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Updated on September 26, 2022

Preventing Relapse

What is Relapse?

Relapse occurs when a person drinks alcohol again after a period of sobriety.

Intense cravings or thoughts about alcohol might trigger someone to relapse. Stress or other life problems often occur before these cravings and urges.

After relying on alcohol to help cope with life problems, it can be difficult not to use it when faced with these challenges again.

The relapse rate among those who complete treatment is approximately 90 percent.4 Because of this, many consider alcohol use disorder a chronic, relapsing disease.

Some even believe alcoholics are powerless in preventing relapse and require ongoing treatment, even when things seem to be going well.

What Causes Relapse?

The answer to this question varies as much as the person experiencing a relapse. For many, relapse occurs after a series of events (like personal problems or negative situations).

As the person becomes overwhelmed by emotions and events, they feel out of control and turn to alcohol for relief. For others, shame and embarrassment play a role in relapse.

Some people relapse because of their negative feelings about themselves. These people have the belief that they can't change. Preventing relapse is impossible when a person believes they'll fail.

A 2013 study published in the journal Clinical Psychological Science

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Prevention Plans for Alcoholism

Adopting a plan for preventing relapse is one of the best ways to avoid relapsing. There are different schools of thought on what to include in a relapse prevention plan.

According to T. Gorski, a comprehensive plan should include:2

  • Stabilization: The person must be sober and focus on remaining so each day.
  • Assessment: Involves looking at a person’s history and considering drug and alcohol use throughout their lifetime.
  • Relapse education: Learning that relapse is normal and shouldn't provoke shame.
  • Warning sign identification: Learning a person’s triggers and understanding that they're typically a combination of factors.
  • Recovery planning: Attending AA meetings and working with a sponsor.
  • Inventory training: Taking a daily mental inventory to look for relapse warning signs.
  • Family involvement: Asking family members and friends for support. This might include attendance at Al-Anon meetings.
  • Follow up: Reviewing the plan, especially during the first few weeks of sobriety.

Marlatt’s Cognitive-Behavioral Model is another relapse prevention model. It's based on identifying risks or triggers for relapse.6

The model requires working with a therapist to create the best response to high-risk situations. This process includes carefully examining each trigger and a plan for targeting weaknesses when faced with those triggers.

Finding an effective strategy for preventing relapse is an essential part of recovery. It should be a goal of anyone struggling with alcohol use disorder or trying to support someone with AUD.

5 Prevention Skills for Alcoholism

There are also plenty of relapse prevention techniques to help people maintain recovery and achieve short and long-term goals. These skills should be used in each recovering person's daily schedule and routine to prevent or reduce the risk of alcohol cravings.

1. Self-care

By exercising and consuming a balanced diet, a person becomes healthier and can improve their quality of sleep.

This is done by following a structured sleep, exercise, and eating schedule. By following self-care practices, a person can retrain the body to sleep better and reduce the risk of relapse.

2. Mindfulness meditation

This concept teaches people to become more self-aware.

When we're more self-aware, we can cope better with relapse triggers. A study found significant improvement in people in recovery who practice mindfulness meditation programs compared to those who don't.

3. Understanding triggers

Triggers can be internal, such as feelings of anxiety, stress, or anger. Or they can be external, like people, places, or things that remind someone of their past use.

Making a list of internal and external triggers can help someone better understand them and reduce the risk of relapse.

4. Making an emergency contact list

When a craving occurs, it can be challenging to manage it, especially during the beginning of recovery. Making a list of healthy family members or friends you can call for support is a good idea.

Having a safe person to speak to can help you remember why you don't want to return to previous behaviors. Keep the list on you at all times, so it's readily available.

5. Practice deep breathing

Practicing deep breathing allows you to gain more control over your life.

Breathing isn't just connected to various functions throughout your body, but it also has a significant effect on your brain chemistry. Breathing impacts your emotions and helps regulate your mood.

Deep breathing is a great relapse prevention method because you can practice it anywhere without anyone knowing.

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Relapse Risks

Several factors increase someone’s likelihood to relapse, including:

  • Physical withdrawal symptoms
  • Anxiety
  • Stress
  • Dysphoria, a feeling of being dissatisfied with life
  • Anhedonia, the inability to experience pleasure in life
  • Limited or no support from family or friends
  • Failure to participate in recovery aftercare, including counseling and/or 12-step programs
  • Falling back into old habits
  • Not using coping skills to redirect thoughts or urges to use

Seeking Support If You Experience Relapse

Medical professionals recommend anyone experiencing a relapse avoid self-criticism and seek support.

Support might include:

  • Attending a 12-step meeting or increasing participation in meetings if you're involved in a program
  • Beginning personal and/or group counseling
  • Remaining objective and honest about your situation

The support system in place after a relapse should encourage treatment following the relapse.

A support system consists of:

  • Counselors
  • Psychiatrists
  • Psychologists
  • Sponsors
  • Friends
  • Family

There's a certain degree of shame that occurs when someone relapses. However, thinking “I’m a bad person because I started drinking alcohol again,” is all-or-nothing thinking that doesn't help.

Whether or not relapse is a normal part of recovery is debatable. But there's no debate that it occurs. It’s best to accept it and seek the help needed to prevent relapse from happening again.

Someone with alcohol use disorder should see treatment not as a sign of weakness, but as a tool for recovery.

Despite the effectiveness of support and treatment, some people struggling with addiction don’t want to participate.

There are several reasons for this:

  • Denial and believing help isn't necessary
  • Assuming treatment won’t work, either because of their flaws or flawed programs
  • Making excuses for attending treatment by claiming they can’t afford it or don’t have time
  • Giving in to negative feelings and self-talk
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Resources

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  1. “Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 18 Feb. 2020
  2. Gorski, Terence. . The Cenaps Model of Relapse Prevention: Basic Principles and Procedures. Journal of psychoactive drugs. 22. 125-33
  3. Larimer, Mary E, et al. Relapse Prevention An Overview of Marlatt’s Cognitive-Behavioral Model. Vol. 23, no. 2, 1999
  4. Relapse and Craving, National Institute on Alcohol Abuse and Alcoholism, No. 6 PH 277, October 1989
  5. Randles, Daniel & Tracy, Jessica. . Nonverbal Displays of Shame Predict Relapse and Declining Health in Recovering Alcoholics. Clinical Psychological Science. 1. 149-155
  6. Larimer, M E et al. “Relapse prevention. An overview of Marlatt's cognitive-behavioral model.” Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism vol. 23,2 : 151-60
  7. Bowen, Sarah et al. “Mindfulness-based relapse prevention for substance use disorders: a pilot efficacy trial.” Substance abuse vol. 30,4 : 295-305

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