Completing alcohol or drug rehab is no small feat, and it’s worth being proud of; however, your journey doesn’t stop there. In the weeks and months of recovery following rehab, you’re still at an elevated risk for a relapse. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), almost 60 percent of people admitted for substance abuse treatment have been in treatment at least once before, and 13 percent have been in treatment five or more times.
This makes it of utmost importance to get continuing support, also known as aftercare, to help you stay abstinent from substance use. Aftercare can take a variety of forms, but they all focus on the same central theme: helping you avoid falling back into a pattern of addiction. According to the National Institute on Drug Abuse (NIDA), aftercare programs help reduce the risk of relapse.
Help is available at each stage of the recovery process. Even if you lapse, that doesn’t mean a relapse is inevitable, says a review in Alcohol Research and Health. However, most people cycle through relapse and recovery several times before they stabilize and enter remission from substance abuse, so relapse is no reason to be ashamed.
According to SAMHSA, recovery has four major components:
- Home: Having a secure and stable place to live
- Health: Overcoming substance abuse, managing co-occurring health conditions (including mental health disorders), and making healthy decisions that support emotional and physical wellbeing
- Purpose: Engaging in meaningful activities on a daily basis, such as a regular job, school, caring for a family, volunteering, art, or sports, and having the self-sufficiency and financial means to participate in society
- Community: Building healthy relationships and social networks that provide friendship, support, and love
Relapse prevention planning
Relapse prevention planning is one of the focal points of advanced recovery and aftercare. Psychiatric Services states that this therapeutic model is most effective for individuals who are actively engaged in recovery, or who have completed a recovery program and are maintaining their sobriety. However, the process of preparing for a relapse can actually begin as early as the detox phase. From the beginning of a treatment program, therapists can anticipate their clients’ needs by assessing factors such as:
- Substance abuse history
- Prior episodes of treatment
- Medical and psychological health
- Current support system
- Level of internal motivation
- Personal stressors (financial, emotional, social)
The more consistently the practices of relapse prevention are implemented, the greater the client’s chances of maintaining long-term abstinence. In outpatient care and partial hospitalization programs, relapse prevention sessions are scheduled on a regular basis to keep these topics at the forefront of the client’s mind.
Guiding Principles
Relapse prevention focuses on the thought patterns and behaviors that lead to relapse, and on how to replace them with more constructive thinking and decision-making. Some principles of relapse prevention, as outlined by Alcohol Research and Health, include:
- Learning to identify high-risk situations, also known as triggers, helps you manage or exit these situations without using substances to cope. Such triggers might include:
- Anger, anxiety, depression, frustration, or boredom
- Arguments with friends or family members
- Social pressure to drink or use substances
- Positive messages about drugs or alcohol, such as at celebrations or while passing a favorite bar
- Feeling the need to test one’s “willpower” by getting near drugs or alcohol
- Developing coping strategies for stress and cravings offers alternatives to using substances in times of high risk.
- Re-evaluating expectations for the consequences of substance use. Many people who are recovering from addiction return to drugs or alcohol thinking that using will make them feel better. In reality, such feelings are fleeting, but consequences like overdose, medical complications, problems at work, relationship conflicts, or incarceration are lasting. Relapse prevention teaches patients how to make wiser decisions before they consider using.
- Keeping lapses from becoming relapses by teaching how to view each lapse as a result of a high-risk situation or trigger, rather than as the result of a personal failing. This increases the likelihood of the patient feeling a sense of self-control and agency, which boosts their ability to abstain in the future.
Extended Care
Extended care offers a safe and structured living environment for people who have completed rehab (or are otherwise in remission) but who would be at high risk for relapse if they went to live on their own. In safe living, residents are required to abstain from substance use (often proven by passing drug tests), and they have access to other treatment services, like group therapy. Extended care also provides a social support network for recovering residents. According to research in the Journal of Psychoactive Drugs, sober living programs increase rates of abstinence and recovery. They also improved employment, psychiatric, and legal outcomes.
Outpatient Treatment and Self-Help Groups
Outpatient care can offer similar levels of treatment as residential rehab programs for patients who are ready to live at home. This might include individual therapy, group therapy, or medication therapy. Patients with co-occurring mental health disorders may also need ongoing therapy to treat those conditions. Research in the Journal of Studies on Alcohol found that outpatient care improves one-year sobriety outcomes.
Twelve-step self-help groups, such as Alcoholics Anonymous or Narcotics Anonymous, offer a structured support group for recovering addicts. They teach that addicts are powerless over their addiction, and that they must submit themselves to the control of a higher power. Abstinence is the only solution for living free of addiction, and continued attendance of meetings and participation in activities are the keys to abstinence.
Although the spiritual slant of 12-step programs means they are not suitable for everyone, the Journal of Studies on Alcohol and a great deal of other research has demonstrated their effectiveness in helping maintain abstinence and recover from relapse. Participants in 12-step programs can get social support not just from their peers, but also from a sponsor, who is more experienced in recovery and can offer a one-on-one relationship and guidance throughout the program.
Life Skills Training and Coaching
Skills training gives patients a set of practical tools and strategies for dealing with the world without drugs. These can include:
- Risk-managing skills to teach patients how to avoid high-risk situations, how to exit high-risk situations once in them, and how to resist using substances
- Coping skills for times of stress or other intense emotions like depression, anxiety or anger
- Social skills for dealing with others, such as how to communicate needs, resist peer pressure, assert oneself, make friends, and navigate stressful social situations
Skill training is most effective in group therapy, as it allows patients to practice their newfound skills with others. According to research in Addiction, skills training improves substance use outcomes.
Life coaching is not affiliated with any particular treatment method and does not involve formal or licensed therapy. Instead, life coaches help patients get treatment and make positive changes in their lives. A life coach can help a patient implement what they’ve learned in therapy, working together for improvements like finding housing or employment, building and rebuilding personal relationships, and understanding the role that addiction has played in their life.
Learn More
At Orlando Recovery Center, we are dedicated to helping our clients progress to the next level of their recovery. Relapse prevention is an essential component of our aftercare, outpatient, and partial hospitalization programs. By working consistently and constantly with our clients to prevent setbacks after treatment, we empower them to take control of their own sobriety in recovery. For information about our fully integrated recovery services, call our intake counselors today.