Addiction is a lifelong battle for all those who face this chronic relapsing disease of the brain. Making the decision to get sober can be difficult and the road to recovery also comes with a multitude of challenges. It is important for individuals suffering from substance abuse to understand that the potential for relapse is always present. However, recognizing relapse triggers and the warning signs of a relapse can help avoid it. Furthermore, it is equally important for friends and family members to be educated on what to look for as potential triggers for relapse.
Understanding Addiction and Relapse
Addiction is a chronic disease of the brain, making relapse a potential danger no matter how long a person has maintained their sobriety. The disease of addiction is often described as cunning, baffling, and powerful. If left untreated, his progressive mental illness predisposes the recovering individual to a potentially fatal relapse. In fact, individuals seeking recovery from addiction of any kind, often experience at least one relapse according to the National Institute on Drug Abuse (NIDA).
Once an individual in recovery experiences a relapse, it can be difficult for an individual to get back on track with their sobriety. Oftentimes, these individuals will experience extreme physical and mental cravings for their substance of choice, making it difficult to abstain. Relapse can be especially dangerous for individuals who have maintained long-term sobriety as their tolerance for drug abuse is often lost. If an individual has abstained from drug use for an extended period of time and returns to consuming the same amount they were accustomed to consuming before, relapse can result in overdose and even death. As a result, helping an individual get back into a rehab program as quickly as possible following relapse is crucial to their long-term health and recovery.
What are Relapse Triggers?
Triggers are environmental, social, or emotional situations that remind recovering individuals of their past substance use disorder. These unique memories or cues often lead to urges that can potentially provoke a relapse. Unrecognized and unaddressed triggers increase the likelihood of drug and alcohol abuse.
Long-term drug use cultivates a complex connection within the brain between daily routines and habits with drug experiences. For example, certain triggers can lead to uncontrollable drug or alcohol cravings. These intense cravings are a reflex to external or internal triggers and do not discriminate from individuals who have abstained from their addiction for an extended period of time.
External Relapse Triggers
External triggers are categorized into people, places, activities, and objects that provoke cravings associated with drug or alcohol addiction. Individuals in recovery can avoid the dangers of external triggers by planning ahead to stay away from triggers that remind them of their addiction. It is also important for recovering addicts to learn the proper coping skills to deal with thoughts and cravings associated with these triggers.
Common external triggers include:
People
Family members and loved ones who are closest to the recovering individual often set off cravings. Dysfunctional family dynamics and complicated relationships can be detrimental to an individual’s recovery. It is absolutely vital that the recovering individual avoids addicted loved ones.
- Drug dealers
- Friends
- Employers
- Family members
- Spouses
- Co-workers
- Former addicted friends
- Neighbors
Places
Triggering environments such as high-risk places remind recovering addicts of times when they indulged in substance use. Simply driving by or walking through places where these individuals used to purchase, drink, or consume drugs can often spark a triggering memory of past substance abuse.
- Bars/Clubs
- Concerts
- Bathrooms
- Highway exits
- Neighborhoods
- Gas stations
- Schools
- Downtown
- Worksites
- Former drug stash locations
- Former drug dealer’s homes
- A friend’s home
- Hotels
Things
Objects that are present in an individual’s everyday life can trigger a craving and ultimately a relapse. For example, drug paraphernalia can trigger intense memories of drug use without the recovering addict.
- Movies
- TV Shows
- Paraphernalia
- Magazines
- Straws
- Empty pill bottles
- ATM’s
- Cash
- Credit Cards
Internal Relapse Triggers
Internal triggers are often more difficult to manage than external triggers. Feelings, thoughts, emotions, or painful memories associated with substance abuse can be challenging to mitigate. Internal triggers often lead to questionable behaviors that can deter a recovering individual’s progress. Without proper coping skills, internal relapse triggers may cause individuals to crave and go back to abusing drugs and alcohol.
Overwhelming emotions that often act as internal triggers include:
- Anger
- Resentment
- Hate
- Envy
- Fear
- Anxiety
- Irritation
- Overconfidence
- Guilt
- Shame
- Depression
- Boredom
- Insecurity
- Embarrassment
- Loneliness
- Pressure
- Tiredness
- Neglect
- Celebratory feelings
- Exhaustion
- Failure
- Happiness
- Loneliness
- Inadequacy
- Rejection
- Abandonment
- PTSD
- Stress
The Stages of Relapse
Oftentimes, many individuals in addiction recovery will experience a relapse before the relapse. In other words, triggers for addictive behavior do not equate immediate use. The ongoing battle increases vulnerability to cravings which can lead to a potential relapse.
Emotional Relapse
During this first stage of relapse, recovering addicts are often in denial about their thoughts of using. More often than not, these individuals are ashamed of their use and often develop negative behaviors to cope with their thoughts. Denial combined with suppressed negative emotions can encourage poor behaviors that can lead to full-blown relapse.
- Isolation
- Avoiding 12-step meetings
- Disengaging from sober activities/community
- Projecting negative feelings onto other people
- Mood swings
- Discontentment
- Irritability
- Restlessness
- Poor eating/sleeping habits
Mental Relapse
The mental relapse stage is the continuous battle between wanting to use and knowing you shouldn’t. Oftentimes, individuals will justify and minimize the dangers of the delusion of “just one more use.” At this stage of the relapse process, many people give into the idea that they can control their drinking or drugging. However, the frequency of use can lead to a dangerous period of relapse.
- Lying
- Justifying
- Bargaining
- Drug/alcohol cravings
- Glamorizing former substance abuse
- Planning a relapse
- Actively seeking relapse opportunities
Physical Relapse
The final stage is physical relapse when the individual begins to abuse drugs and alcohol again. Physical relapse is a combination of emotional and mental relapse. Once the physical relapse begins, the user may find it extremely difficult to overcome. More often than not, the user will convince themselves that their use will cause no harm.
Relapse Prevention
Addressing the mental, emotional, and physical triggers can be a vital tool for preventing relapse. Recovery is not an easy process, but practicing radical acceptance can help mitigate relapse triggers. Here are a few ways to cultivate a strong relapse prevention plan:
- Identify your triggers
- Write down a list of potential triggers and changes in behaviors that are associated with potential relapse.
- Discuss your triggers and unhealthy patterns of behaviors with your support system to help keep an eye out for warning signs
- Avoid people, places, and situations that make you vulnerable to drug and alcohol use.
- Attend therapy, 12-step support groups, and engage with other alcoholics and addicts
- Avoid exposure to drugs and alcohol
Participation in a drug and alcohol rehabilitation program is a necessary step to relapse prevention. The protective and supportive environment of a substance abuse treatment facility can cultivate a safe path to recovery. Lastly, maintain a healthy lifestyle to improve your quality of life and cultivate a foundation for sustainable recovery.