Replapse Prevention for Substance Abusers

I am a retired substance abuse counselor who has gained a knowledge of the recovery process through work and personal associations. I believe that there is a need for specific relapse prevention skills. That's what my blog is all about.
Please read on to learn more.

One of the most critical challenges faced by substance abusers after they have completed treatment is avoiding a return to drinking or drugging. This is an especially significant challenge because most treatment centers offer relatively short programs that are not fully adequate in time length. The average is 30 days.

Some offer aftercare programs, according to what insurance will pay for. And AA and NA programs offer free support meetings.

These are helpful options, but recovering people need a specific plan for preventing relapse. In order to develop a plan, a person must first understand the difference between abstinence and sobriety. They also need to learn healthy communication skills.

ABSTINENCE
Recovery is a process that requires work, and the first stage of recovery is abstinence - avoiding use of alcohol and drugs. In this step we learn what we need to do in order to get and stay healthy.

SOBRIETY
Sobriety is abstinence plus redeveloping mental,physical and spiritual health. I will cover some coping skills that will help you stay sober.
Now that you are clear about the difference between these two, let's move on to the specifics.

Coping skills
- Coping with stress in healthy ways. Learn to recognize when tension builds up. When that happens, do something to help you unwind. Take deep breaths. Give yourself positive suggestions, like "I'm OK, I'll get through this". "Everything will work out-this is not a big deal". Or, "God is in charge-all is well."

- Do something physical, such as taking a walk or doing something around the house.

- Expressing feelings in healthy ways. When you talk to family and friends about something that is bothering you, practice presenting it in a way that avoids blaming and "shoulds".

Example:
"When you say something that sounds critical I feel angry. "
It's best to say I FEEL this way when.... Rather than trying to make it the other person's problem. It's all about taking responsibility for your feelings and actions.

- When something is bothering you, stop and think before you speak. Take a deep breath. Ask yourself "what's really bothering me right now ?"

- Once you identify the problem, ask yourself if it is a situation that you can do something about. repeating the serenity prayer to yourself will help you decide. God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.

- Identifying negative, self-defeating thinking.

Spirituality As Part of Coping Skills

Coping skills must involve spirituality. Spirituality is defined by YOU, but it should be oriented to inner resources such as meditation or prayer. Developing spirituality involves learning how to develop the power of the mind to direct thoughts and behavior. At this point I will explore specific tools that will help you achieve that.

* Affirmations: brief, positive statements centered in the NOW that say what you want to accomplish.

Examples may include:

1) I am powerless over my alcohol/drug use. I cannot control it.

2) I believe that I can achieve lasting sobriety.

3) I can achieve lasting sobriety with the help of my Higher Power.

4) When of myself I cannot see a way to heal, I know my Higher Power shows me the best way.

Consider that addiction is a thinking problem as well as a drinking/using problem. By learning to change your thinking you can enhance your recovery process. AA says that relapse begins with "stinking thinking" - old thought patterns that say "drinking/using will help me cope with this problem". Or "I'm not an alcoholic, I only drink on weekends". "I can have one drink and stop", "I am a social drinker/user, I am capable of control".

Addiction can cause brain dysfunction that distorts feelings. Irrational thinking and poor judgement can distort circumstances and make you feel like a victim. Feeling like a victim can trigger relapse.

These ideas and suggestions are certainly not the be-all of relapse prevention. There are many good books on the subject. Listed below are some of the best authors.

* David and Merlene Miller

* Terence Gorski

* Alan Marlattt

*Father Joseph C. Martin

*Earnie Larsen

Watch for my e-book on relapse prevention on WizIQ

Mental Health Problems and Substance Abuse

Many people with substance abuse problems also have mental health problems, some that existed before they began drinking or drugging. This is called dual diagnosis. Some people begin abusing alcohol or drugs to "medicate" themselves, to change the way they feel. At this point we need to review the mental health problems that are most likely to drive individuals to self medicate.

1)Depression
2)Bi-Polar Illness
3)Obsessive Compulsive Disorder
4)Attention Deficit Disorder

A large percentage of individuals with substance abuse problems also have dual diagnoses, many of which have gone untreated. Some will readily admit that they used alcohol or other drugs to "mellow out". This can create a chicken-or-egg situation in which the substance abuse depletes the level of endorphins and serotonin that the brain produces. When production of these chemicals is depleted,it can exacerbate the mental health problem, causing people to use more alcohol or drugs to achieve the same effect that it did originally.

Lets look at the symptoms of each of these mental health problems in an effort to support a fuller understanding for the family and friends of those who have them.

Depression: a lack of interest in things you were once enthusiastic about,sleeping to much or not enough,loss of appetite, feelings of hopelessness, irritability and sometimes suicidal thoughts.

Bi-Polar Illness: Extreme mood swings from feeling euphoric and being hyperactive to
extreme depression. Mood swings can cycle between these two opposites every few days or several weeks.

Obsessive Compulsive Disorder: Thought patterns that compel you to do odd or repetitive things like frequent hand washing, constantly checking on things that don't need frequent attention,irrational fears, or religious beliefs that God will
punish you for something that is unrelated to moral issues. A good summary of this is feeling that you can't NOT do something.

Attention Deficit Disorder: This is an inherent and genetic brain dysfunction that is present from birth. Characterized by hyperactive behavior, unusally high need for constant stiumlation, difficulty concentrating, focusing and following through with routine tasks. People with this disorder had trouble paying attention and sitting still in school as children.

These descriptions are just sketches,and not everyone has all of the symptoms. In some cases the characterstics can overlap with each other. Check with your mental health professional if you think you or someone you love has these symptoms.

People with dual diagnoses need mental health care as well as substance abuse treatment, and their recovery can be complicated and more lengthy.