The creation of this Relapse Prevention Plan is meant to be an aid in your recovery.
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Please listen up, This Is Important:
“The best plan in the world does not mean a thing unless you put into action”
Sorry about that, I didn’t mean to shout. There is a reality to be addressed here, though, and that is that a number of people relapse with a beautifully constructed plan that they never used or put into action.
Having a great plan that is not utilized, or acted on is the same thing as having no relapse prevention plan and all. No positive action occurs. You cannot help hearing at 12 step meetings the often repeated phrase, “This is a program of action”. In fact, almost every single person who returns to 12 step meetings after relapse has this commonality, they almost universally say “I stopped going to meetings and working my program”.
If you are not a big fan of 12 step groups, let me just reinterpret that last statement as saying “I stopped acting on a plan of action”.
OK, I guess that’s enough chest thumping, and browbeating, let’s get on with the show…
Onward,
Creating Your Relapse Prevention Plan
To get started we should look at the various parts of our life that Addiction has affected.
Sometimes addiction is referred to as a “bio-psycho-socio-spiritual disease”.
I know, I know, is there anything else they could have added on there to make it less understandable?
Let’s break it down:
1. Bio=Biological
Addiction definitely affects us on a biological level. It affects just about every major system within our body, and can also alter our physical activity level.
2. Psycho=Psychological
We’re definitely affected on a psychological level. It is becoming generally accepted that the majority of people with addiction have another co- occurring mental health diagnosis. In fact, there are whole groups of Mental Health diagnosis that began with “Substance induced”. Take away the substance and sometimes you lessen mental health issues.
3. Social
Addiction affects us socially in many ways. I believe that addiction is a disease of isolation, and that in order to continue using, we break more and more family, friendship, and social ties. It wreaks havoc with our relationships.
4. Spiritual
Unfortunately, addiction affects us on a spiritual level as well. Many people who believe in a Higher Power admit that they feel they have become ‘disconnected’. Another way of looking at how Addiction affects us spiritually, it is that we have started act against our moral principles and values. We are doing things we never would have imagined.
If we can agree that addiction affects us in these different life areas, then perhaps it makes sense to develop a plan that addresses each of them. We want to expand and explore concepts at a greater depth rather than simply relying only on “Just Say No” approach.
Relapse Prevention Plan Work Sheet
Grab a sheet of paper and start writing. Our starting point will to answer a couple of questions on recovery and sobriety:
1. Do you really want to get and stay sober? Are you ready to go to any lengths, to do what ever it takes, to get and stay sober?
Pay particular attention to the second part of this question. A lot of people have a desire to stay sober if it is convenient and not too hard, or does not require “giving up too much.” Are you willing to make it the number one priority in your life with no “buts”
2. If you do not remain abstinence what will be the consequences of your return to using?
Think this all the way through, examine the short-term consequences and the long-term consequences. Thinking in terms of emotional consequences to yourself, the effects your actions will have on family and friends, and the toll it will take on you physically. How difficult will it be for you to read engage in recovery should you lapse or relapse?
3. Identify your top 5 relapse warning signs, put them in order of importance.
a. (For example)…I started withdrawing from people and getting lonely
b. (For example)… I began asking myself “Is this all there is?”
c.
d.
e.
4. For each of the items identified in the previous section, write out the problems they generated:
a. Withdrawing from people – I stopped going to fun things and started to believe nobody understood me…
b. “Is this all there is?” I began to question if the amount of happiness that I had was worth all the effort.
c.
d.
e.
5. Now for each of those problems identified in #3 previously, list some action you can take to prevent the problem from expanding and getting worse. It is important to make sure that your solutions are specific, achievable, time related, and measurable if possible.
a. Withdrawing from people – I can go visit my family this weekend. I can go to a 12 Step meeting at 8:00 p.m. tonight.
b. “Is this all there is?” I can write a list of 10 things that I am grateful for right now that I did not have when I was using. I can make a list of goals and see if there realistic…
c.
d.
e.
6. List any resources you may need to employ to deal with each of the problems, and set up any groundwork needed.
a. “I can go visit my family this weekend. I can go to a 12 Step meeting at 8:00 p.m. tonight” – I’ll have to make sure that I have an open invitation to visit. I’ll have to call the local AA office and find out where the local meetings are.
b. “Is this all there is?” one of my goals is to take some courses the local community college so I call up and find out what the entrance requirements are and what courses are available
c.
d.
e.
How did you do? I’ll bet that was a little bit more difficult than you anticipated. Don’t worry, or get discouraged, the idea is that your thinking, the emotions your feeling, and action you are taking, are all working together to develop a strong foundation for recovery.
OK, let’s move on and look at the Prevention Plan or action plan that encompasses all the elements of addiction as a bio-psycho-socio- spiritual disease:
Physical Or Biological Area
One of the most basic needs that we have is to be well physically. There are certain areas that we can take a look at and things we can do to help our physical well-being. De you need to address any of the following areas? If so, write down the action you will take to address it and the time frame you will have it done by.
A) Have you had a thorough physical checkup, including blood work with a hepatitis screen?
In my view, it is critical the get tested for hepatitis. It is not commonly included in a routine blood screening. I discovered I had hepatitis after being sober for 15 years. All my doctors missed it.
B) Are you eating in a healthy manner? Do you need to change your eating habits?
Drinking alcohol, or using drugs, for an extended period of time can severely interfere with the intake of vitamins, especially vitamin B. It is a great idea to take a multivitamin every day. Eat smarter, ‘nuf said.
C) Are you getting proper exercise?
We discussed the concept of ”move a muscle change thought” when we discussed cravings, but physical exercise also releases natural ‘feel good’ chemicals in the brain.
D) Are your sleep habits regular?
If you are not sleeping regularly, you will obviously be tired (Duhhh) but, this can cause an inability to think clearly, and be more susceptible to depression and anxiety which are clearly relapse triggers. If you need help or suggestions for sleep; search on the Internet for the phrase “ sleep hygiene” and look for a website that ends in .edu ( those are generally universities are colleges) or.gov( those will be government sites).
E) Are you complying with any medications prescribed by your physician or psychiatrist?
There are two sides to kick around on this question. One thing that is not uncommon to hear from people who have relapsed when questioned about their medication compliance is “I started feeling really good so I stop taking my medication”. So, keep taking it, it’s working. Now the flip side is if the medication is not working, ask your doctor or psychiatrist to try new one. This is especially true with the anti depressants, as the reality of the situation is there are many of them and not all of them work for everyone Sometimes it is a hit or miss situation to find one that will work for you.
Psychological Area
1. Is there a possibility you may benefit from a consultation with a psychologist psychiatrist?
It is more common than not for people with addiction to have, Co -occurring mental health issues such as anxiety, depression, or eating disorders. If this is the case, you may benefit from getting help with the mental health issues along with the Addiction issues.
2. Sometimes this situation may arise which will cause us to be temporarily depressed or anxious. List five things you can do to help with depression and anxiety.
Depression:
1.2.
3.
4.
5.
Anxiety:
1.2.
3.
4.
5.
Social Area:
1. Boredom and isolation have been identified consistently as being contributing factors to relapse. List 5 activities, or things you can do, to help with these problem areas, and when you will start them.
1.
2.
3.
4.
5.
2. There’s a high probability that our relationships with our family have suffered. List for concrete actions you can initiate that may help repair family some relationships.
1.
2.
3.
4.
List three things you can do to protect yourself when you find yourself in social situation where alcohol is being served, or drugs are being used.
1. Make sure I have away and out, drive my own car, or go with a friend so I can leave if I need to.
2. Practice a standard answer for refusing drugs or alcohol such as” no thanks” or “the doctor said I can’t drink any more”, whatever, be concise and direct in saying no.
3. Give them all a real good eye roll and say “That is soooo last year”
Spiritual Area:
1. List any behaviors you have developed that need to be corrected that go against your sense of values or ethics when you were using are still with you. How will you correct them?
1. I became sneaky and dishonest. I will stop doing things that I need to lie about. I’ll take responsibility for my actions
2. My in action sometimes hurt people, Earl lot of things I did not do – stepped up to the role of being a man, husband, and father. Be less selfish with my time.
3.
4.
5.
2. If you feel spiritually distanced from your Higher Power, ask yourself who moved? What concrete action steps can you take to move spiritually closer to your spirituality and/or Higher Power
1. I can start mediating and trying to connect by praying daily
2. I can try to go to church, or find one I like
3. I could try helping someone out
4.
5.
3. How can I improve relationships with the following:
A) Myself
B) My family
C) My higher power
D) The community of people around me
Yeah! You Are Done!
Don’t forget there is a clean copy that you can print off in a separate PDF titled relapse Prevention Plan
In Closing:
OK, we’re done with our relapse prevention discussions and exercises. We have looked at the meaning of the process of relapse, relapse warning signs, and relapse triggers and cues. We have constructed an individualized Relapse Prevention Plan. I hope this was of value to you.
I’ll say it again… Having a great plan that is not utilized, or acted on is the same thing as having no plan and all. No positive action occurs.
“The best plan in the world does not mean a thing unless you put into action”
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{ 5 comments… read them below or add one }
Very thorough list. I would add that completing this list, fully and honestly, is a good first act toward recovery. The act of writing this out not only provides the foundation for a plan, but when we write things down we are more likely to act upon them then if we don’t (something to do with the way our brains are hardwired). And breaking it down like this, or “chunking it,” also breaks big steps into more manageable baby steps.
Part of where people get overwhelmed and begin to feel powerless, be it coping with addiction or coping with stress (my own area of focus), is because the big step necessary seems impossible – or more accurately, looked at in its entirety, it seems impossible to know where to begin. Describing the problem in detail and the steps planned to take action on it, is the key to making something that seems “impossible” not only possible, but easier over time as we look back at our list and see the progress we’ve made.
As you say though, the first step to do when the writing is done, is to begin acting on it!
-Brian
This is really great information struggling with addiction to have. I’m sure dealing with thoughts of relapsing is overwhelming for a used to be addict and having a step by step plan of recognition would surely help them to organize their thoughts and deal with the temptation battle. Good info!
This is a great list for someone to use. Putting all this out on paper can be a great first step towards recovery. It’s obviously a long, difficult road, but this is a nice starting point.
Very practical advice, Bill! I have a friend who has just become mom. She will be very happy to use these tips, as she is scared not to relapse….
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This was really a very nice and informative article. We can see that consumption of alcohol had increased to a wide extent. Even though individual had taken treatment from rehabilitation centers, relapse is also occurring at much faster rate. I was highly inspired by the first point about prevention. Individual who are willing to become a sober must give top most priority to this subject in his life.