Relapse Prevention at Hope Rehab

What is relapse prevention? After making changes to your life, it is important to consider how to maintain these changes so they are sustainable throughout everyday life. Relapse prevention will equip you with the tools you need to ensure that you do not fall back into old habits.
Relapse Triggers
Psychologists prefer the word cues, originating from research in which a reward or punishment is paired together with something else i.e. the cue together with food. For example; dogs will associate the sound of a bell with food over time and will begin to salivate as soon as the bell rings. This is known as classical conditioning (based on the research by Ivan Pavlov known as the phenomenon of Pavlov’s dog or Pavlovian Response) and forms part of relapse prevention work.
The body itself has been conditioned to respond to routine behaviour. Most living creatures have an internal timing system that makes them automatically respond to the course of the day to meet their needs. For example, people feel the urge to drink after work, have an evening joint, bedtime pill, weekend of meth, a binge, daily fix or even hourly fix. We’ve become programed to expect something.
Unfortunately, without setting yourself clear goals and using tools to cope, it is very common for most people with addiction issues to experience relapse and remission.
In the 1800’s Ivan Pavlov conducted experiments on how cues around dogs would stimulate them to respond to eating. For example: whenever a bell was rung the dogs would receive food. Eventually, the dogs would salivate as soon as the bell was rung. This is known as classical conditioning , it now forms part of the basis of the relapse prevention work we cover at Hope Rehab. For more in-depth information please visit our “Relapse Triggers & Radar” page.
– National Institute on Drug Abuse (NIDA)
Common problems
Although common, the harm and impact this has on your life should not be minimised. Instead, one should consolidate the reasons behind this and work to avoid those triggers in future. Remission is the beginning of a relapse. Slipping back into old ways of behaving can often be on the cusp of relapse back into drink or drug use. You have to be honest with yourself, where have you gone wrong before?
Not all relapse triggers are external cues – some come as stress builds up from pre-existing conditions such as depression, psychosis, obsessive behavior, bi-polar and other psychiatric illnesses. Non-compliance with medical treatment and medicines can lead to self-medicating with more mind-altering substances such as alcohol and other drugs.
Dual-Diagnosis – Those with dual-diagnosis (the co-existence of substance-use and psychiatric issues) need to factor in special consideration for this and often draw support from planning with Hope and addiction groups like Dual Recovery.
Relationships – supportive relationships can often be difficult and can unfortunately lead to stressful factors and even present direct triggers to use. It is not recommended that in early recovery you pursue new romantic relationships. Sexual relations and non-sexual relations can be both a source of pain and pleasure, in other terms –emotional stress.
Environment
External Triggers
People: Parents, friends, family members, co-workers
Places: Bars, neighbourhoods, home, holidays
Things: Cash, paraphernalia, bottles
Events: Weddings, funerals, BBQ’s, birthdays, weather
Sensory: Smells, sight, sound, taste
Internal Triggers
Emotional: Anger, depression, anxiety, euphoria, memories
Mental: Insane and distorted thinking patterns
Euphoric Recall
A common trait for many people recovering from drug and alcohol usage is to only recall the positives from their usage. This is called euphoric recall. Often, people remember the times where they partied on drink and drugs and forget all about the agony.
By unconscious desires to use alcohol or drugs, the mind filters out the negativity and potentially glorifies past experiences. Even music can be a powerful trigger, recalling moments of euphoria, memories of using, positive connections or alternatively negative feelings of depression and anxiety.
Sometimes when people leave treatment they are suddenly faced with an urge to use drink or drugs again. It is important to recognise that cravings are an understandable part of the process and they come and go in waves. The first wave is characterized by intense feeling or desire to use. Eventually, over the span of a few minutes or more, the wave begins to diminish. However, it can return at similar levels.
The Recovery Map
The recovery map is the last exercise of the client’s treatment. It helps the client to get a clear view of their new recovery life, what they are going to do, plans and commitments etc., as well as of their personal triggers and slippery behavior, which would lead the client back to the addiction.
Clients fill in their bottom lines in the center of the recovery map. Bottom lines are the things they cannot go back to, i.e. alcohol, medication, heroin and/or cocaine. They also write down their clean date at the bottom of the bottom lines.
After the bottom lines, the focus is on the outer part of the recovery map, the four corners about health and lifestyle, work and education, relationships and their recovery. It is important that clients honestly describe what they are going to do after treatment, and not make a ‘wish list’.
A few examples:
Health / Lifestyle
Yoga 3 times per week
Biking to work at least twice a week
Biking to work at least twice a week
Work / Education
Back to the old job
Start a study
Applying for a new job
Enroll in a course
Relationships
New friends from meetings
Taking your spouse to the zoo
Contacting ‘good’ old friends
After the center and the outside of the recovery map, it is time to write down the triggers and slippery behaviour.
What leads the client from their new recovery life back to their addiction/bottom lines?
A few examples:
Health / Lifestyle
Laziness
Boredom
Not sticking to the goals
Not exercising
Work / Education
Stress
Not finding a job
Not doing homework
Coming late
Relationships
Anger
Visiting old using friends
Mother in law
Lack of assertiveness
Recovery
Complacency
Excuses
Not going to meeting
Lack of routine
Going to a bar
Availability
Address underlying issues
Long enough period of time is critical
Individual counselling
Group work
Diagnose mental disorders
Medically assisted detoxification
Treatment voluntary or coerced