A relapse prevention plan is a preventative measure taken to reduce or eliminate the likelihood of lapse or relapse, typically in the context of an addiction. Relapse prevention plans typically include a list of coping strategies, emergency contacts, support groups, and other helpful resources.
What Is Relapse Prevention?
Specific to substance use, research has found that about two out of three of individuals in active recovery relapse within the first several weeks to months of starting; greater than 85% of individuals relapse within a year after treatment.1 Given the fact that tolerance diminishes while abstinent, relapse could result in severe consequences.
3 Stages of Relapse
An understanding and awareness of the three stages of relapse, whether from substances or a behavioral addiction, can help you make an informed decision to seek assistance. To best minimize the likelihood of physical relapse occurring, it is important to intervene during the emotional or mental stages.
The three stages of relapse are:
- Emotional: Emotional relapse is marked by a gradual increase in negative emotions (e.g., anger, anxiety, depression, frustration, irritability, sadness).2 It occurs prior to the onset of any cravings or urges, but may ultimately lead toward them if the negative feelings become overwhelming and/or your coping ability is compromised.2
- Mental: Mental relapse is when you begin seeking an escape from the emotional pain—at this point the individual is now beginning to actively fantasize about using.3 Although it is common for random thoughts of using to occur, especially shortly after recovery, this stage progresses to the point of actively choosing whether or not to use again.3
- Physical: Physical relapse is when use occurs.2 Actual use and the process of acquiring the substance are considered here.2
What Is a Relapse Prevention Plan?
A relapse prevention plan is an important tool for anyone recovering from any substance of abuse. They’re often drafted alongside a professional in treatment and can serve as a contract between counselor and client. Such plans help you recognize the risk factors for addiction, identify warning signs of relapse, and stay sober. They can also be drafted for loved ones.
A detailed relapse prevention plan details exactly how to deal with cravings and urges when they come. It could include specific coping mechanisms like deep breathing exercises, mantras, and relaxing postures. Emergency contacts are also helpful to talk the individual out of a relapse if necessary. A healthy next step in the plan could be attending a support group (live or virtual).
Relapse prevention plans are only as good as the intention behind them. If you are committed to recovery, then it’s an extremely helpful tool. If not, then it’s as useless as a blank piece of paper. It’s also important that the plan is custom-tailored to you and/or others. If medications are involved, list them. Whatever is healthy, safe, and helps prevent relapse is fair game for inclusion.
7 Steps to Make an Effective Relapse Prevention Plan
While drafting a relapse prevention plan, it is important to be as specific as possible. Coping strategies should be those that you are familiar with and willing to engage in. Resources should be as close to local as possible and emergency contacts should be those with whom you feel most comfortable sharing.
Here are seven steps to make an effective relapse prevention plan:
1. Assess Your History
It helps to begin by assessing your history. Though it may be difficult, it is important to be as honest with yourself as possible. Everything in the plan begins here.
Questions to consider include:
- What is my drug of choice?
- If my drug of choice is not available, what do I go to next?
- Do I have an issue with multiple substances at once? If so, what substances do I use frequently?
- When did I first use?
- Have I ever had periods of sobriety since first use?
- For how long have I used?
- What is the frequency of use?
- How much do I use while using?
- Do I have a family history of use? If so, who struggled with use, and how has it impacted me?
- Who else uses among my friends and family?
- Who do I use with?
- What are my most significant triggers?
- Where do I frequently purchase substances?
- Where do I use most frequently?
- Are there any mental or emotional health issues that need to be addressed?
2. Determine Signs That Could Lead to Relapse
The best means of preventing relapse is understanding what triggers it. Often, when committing to a true recovery effort, there is a necessity to change patterns of people, places, and things. These people may include those who contribute toward a toxic relationship or “drug buddies.”
Places may include spots where you purchase substances and use them. If alcohol is a problem, bars and pubs may be especially problematic. Things may include drug paraphernalia, alcohol-related glassware, or anything else that inspires use. Particular activities, movies, television shows, music, and video games, may also be included.
3. Set Goals
Investing time in setting goals can make all the difference moving forward. Ultimately, the long-term goal should be abstinence and living a healthy lifestyle. Short-term goals entail anything that helps contribute toward the long-term goal (e.g., attending support groups, seeing a counselor, getting a job, seeking prosocial support, etc.) The more concrete the goal, the easier it is to follow.
4. Manage Cravings & Triggers
Managing cravings and triggers requires an awareness of what they are. Prior to recovery, what led you toward using. Was it experiencing negative emotions? Was it boredom? Was it because you wanted to celebrate? Perhaps use was normalized in your social group. Write down what you recall about cravings and triggers.
While in recovery, continually note all the things that make you want to use. Remember, cravings and triggers are not as problematic as what one decides to do or not do about them. Whenever a new trigger is unveiled, make note, take corrective action, and remain on track.
5. Establish Healthy Coping Mechanisms
Coping mechanisms should be healthy, practical, and even enjoyable. Above all, they should be things that you will actually do. Mechanisms may include deep breathing, meditation, exercise, playing an instrument, writing, taking a walk, reading a book, watching a program, or even playing video games.
Whatever coping mechanism you prefer, just make sure that it does not lead to cross-addiction, which is transferring one addiction to another. For additional information, review our articles on healthy coping mechanisms and self-care.
6. Set Up Communication
Having someone who will hold you accountable to speak with when times get rough can make all the difference. This individual may be a friend or family member but should be someone who encourages sobriety and has your back.
Professional contacts may also be necessary. If seeing a therapist, it helps to have their number, as well as substance abuse and crisis hotlines, local hospitals, and support groups. If attending support groups, having the number of a sober sponsor is also recommended.
Additionally, it helps to delete and block numbers of past drug contacts or others who may compromise your recovery effort.
7. Hold Yourself Accountable & Stick to It
The most important thing is to remain motivated to change. Intrinsic motivation, the kind that comes from within, is always strongest. One must be intentional and consistent with the recovery effort. This entails keeping recovery at the forefront of one’s mind while not making excuses to distract from that.
Three helpful forms of accountability include:
- Keeping a calendar of sober days
- Attending a daily support group (online or in-person)
- Celebrating accomplishments in a way that keeps you away from using (e.g., coins given to AA members)
Remember that slip-ups are common and only as catastrophic as you allow them to be. Rather than punish yourself, note what went wrong, stick to your relapse prevention plan, and get back on track.
When to Seek Professional Help
Although relapse prevention plans are generally devised in therapy with a professional, it’s possible to draft one on your own. However, the reality is that addiction is an incurable disease that takes many lives annually. Struggles with treatment and recovery are normal, and it often takes professional intervention to get back on track.
If you find that your plan is not working, seek assistance. Working with a professional counselor in outpatient or enrolling in residential treatment is ideal. Support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), SMART Recovery, NAMI Dual Recovery Anonymous (DRA), and others can also prove extremely helpful.
The bottom line is that when the going gets tough, you should never face the issue alone. Help is out there regardless of finances, location, and demographics. It is on you to find and accept it.
Final Thoughts on Making a Relapse Prevention Plan
Addiction is hard to overcome, but any step in the right direction is a step forward. And slip-ups are only as detrimental as you allow them to be. If you are struggling with addiction and just read this article, you already took a step in the right direction. The next one is to follow-through. Remember, you’re not alone.
For Further Reading
- SAMHSA’s National Helpline: 1-800-662-HELP (4357)
- Hazelden Betty Ford Foundation
- SMART Recovery Toolbox
