After transitioning out of a drug and alcohol rehab programme and into a sober living programme or life at home, every individual in recovery will encounter a number of triggers that can cause relapse. If you are currently in recovery, you’ve probably realized by now that there’s no way to avoid everything that may cause you to stumble, but there are several ways to combat these triggers well before you ever experience them.
Understanding the Three Stages of Relapse
First and foremost, the best way to fight back against relapse triggers is to make sure you fully understand the relapse process. According to a recent article published in the Yale Journal of Biology and Medicine, there are three main stages of relapse: emotional relapse, mental relapse, and physical relapse.1
In this stage of relapse, you are not typically thinking about using again. Instead, you are setting yourself up for relapse with unhealthy emotional responses and poor-self care. In many cases, this includes skipping IOP meetings, not sharing in those meetings, focusing on the needs of others instead of yourself, isolating yourself from others, and not caring for yourself properly (unhealthy meals, lack of sleep, and poor hygiene). This relapse stage is typically characterised by the acronym HALT, which stands for hungry, angry, lonely, and tired.
In this stage, you are battling yourself, constantly fighting an inner war between not using and using. You might begin bargaining with yourself, replacing one substance with another or you might begin to rationalise the use of drugs and alcohol by minimizing the consequences. You might also start giving yourself permission to use a substance once or twice a year, thinking you’ll be able to control your usage habits. Although it’s important to note that occasional thoughts of using while in recovery is normal and even frequent, but dwelling or acting on those thoughts is what will lead to relapse in the end.
This stage is what most of us associate with relapsing: actually using a substance. Most often, a physical relapse takes place during a situation in which you believe you will not get caught. Then a single use leads to uncontrolled usage and you find yourself unable to stop and continually obsess about using more and more.
As an individual in recovery, it’s vital that you understand each of these stages of relapse so you can better combat them. This can only be done with peer support and clearly defined relapse prevention strategies. These strategies are formulated in drug rehab and can be practiced safely within a transitional housing situation.
Common Relapse Triggers
Research has shown that certain triggers or cues bring back seeking or wanting behaviors involving drugs and alcohol.2 Here are a few of the most common relapse triggers, in addition to tips on how to avoid them.
Whether you’re at the grocery store, hanging out with friends, or walking down the street, you’re likely to encounter someone drinking a beer, stocking a shelf with liquor, or even using an illegal substance. Seeing someone use a substance or even just seeing it sitting on a shelf can cause you to fantasize about using again.
How to resist: In situations like these, utilise the self-control and coping skills you learned in drug rehab. Choose to focus on the reasons why you stopped using in the first place and purposefully think about those. Avoid the alcohol aisle at convenience stores and invite sober friends with you when you go to the mall or out to run errands.
Emotional highs or lows
Sadness, depression, and anger can lead to relapse just as much as extreme happiness can. Some people experience cravings when they’re feeling good because they want to feel even better, while the same person may also experience cravings when they’re feeling especially down or sad.
How to resist: Confide in your peer support group. Be open and honest about your feelings and cravings and let your sober coach know that you need help. You never have to feel ashamed about having cravings—they happen to everyone in recovery and they are an ongoing part of life. Quickly addressing these issues and situations with a peer support group is the key to keeping those cravings under control.
Rekindling of old relationships
Seeing an old friend you used to use with can cause you to develop urges or cravings to use again. Additionally, running into an old drug dealer or spending time with a person who uses drugs and alcohol are both extremely dangerous and tempting situations to be in.
How to resist: Cut off harmful relationships by deleting numbers from your phone, changing your phone number, or relocating to another city or state. Be tactful but firm when telling old friends why you won’t be hanging out with them anymore and make an effort to spend your free time with sober friends instead. Resist the temptation to isolate yourself and instead, get out and join a community support group to meet other people in recovery who understand and support your commitment to sobriety.
Places you used to use drugs and/or alcohol
The places you used to use drugs or drink alcohol carry strong memories and may cause you to linger on thoughts of using again. Whether it’s a friend’s house, a bar or club, or a particular neighborhood near your home, it’s normal to feel a need or want to return to those places.
How to resist: Avoid visiting these places, and if you must, bring a sober friend with you. Begin new traditions with sober friends involving other locations that aren’t focused on drug and alcohol usage. Replace your old favorite bar with a new hiking spot. Instead of going to a friend’s house where you know there will be drug use, go see a movie with your sober home roommates.
Holidays, birthdays, graduations, and other celebratory events are often associated with substance abuse. Conversely, the anniversary of a loved one’s death or a funeral may also conjure thoughts and emotions that lead to substance use. Regardless of whether it’s a celebratory or sad event, you may experience cravings that you otherwise wouldn’t during these times.
How to resist: While you used to view these types of events as motivation to use, your new sober lifestyle requires that you view them in a different way. Although emotions and memories associated with these events may make it difficult not to use, addressing these feelings with your counselor and support group can help you to learn how to manage them in a more effective way. You can still feel sad or happy as it pertains to a certain event, but the way in which you manage those emotions will determine your behaviors and mental state.
Objects like syringes, wine glasses, pill bottles, or pipes may be difficult for you to look at. These objects may remind you of your previous use and cause you to linger on thoughts of using with old buddies or alone at your home.
How to resist: Sober living homes prohibit these types of objects, so if you’re not already enrolled in a transitional housing program, doing so could help you maintain a healthy living environment after rehab. If you are living at home, you may need to have a conversation between you, your family, and your therapist to discuss the impact of a negative living environment on your recovery efforts. Your family may not even realize that certain objects have that effect on you. Helping them understand your struggle and appropriately react is one way to reduce triggers within the home.
Returning to Sobriety After Relapse
Just because you’ve relapsed doesn’t mean you’ve completely failed. Developing a relapse prevention plan with your counselor before exiting your drug and alcohol rehab programme will help ensure that you know how to respond to relapse situations effectively and productively.
A relapse prevention plan also puts clear plans into place to address drug and alcohol use if it happens. These typically involve people in your recovery support circle who can help lead you back to a life that is free of substance abuse and help you get back on track.