According to the National Institute on Alcohol Abuse and Alcoholism, nearly 90 percent of recovering alcoholics will experience at least one relapse after treatment. Factors contributing to high relapse rates include severity of the addiction prior to recovery, perception of the cravings experienced and underestimating the intensity that the idea of drinking alcohol has over inducing euphoric recall in the mind. Mid-Ohio Psychological Services explains that the goal of relapse prevention is to identify behavioral choices toward recovery, outline options for managing the difficulties of staying sober as well as creating a working plan for maintaining sobriety once abstinence is achieved.
Identify Links in Relapse
Developing a relapse prevention plan begins with recognizing the intricacies of the relapse process. According to Mid-Ohio Psychological Services, returning to alcohol use involves direct and remote factors. Direct factors are those linked to places, people or events that are associated with alcohol use such as drinking only at a certain bar or spending time with a companion who drinks. The remote factors are the internal factors linked to alcohol use such as maladaptive thinking patterns, feelings or automatic behaviors. Creating an effective alcohol relapse prevention plan centers on not only knowing the differences between the direct and remote factors, but also recognizing these factors when they present a risk.
Stabilize and Abstain
Relapse prevention is achievable once abstinence from alcohol begins. The Addiction Web Site of Terence T. Gorksi explains that stabilization through detox from alcohol for the first week is necessary prior to planning longer-term recovery. During initial stabilization, regaining physical strength and getting through the withdrawal symptoms is primary. Depending on the severity and frequency of alcohol use, medical supervision might be required as well as medications to decrease nausea, vomiting and anxiety associated with initial abstinence. This is also the time when post-acute withdrawal symptoms appear. According to TLC Recovery, post-acute withdrawal begins after the seventh day of abstinence and results from the psychological and physical damage done to the body by alcohol use.
Recall Patterns Leading to Relapse
Developing an honest account of historical alcohol use and relapse patterns is important in relapse prevention. The Addiction Web Site of Terence T. Gorski explains that exploring life history of alcoholism, including legal ramifications of alcohol use, relationship losses and employment problems, is important in relapse-prevention planning. A written account of events is constructed in the history not only to identify what went wrong but also to identify healthful patterns that might have started yet were curtailed by alcohol use. Mid-Ohio Psychological Services suggests listing at least 10 historical events centered on alcohol use, life becoming unmanageable and if applicable, relapse failure attempts.
Clarify Specifics in Alcoholic Behavior
In conjunction with writing historical events related to alcoholism is identifying thoughts, feelings and behaviors specific to each event. The Addiction Web Site of Terence T. Gorski notes that relapse education aids in teaching how to distinguish thoughts from feelings and behaviors so that a detailed account of historical patterns is thoroughly written. This is often the most difficult portion of the relapse prevention plan because it requires recall of remote links of past use. Thoughts linked to alcohol-related events might include giving yourself permission to drink because of a job loss or thinking that no one will find out how much alcohol you're drinking. Feelings associated with the thoughts can include defeat, hopelessness or jealousy. The behaviors linking all together is what was actually achieved, or the action, as a result of the thoughts and feelings.
Recognize Risks and Alternatives
A thorough review of history and identifying common thoughts, feelings and behaviors builds upon the next portion of relapse prevention planning. Risks or warning signs are a series of indicators that a relapse might occur if intervention is not taken. Writing the possible risks creates better practices. Although every risk cannot be avoided, it can be managed with increased awareness. A risk or warning sign might include scaling from one to 10, the stress experienced from a day at work, then the accompanying thoughts and feelings resultant from the stress. Write the risk in the prevention plan, then note five instances that could occur as a result of using alcohol to deal with the stress. The Addiction Web Site of Terence T. Gorski explains that the next portion of recognizing specific risks would include writing alternatives to drinking to better deal with the stress.
Support and Intervention Options
The goal of relapse prevention is continued abstinence and recovery. However, the rate of possible relapse is high, therefore if a possible relapse should occur, identify what needs to occur to quickly regain stabilization. Create a portion of the prevention plan dedicated to identifying support people including names, numbers and addresses to refer to in the event of relapse. Include in the prevention plan, preferred intervention strategies the support people can help implement. For instance, get taken to detox immediately, call a substance abuse counselor for an emergency session or go to an Alcoholics Anonymous meeting that day.
