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Relapse Prevention

Relapse Prevention
Annamarie
Medically Reviewed
Annamarie Coy, BA, ICPR, MATS
Alyssa Hill
Written by

Alyssa Hill
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The 3 Stages of Relapse
The 3 Stages of Alcohol Recovery
How to Create a Relapse Prevention Plan
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Why is Relapse Prevention Important?
Whether new to sobriety or sober for many years, relapsing is always a possibility. It is vital to understand the stages of relapse and which factors may put you at risk.

Understanding relapse prevention techniques and knowing how to help yourself is critical for a successful, long-term recovery. Additionally, creating a relapse prevention plan for alcoholism can help you maintain sobriety and avoid relapsing.

The National Institute on Alcohol Abuse and Alcoholism estimates that 90 percent of people recovering from alcohol use disorder will experience at least one relapse within the first four years following treatment.

NIAAA
The 3 Stages of Relapse
A relapse typically doesn’t occur as a spur-of-the-moment event. In most cases, there are three main stages of relapsing. Understanding these stages, and what to do when they occur, can help stop a relapse before it takes effect.

The 3 stages of relapse include:

1. Emotional Relapse
During an emotional relapse, a person is not consciously thinking about drinking. However, their emotions and behaviors are setting the stage for a relapse.

During this stage, denial plays a big role. Many of the signs that occur during emotional relapse are also symptoms of post-acute withdrawal (PAWS). To help minimize the risk of relapse, it is important to recognize that many of the uncomfortable feelings you experience in early addiction recovery could be symptoms of PAWS.

Symptoms of PAWS include:

Foggy thinking/trouble remembering
Urges and cravings
Irritability or hostility
Sleep disturbances, such as insomnia or vivid dreams
Fatigue
Issues with fine motor coordination
Stress sensitivity
Anxiety or panic
Depression
Lack of initiative
Impaired ability to focus
Mood swings
Emotional relapse warning signs include:

Anxiety
Restlessness
Intolerance
Discontent
Anger and irritability
Defensiveness
Mood swings
Bottling up emotions
Isolation and not asking for help
Not attending support groups (or attending and not sharing)
Poor self-care (not eating, sleeping, or practicing good personal hygiene)
During an emotional relapse, the main goal should focus on self-care. The acronym HALT– hungry, angry, lonely, and tired–is an important thing to keep in mind during this stage.

Ask yourself questions like, “are you feeling exhausted or mentally drained?” or “are you taking time for yourself?” If the answer to these questions is no, it might be time to take a step back and practice self-care. You might also want to share your feelings with a support group or counselor.

2. Mental Relapse
During a mental relapse, a person is at war with their mind. A part of them knows they shouldn’t use, while the other part is looking for excuses to use. As this stage progresses, a person’s resistance to alcohol diminishes and their need to escape through alcohol use increases.

Early warning signs of mental relapse include:

Thinking about people, places, and things associated with past use
Spending time with users
Cravings for alcohol
Glamorizing past use
Minimizing the consequences of their past use
Bargaining
Lying
Thinking of ways that they could better control their alcohol use
Looking for opportunities to relapse
Planning a relapse
During this stage, it is critical to seek help in order to prevent a relapse. You can do so by talking to non-using friends, attending a meeting, or speaking to a counselor.

You can also find something to distract yourself. It takes 15 minutes for craving urges to go away, so it’s important to stay busy and use coping skills.

3. Physical Relapse
Physical relapse is the act of taking a drink and then using again, as well as the act of driving to the liquor store and purchasing alcohol. If you are unable to address the problems of emotional and mental relapse, it doesn’t take long to progress to physical relapse. For this reason, understanding and recognizing the signs of emotional and mental relapse is crucial.

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The 3 Stages of Alcohol Recovery
Research shows that there are three main stages in the recovery process. Each stage has specific tasks that can assist in preventing alcohol relapse. However, recovery is a personal process, and the length of each stage varies from person to person. The three stages include:

1. Abstinence Stage
The abstinence stage starts immediately after alcohol cessation and can last for one to two years. During this stage, the main focus is fighting cravings and avoiding alcohol use. Other goals of abstinence include personal self-care and development. It is also common for PAWS and relapse to occur during this stage.

Some key tasks of this stage include:

Accept that you have an addiction
Be honest with yourself and in your life
Develop coping skills to address cravings
Become an active member of your support groups – be willing to share
Focus on self-care and be kind to yourself
Change your group of friends – stay away from friends that still use
Develop healthy alternatives to drinking
See yourself as a non-user
2. Repair Stage
The repair stage focuses on repairing the damage caused by alcohol addiction. In many cases, it can last two to three years. During this stage, recovering alcoholics must confront the damage their addiction caused to relationships, their careers, their finances, and how they feel about themselves.

This stage is where a person works to overcome guilt and negative self-labeling in order to move forward.

Some helpful tasks during this stage include:

Understand that a person is not their addiction
Begin repairing personal relationships with family and friends
Work to improve self-care and make it an integral part of your daily life
Continue to be active in support groups
Continue to develop healthy alternatives to drinking
3. Growth Stage
The growth stage is all about moving forward and typically begins three to five years after alcohol cessation. This is the start of a new lifelong path to sobriety. In some cases, this is the time to address and confront any underlying cause of your initial addiction.

While many may want to address this sooner, they typically do not have the coping skills necessary to do so without increasing their relapse risk.

Some recommended tasks during this stage include:

Identify and begin to repair self-destructive patterns and negative thinking
Understand how familial patterns and past trauma may have contributed to your use and begin to move forward
Set healthy boundaries
Give back and try to help others
Take time on a regular basis to reevaluate how you are living
Take care of yourself in order to keep moving forward
How to Create a Relapse Prevention Plan
Whether on your own, with a rehab counselor, or through your support group, you should create an alcohol relapse prevention plan. While all prevention plans are unique, there are some major points you should always address.

These relapse prevention skills include:

Triggers – Begin by creating a list of all possible relapse triggers. These can be people, places, events, or emotions. While you may not know all of your possible triggers at the beginning, it can be a list that evolves over time.
Healthy coping skills and preventative tools – Create a list of healthy coping skills and tools you can use when cravings or thoughts of relapse occur. This can include building a healthy support system of friends and family you can turn to. Activities, such as exercising or journal writing, can also provide a distraction when triggering events occur. Another coping skill is to create a list of consequences, should you relapse. Often times, this is enough to redirect your thoughts and get you back on track.
Find and participate in a support group – Support from others is a crucial part of relapse prevention. Having the ability to talk to others that understand your recovery process can help. Finding a sponsor or counselor that you can turn to in times of crisis is also beneficial. While 12 Step programs work for many people, other options are available.
Lifestyle changes – Recovery involves more than not drinking. For example, you must create a life that makes it easier not to turn to alcohol. Look for new activities and hobbies. Set new career goals. Meet new people and create new social circles that encourage your recovery.
Don’t be afraid to ask for help – Recovery is not something you have to do alone. Asking for help is not a sign of failure, but rather a sign that you understand what is happening and that you need assistance. Self-help groups and support groups are a great place to start.
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Related posts:
Preventing Alcohol Abuse
Alcohol Awareness Month
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Annamarie
Medically Reviewed
Annamarie Coy, BA, ICPR, MATS
Alyssa Hill
Written by

Alyssa Hill
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