As individuals prepare to complete residential treatment at Cedars at Cobble Hill often their greatest fear is that they may relapse once they’ve settled back into their daily routine. While the topic of relapse prevention is extensively covered during the course of a patient’s individualized treatment plan, this article is intended to be a reminder for people in early recovery and family members that relapse is preventable and sustained recovery possible.
A major key to relapse prevention is being able to identify our own unique set of triggers and cues that could set us up for relapse. These can be environmental cues – the sights, sounds and situations that may have been connected to our addiction in the past, and our emotional triggers – feelings such as anxiety, self-pity, or loneliness that we may have used mood altering substances like drugs or alcohol, or engaged in process addictions such as gambling, sex, or disordered eating like anorexia, bulimia and binging, to cope with in the past.
Generally environmental triggers are easier for people in recovery to recognize. For example, watching a beer commercial or seeing drug paraphernalia can trigger a craving or deep desire to drink or use drugs. Even after years of abstinence, people may experience a profound craving if they visit a location where they formerly used drugs. Researchers have shown how environmental triggers can result in physical reactions such a changes in heart rate and blood pressure. They have also mapped changes in the brain when a craving to use mood altering substances or engage in addictive behaviour occurs.
We often ask patients to identify social or familial situations they expect to encounter which may test their recovery. For example, a client may be worried about a group of friends who may not understand his or her needs and desires to stay clean, sober or abstinent. If he or she were invited to go out with one of these friends then a red flag should go up. The best advice we can give people in early recovery is to avoid those individuals, places and things associated with their former substance abuse or addiction.
Emotional cues can be more difficult to identify; family members will often spot the warning signs before an addict in early recovery is aware of them. Sometimes family members will call the clinical staff members at Cedars stating their loved one in recovery is becoming argumentative, defensive, or is showing signs of being under pressure at work or at home.
Because stress affects our ability to think clearly and brings up all kinds of unwanted emotions, we spend time in addiction treatment talking about alternative coping strategies and healthy recovery behaviours. We stress the importance of fellowship and connection and the need to speak to others in their support network about feelings and problems in recovery as they arise.
Some common warning signs which can often precede a relapse that recovering addicts and those close to them should be watching for are:
– Not wanting to talk about thoughts and feelings
– Isolating from others
– Feeling overwhelmed by ordinary issues
– Outburst of anger
– Rejecting counselling and/or not attending support groups
– Avoiding people who will give honest feedback
– Denying the seriousness of addiction
Everyone has different triggers. That is why when people leave treatment we develop a continuing care plan unique to them and encourage everyone to attend the six month continuing care program, which consists of weekly group therapy facilitated either in person or in their respective communities such as Nanaimo, Victoria, Vancouver, BC, Edmonton, Calgary, AB and across Canada to get the support they need for a sustained recovery. A patient departing Cedars is also invited to attend weekly online Skype counselling facilitated by Cedars Continuing Care Coordinators if a provider is not available in their area, or online counselling suits their needs.