The creation of this relapse prevention plan is meant to be an aid in your recovery. But please know, because this is important: "The best plan in the world does not mean a thing unless you put it into action."
There is a reality to be addressed here, and that is that many people relapse with a beautifully constructed plan that they never used or put into action.
Having a relapse prevention plan that isn’t used is the same as having no plan at all—no positive action occurs. At 12 step meetings, we often hear the phrase, "This is a program of action." In fact, almost every single person who returns to 12 step meetings after relapse shares this experience. They almost universally say, "I stopped going to meetings and working my program." If you aren't familiar with 12 step groups, that last statement is like saying, "I stopped acting on a plan of action."
Now that we're all clear, here's our step-by-step guide to help in the event you find yourself on the brink of relapse.
Creating Your Relapse Prevention Plan
To get started, we should look at the various parts of our life that addiction has affected. Addiction is sometimes referred to as a "bio-psycho-socio-spiritual disease." Let's break that down:
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.
Psychological: On a psychological level, it is generally accepted that many addicts have another co-occurring mental health diagnosis. In fact, there are whole groups of mental health diagnoses that began as "substance-induced." Taking away substances may diminish mental health issues.
Social: Addiction affects our social lives in many ways. Addiction is a disease of isolation—to continue using, we break away from family, friends, and social ties. Ultimately, it wreaks havoc on our relationships.
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 addiction affects us spiritually is that we start to act against our moral principles and values. We find ourselves doing things we would never have imagined.
If we can agree that addiction affects us in these areas, it makes sense to develop a plan to address each area. We want to expand and explore concepts at a greater depth, rather than simply relying only on a just-say-no approach. With that said, here's our complete guide to help you work through difficult situations without falling back into use.
Your Relapse Prevention Plan Worksheet
Grab a sheet of paper and start writing. Our starting point will be to answer a couple of questions on recovery and sobriety:
A. Do you really want to get and stay sober? Are you ready to go to any lengths, to do whatever it takes, to get and stay sober?
Pay particular attention to the second part of this question. Many people have a desire to stay sober if it’s not too hard or doesn’t require "giving up too much." Are you willing to make it the number one priority in your life, with no ifs or buts?
B. If you do not remain abstinent, what will be the consequences of your return to using?
Think this all the way through—examine the short-term and long-term consequences. Think of the emotional and physical toll it will take on you and the effects it’ll have on your loved ones. How difficult will it be for you to re-engage in recovery should you relapse?
C. Identify your top 5 relapse warning signs and list them in order of importance.
- (Example: I started withdrawing from people and getting lonely)
- (Example: I began asking myself, "Is this all there is?")
D. For each item identified in the previous section, write out the problems they generated for you or those around you.
- (Example: Withdrawing from people – I stopped going to fun things and started to believe nobody understood me…)
- (Example: "Is this all there is?" – I began to question if the amount of happiness I had was worth all the effort.)
E. For each problem identified in section C, list some actions you can take to prevent the problem from getting worse. It is important to make sure that your solutions are specific, achievable, timely, and measurable, if possible.
- (Example: Withdrawing from people – I can visit my family this weekend. I can go to a 12 Step meeting at 8:00 p.m. tonight.)
- (Example: "Is this all there is?" – I can write a list of 10 things that I’m grateful for right now that I didn’t have when I was using. I can make a list of goals and see if they’re realistic, then write out specific steps to achieve each one.)
F. List any resources needed to help you deal with each problem listed in section C, and set up any required groundwork.
- (Example: "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 I have an open invitation to visit. I'll have to call the local AA office and find out where the local meetings are.)
- (Example: "Is this all there is?" One of my goals is to take some courses at the local community college. I can call or browse online to find out what the college entrance requirements are and what courses are available.)
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 here is to think about the emotions you're feeling and the actions you're taking. These will all work together to help develop a strong foundation for continued recovery.
Now, let's look at the bio-psycho-socio-spiritual elements of addiction and devise a relapse prevention plan.
Biological Element of Addiction
One of our most basic instincts is the desire for physical wellness. There are certain areas that we can address to help improve our physical well-being. Please write down the action you will take to address it and the time frame you need to achieve it.
A. Have you had a thorough physical checkup, including blood work with a hepatitis screen?
Hepatitis is a serious consequence of substance abuse, yet it's not commonly included in a routine blood screening. In my personal experience, I discovered I had hepatitis after being sober for 15 years.
B. Are you eating healthily? Do you need to change your eating habits?
Abusing drugs or alcohol for an extended period can severely interfere with the intake of vitamins, especially vitamin B. A relapse prevention plan should include taking a daily multivitamin and eating food that nourishes your body back to health.
C. Are you getting proper exercise?
The concept of "move a muscle, change a thought" is a good way to combat cravings. However, physical exercise also releases natural feel-good chemicals in the brain.
D. Are your sleep habits irregular?
If you are not sleeping regularly, you will obviously be tired. Besides, this can cause an inability to think clearly and increase vulnerability to depression and anxiety, among other relapse triggers. If you need help or suggestions for sleep, look up proper sleep hygiene, and get yourself on a consistent routine.
E. Are you complying with any medications prescribed by your physician or psychiatrist?
There are two sides to this question. One thing that’s commonly heard from recovering addicts in regards to taking medication is, "I started feeling really good, so I stopped taking it." If your medication is doing what it's supposed to do, continue taking it exactly as your doctor prescribed.
On the flip side, if the medication is not working, do not attempt to change your dosage on your own. Let your doctor know and be open to trying a different type of medication. This is especially true for antidepressants, as they don't all work for everyone and sometimes require trial-and-error before finding something that works.
A. Is there a possibility you may benefit from a consultation with a psychologist or psychiatrist?
It’s 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 that accompany your addiction.
B. Sometimes, situations may arise, which will cause us to be temporarily depressed or anxious. List five things you can do to help with depression and anxiety.
Social Element of Addiction
A. Boredom and isolation have been consistently identified as contributing factors to relapse. List 5 activities (or things you can do) to help with these problem areas and how you can implement them.
B. There's a high probability that our relationships with loved ones have suffered. List 4 concrete actions you can initiate to help repair these relationships.
C. List 3 things you can do to protect yourself when in social settings where drugs or alcohol are being used.
- (Example: Make sure I have a way out, drive my own car, or go with a friend so I can leave if I need to.)
- (Example: Practice a standard answer for refusing drugs or alcohol such as " no thanks" or "the doctor said I couldn't drink anymore." Whatever the reason, be concise and direct in saying no.)
- (Example: Give them all a real good eye roll and say, "That is soo last year.")
Spiritual Element of Addiction
A. List any behaviors you developed when you were still using that go against your sense of values or ethics. List how you will correct these behaviors.
- (Example: I became sneaky and dishonest. I will stop doing things that I need to lie about. I'll take responsibility for my actions.)
- (Example: My actions, or lack thereof, sometimes hurt people. Be less selfish with my time.)
B. If you feel spiritually distanced from your Higher Power, ask yourself who moved? What concrete actions can you take to get closer to your spirituality and/or Higher Power?
- (Example: I can start meditating and try to connect by praying daily.)
- (Example: I can try to go to church or find one that I like.)
- (Example: I could try helping someone out by _____.)
C. List how you can improve your relationship with each of the following:
- My family
- My Higher Power
- The community of people around me
Again, I'd like to emphasize that having a great plan that isn’t utilized is equivalent to having no plan at all. The best plan in the world does not mean a thing unless you put it into action.