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Preparing for Common Relapse Triggers

June 16, 2008
by Brian Duffy, LMHC, LADC-I
| Reprints
Clinicians can establish tailored prevention strategies with clients

There are a gazillion reasons to drink (or drug). From tears of anguish to tears of joy, from getting fired to getting promoted, from being alone to the being the life of the party, an addict always can find a “reason” to use.

But I've noticed some trends, so here I have categorized what I see as the most common triggers to relapse. This list is not the result of scientific research, but simply observations gathered over a decade's work in the field.

Perhaps you and your clients can use this article to identify the scenarios most likely to trip them up—and to devise strategies by which to prevent relapse. As some counselors will share this material with clients, I'll speak directly to the person in recovery. In no particular order of importance, here are descriptions of my top six triggers.

Money

Here's an interesting fact I've heard: Regardless of what day of the week a person emerges from jail, his most likely day of relapse is the Friday following release. It's probably because Friday, generally being payday, is when the person's friends celebrate his release—by getting him good and drunk.

Money can be a trigger for anyone in recovery. It's amazing how a person having no cravings can suddenly get “that idea” once a roll of bills is in his pocket. I have seen people completely surprised by the speed and intensity of their cravings—once they've visited their ATM.

Here are some relapse prevention strategies in this area:

  • Have a trusted friend/relative handle your money.

  • Ask a friend/sponsor to accompany you to the bank.

  • Delay owning an ATM card.

  • If a retroactive paycheck or an inheritance is coming your way, share that information with your sponsor.

Romance

Unfortunately, many dating rituals include the consumption of alcohol. Meeting for drinks often constitutes a first date. Parties and dances sometimes include the use of other substances, with an overt or at least implied sense of normalcy.

Moving from the teen years into our 20s, we often see an increase in our sexual activity matched by an increase in our drinking. (I'm not suggesting a cause and effect here, just a correlation.) For many in early recovery, the thought of flirting, dating, or having sex without alcohol is downright frightening. (“How do I do that sober?”)

If your only experience meeting a potential partner is in nightclubs, you might assume that's the only way to meet others. This, of course, needs to be challenged. And while we're at it, let's challenge the notion that we can stay sober while dating a person who really likes to drink. Bottom line: We must learn how to have fun, meet others, have sex, fall in love, without the booze. It can be done, and the results will be better and more memorable.

Here are some relapse prevention strategies:

  • Consider abstaining from romantic relationships for the first year of sobriety.

  • If ready for romance, attend Young People in AA meetings (if you're young).

  • Go to sober dances.

  • Take adult education classes.

  • Talk about your fears with other sober people.

  • Meet people (online AA groups?) who are okay with the fact that you don't drink, etc.

Friends and family

You want me to stop associating with the old gang? It may sound outrageous, but it's probably exactly what you need to do. If your old friends are still using, they'll want you to use. Don't be fooled by their promise to make sure you drink Pepsi at the local bar.

They'll say things like, “We respect what you're doing and we'll make sure you don't drink.” Deep down, however, they want you to use with them. Your staying sober is like holding a mirror up to their addictions. It'll make them uncomfortable. What's more, you'll soon become bored with the behavior of intoxicated friends.

Family members who are still using—and this includes parents, aunts, uncles, etc.—are also going to wish, perhaps subconsciously, for your relapse.

Those in early recovery must associate with other sober people. In short, your job is to replace your unsafe relationships with safe relationships.

Here's a typical dilemma: What will you do when invited to the wedding of your favorite cousin? You know there'll be an open bar. Here are some options regarding the wedding:

  • Don't go to the wedding.

  • Go to the wedding but not the reception.

  • Go with another sober person.

  • Make sure you have an exit strategy.

In general, you'll have to replace your old using friends with new sober friends. Sounds harsh, but this is serious business.

Forgetting where you came from

We addicts are great forgetters. We forget how bad our lives had become, we forget that our best intentions didn't improve our behavior, and we forget that we have a progressive and deadly disease.

How many times have you said, “I'll drink, but I won't drive.” Or, “I'll have a couple of beers, but I won't call the drug dealer.” Or, “I've matured. I don't need all these recovery meetings.”

In short, we forget that we're not social drinkers, that life will get worse if we start to use again, and that there are ways to have fun while remaining abstinent, one day at a time.

Here are some relapse prevention strategies:

  • Go to recovery meetings.

  • Talk with another addict every day.

  • Read recovery literature.

  • Work with newcomers.

  • Think through the drink.

  • Guard against complacency.

  • Avoid high-risk situations.

  • Choose an attitude of gratitude, etc.

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