addiction to harmful substances. While someone entering into this phase may be feeling emotionally better and confident about turning their life around, it isn’t uncommon for someone to feel worse when they actually begin to repair the accumulated damage. This damage can be emotional, referring to any harm done to relationships, career, or their finances during their addiction. It also includes physical harm, since consistent use of drugs and alcohol can damage organs, bodily functions, and can cause nutritional deficiencies.

Cognitive therapy is often used during this phase to help the individual overcome negative thoughts, understand that their addiction does not define them, repair relationships, participate in self-help groups, learn healthy eating habits, and begin to form a balanced lifestyle. For relapse to occur in this stage, studies have found common causes to be not having support from peers and self-help groups.

Ongoing Recovery And Growth

This stage of addiction recovery and relapse prevention is to help an individual develop skills to help them continue in their drug-free journey. It aims to deal with any past traumas, as well as issues with family that may lead to relapse. Additionally, this phase helps the recovering person to identify and repair any negative thinking patterns, understand negative patterns within the family, challenge any fears, set healthy boundaries, give opportunities to help others, and reevaluate a positive lifestyle as needed to keep them on track in their goals.

While the primary focus during this phase is helping the individual remain drug-free and develop healthy habits, it is also important that they receive the help to create a happy life that energizes and fulfills them.

For long-lasting recovery that results in long-term abstinence from drugs or alcohol, these steps must be implemented by the individual:

  • Set your focus on starting a new life
  • Be totally honest to themselves, their family, their counselors, and self-help groups
  • Ask for help in recovery. It’s okay to rely on others during this difficult time.
  • Such as relaxing, making time for fun, getting good sleep, and eating right
  • Follow the guidelines of the addiction recovery program, it will help keep you on the right path

Achieve Recovery And Prevent Relapse With Our Help

Recovery is not accomplished by simply not using drugs or alcohol. It is achieved by creating a new life that makes it easier to not use substances. If an individual is not in the position to change their life, the causes of addiction and risks for relapse will still exist. You or a loved one can begin to change your life for the better by looking into a drug or alcohol rehab program.

If you would like more information on treatments and how to find the right one for you, contact us at Our staff has the expertise in answering all of your questions and pointing you in the right direction for the program that’s best for you. Relapse prevention isn’t a lonely job; it takes a team of dedicated professionals and loved ones, and it all starts with the right environment.

National Institute on Drug Abuse - What is an addiction?

National Institute on Drug Abuse - What is a relapse?

NCBI - New Findings on Biological Factors Predicting Addiction Relapse Vulnerability

NCBI - Relapse Prevention and the Five Rules of Recovery

SAMHSA - Find Help

American Institute for Cognitive Therapy - What Is Cognitive Therapy?

National Institute on Drug Abuse - Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

National Institute on Drug Abuse - Treatment Approaches for Drug Addiction

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