How Much is Too Much?

We’ve heard the terms “substance abuse” and “addiction” a lot in the media, especially now in relation to the opioid epidemic, which is sweeping across all parts of the U.S. In a previous blog, we talked about the differences between “substance abuse” as being a general term signaling misuse of some kind. Whereas “addiction” is commonly defined as a disease with symptoms that include a pattern of use, use in risky situations, use that effects the other parts of one’s life (work, home, finances), the presence of tolerance, and usually withdrawal symptoms. Treating addiction and learning how to live again without the substance(s) are part of the recovery process, and Relapse Prevention, is a vital element in recovery.

When we think of a relapse, we typically think of the person with alcoholism who goes to a bar after a period of being sober, and drinks. But in reality, one relapses in their thoughts, feelings, and behaviors long before he or she drinks or uses substances.

Let’s break down the term Relapse Prevention

One of the goals of recovery is to prevent a relapse, or a return to old, negative, and unhealthy behaviors. When we think of a relapse, the image that may come to mind is an individual with alcoholism who goes to a bar and drinks liquor, after a period of being sober, what we term as “falling off the wagon.” Or, the heroin addict who returns to slamming dope after being clean for a period of time. But in reality, one relapses in their thoughts, feelings, and behaviors long before he or she drinks the alcohol or snorts a line of coke.

And the first part of relapse prevention is identifying that denial of relapse potential that most people with addiction struggle with. It may take a professional, however, to point that out, because addiction is the only disease that makes you deny you are in denial.

Furthermore, a relapse may occur once—some call it a “lapse” rather than a relapse—or several times. Maybe you went on a trip and drank throughout the week or continued to use over a given period of time; a week, a month, a few months. All it takes is once, though, to get back into the using mode and pattern. Like they say in AA, one drink is too much and a thousand is not enough. That’s where the loss of control often comes into play. You take one drink, and then you keep drinking.

But, the other half of Relapse Prevention is preventing that return to old thoughts, feelings, and behaviors. You can prevent a relapse, but it takes some work. Here are some things you can do to aid in the recovery process:

    • Get rid of your substance of choice. Clean the house of alcohol or substances, including those secret stashes you have just in case. Get rid of paraphernalia such as pipes, bongs, lighters, etc. You may want to do this with someone else just in case you get the urge to use. Get rid of other stashes or paraphernalia in your car, at work, or outside of the house.
    • Make a Relapse Prevention Plan (we will address this in the next blog).
    • Identify supportive persons who are understanding, willing to help you remain clean and sober, and may help hold you accountable. A supportive person may be a friend, family member, significant other, or sponsor who you can talk to and will not judge you or even take you to a meeting or group.
    • Identify meetings or support groups where you can go for help and support. The biggest reason why people go to meetings like AA or NA is for support; going to a meeting and hearing someone tell YOUR story is healing and helpful. You are not alone even though you may feel like you are!!!!
    • Identify coping skills (alternative behaviors) you can engage in or distract yourself with when you get urges to use. Go for a walk, exercise, meditate, journal, read, watch a movie…whatever would distract you from using and that is healthy, not harmful. Exercise or some kind of active activity can also help with the anxiety or nervousness that you may experience with cravings.
    • Have a structure. Plan out your days because it is during those periods of no activity, no plans, where boredom creeps up and wham, you get the urge to use, your defenses may be down, and it’s a quick fix. Boredom can be a huge trigger. Plan activities that are fun and of interest to you, not just work and chores. You need clean and sober fun.
    • You may want to look into seeing a professional to help you in your recovery process.
  • There are also medication-assisted therapies that may help you initially stay clean and sober. For example, someone with an opiate addiction may benefit from seeing a doctor who can prescribe suboxone or subutex for opiate management, with the goal of tapering down and eventually off of opiates. Or for someone with an alcohol addiction, there is Antabuse or Vivitrol to help prevent drinking and reduce cravings to drink. Again, you need to see a professional who can evaluate you and determine if you are an appropriate candidate, and in turn, either refer you to an MD or prescribe it.

So, to summarize, recovery is a process—a lifestyle– that has many working parts, one of which is relapse prevention. There are several steps you can take yourself as discussed, but keep in mind you relapse in thoughts, feelings, and behaviors before you ever drink the alcohol or use the substance.

Another vital part of preventing relapse, which you may seek help from a professional for, is to develop and follow a Relapse Prevention Plan that takes into consideration triggers, warning signs, strategies to stay clean and sober, emergency planning, and coping skills, all of which will be covered in the next blog.

Would you like more information about substance use and addiction? Contact us for a free initial consultation at the bottom of the page.

Dr. Jennifer Bruha, PhD