There are lots of decisions to make once you decide to enter a drug rehab program. To help make the program a success, you need a relapse prevention plan in place early on. Most relapses occur during the first ninety days in recovery. But relapse can happen at any time and for any of several reasons. All of these reasons lead to urges in one way or another. Rehab will help you learn the techniques to deal with urges and stay in control of your recovery.
Distinguishing Between Urges & Cravings
Cravings and urges are often referred to as if they were the same thing. Although they both refer to the desire to use your addictive substance, they vary in intensity. You can crave something without having the urge to give in to the craving.
Treatment for addiction always begins with detox and the early withdrawal symptoms that keep so many addicts away. During the first day or two after you stop using the addictive substance, cravings are at their most intense. To the addict, the cravings are comparable to the need for oxygen once your air supply has been cut off. If you’ve ever craved a certain food and couldn’t stop thinking about it until you got it, cravings for drugs and alcohol are similar. But they are many times more intense.
After detox, the intensity of the cravings subsides but they don’t go away. Every person and every substance is different. Sometimes they come in waves, building to a peak before subsiding. Some people can ignore their cravings while others need to develop skills to avoid them. While cravings might be described as the strong desire to have something, urges are the sense of urgency that they have to have it now. As relentless as cravings might be, urges can be unbearable.
How Urges Lead to Relapse
Relapse isn’t something that happens all at once. It starts weeks or months before it culminates into an actual event. Relapse occurs in three phases. Certain “triggers” cause you to experience urges during different stages. Recognizing these triggers and understanding the signs and signals as they unfold can help prevent them from leading you into relapse.
Some of the most common triggers include:
- Going through withdrawal
- Post-acute withdrawal
- Being in places where you used before
- Being with friends who you used with
- Things related to your substance use
- Poor self-care
- Relationship problems
- Believing you don’t have an addiction problem
- Negative emotions
- Emotional Relapse – During the first stage of relapse, you aren’t consciously thinking about using. You are feeling a range of emotions and exhibiting behaviors that signal a future relapse. You might experience anxiety, anger, or mood swings. You slack off from going to therapy and start to isolate yourself from others. You stop eating a nutritious diet and aren’t sleeping well. You aren’t willing to ask for help.
The signs of emotional relapse are the same as those of post-acute withdrawal or the protracted stage of recovery. This period is after the physical symptoms of withdrawal diminish. Now that your brain chemistry is trying to get back to normal, it produces more emotional and psychological symptoms. Understanding these symptoms during withdrawal will help you plan for relapse prevention later on. When you know that you are in stage 1 of relapse, you can change your behaviors and change the outcome.
Make an extra effort to take care of yourself. Plan healthy meals and follow a regular sleep schedule. Engage in an activity that you find relaxing, whether it’s fishing, reading, or taking a yoga class. Better yet, go to class with a friend or family member. Interacting and sharing will help keep you from feeling isolated and allowing your negative emotions to grow.
Self-care is one of the most important things you can do to prevent relapse during this stage. Some techniques to help reduce cravings and improve your overall wellbeing include:
- Mindfulness Meditation
- Massage Therapy
These techniques are beneficial for relapse prevention by increasing relaxation and stress reduction.
- Mental Relapse – To visualize this stage of relapse, think of the depiction of having a devil on one shoulder and an angel on the other. The devil wants you to use, while the angel doesn’t. You might think more about the places where you used to use and the people you shared your addictive lifestyle with. Your past takes on a glamorous appearance in your memories that it never had in real life. You begin to think more about using, hanging out with your old friends, and actively considering relapse. You start lying about what you’re doing and planning your relapse. The urge is getting stronger, making relapse more likely.
During stage 2, you aren’t as worried about the consequences of relapse. This time around, you think you’ll be able to control how much and when you use. You might consider taking “just one drink” or using “just one time.” No one will know you’ve relapsed. When you start having these urges, talk to someone about them. Getting them out in the open is the only way to take control over them. It also helps you when you realize you aren’t alone in the battle against relapse.
- Physical Relapse – Getting past the first two stages makes it easier to avoid the third one. If you don’t develop the coping skills to control your urges, you’re more likely to go into physical relapse. Once you take that step and get a drink or use drugs, going back is more difficult. An effective recovery program teaches you to recognize the triggers that lead to urges and relapse.
Why Relapse Is Common
The emphasis that recovery centers, physicians, therapists, and other recovering addicts put on relapse prevention is due to the extreme difficulty of overcoming addiction. Unlike psychological addiction, physical addiction to a substance leads to changes in the brain’s chemistry. It impacts every aspect of your life. There is also the issue of underlying mental or medical conditions that can act as potential triggers.
In comparison to a life filled with pain, depression, bad memories, or trauma, using the substance provides you with a reward, a feeling of euphoria, and the cloud you need to block out the memories. All of the physical, emotional, and mental aspects of addiction are intertwined. You can’t make the decision to stop using and go forward with an addiction-free life. You have to go through the stages and deal with the pain. Sometimes that pain is enough to remind you why you started using in the first place.
Techniques to Help Prevent Relapse
Relapse is common but not inevitable. Everyone has cravings and urges, sometimes years after recovery. When cravings and urges happen to you, be prepared to manage them. Some techniques to help are…
1. Know Your Triggers
Once you know what triggers your urges, the best approach is to try and avoid them. Going to certain places or being around specific people might cause you to start thinking about using. Some triggers are probably unavoidable. But if you know what they are, you can develop strategies for dealing with them when they happen.
2. Engage in a Little Self-Talk
When an urge arises, there’s a good chance you won’t be in the company of someone you feel like confiding in. It’s up to you to use logic and reason to talk yourself out of using. No one knows more about the process you’ve been through than you do. Tell yourself what the potential outcome of using is in comparison to that of staying in recovery. If there are some words of wisdom that you find inspiring, keep them written down and close to you at all times. When you feel the urge to use, read the worlds to yourself. It will help you remember all the benefits of recovery and the future you’re working for.
3. Get Some Exercise
Even if it’s just a walk around the block, the movement will help you resist urges. Regular exercise is also part of self-care and promoting good physical health. It helps you feel strong and makes it less likely that you will use.
4. Engage in Urge-Surfing
Some people deal with urges by disputing them or substituting a different thought or activity. Others run from the situation that triggered them in the first place. Another option you might try is called urge-surfing. Instead of resisting it or trying to stop it, it’s more a matter of acceptance. Accept the urge for what it is. Take a time out to focus on the urge and evaluate the thoughts and feelings you have. Describe what you are thinking, feeling, and sensing.
The reason it’s called ‘urge-surfing” is that urges come in waves. They start to form, build into something big, and then they pass. If you can learn to mentally surf through them without giving in, they will pass.
5. Find New Interests
Build a different life than the one you had while you were using. If you’ve always wanted to start a new hobby, do it now. It doesn’t matter if it’s gardening, cooking, knitting, or horseback riding. Discovering new interests helps distract you from urges and gives you the opportunity to learn something new about yourself. Some hobbies also provide the opportunity to meet new friends with the same interests.
6. Try Behavioral Therapy
Many recovery facilities use behavioral therapy to help patients cope with cravings. Some combine therapy with medication-assisted treatment. During therapy, you will learn techniques that help you whenever urges occur. These techniques rely on visualization, distraction, and redirection.
When you experience an urge, you can distract or redirect your attention to something else. Visualization involves imagining yourself in a place where you feel relaxed and happy. These techniques are ways that you can change your thoughts and put your focus on something besides your cravings until they pass.
7. Reach Out
It’s up to you to take the right steps to go through recovery and fight your cravings and urges. That doesn’t mean you should go through it alone. There are lots of other people out there going through the same thing as you. When urges make it challenging for you to stay on track, reach out. Group therapy will give you a venue for talking about your feelings and sharing with people who understand.
Don’t overlook the importance of maintaining contact with a sponsor. Have someone to call when things get difficult. Having someone to talk you out of giving in to urges is one of your most valuable relapse prevention tools.
8. Participate in an Intensive Aftercare Program
The months after completing a rehab program are the time period in which you’re most likely to relapse. Leaving the program and returning to life as usual is an invitation to relapse. An aftercare program greatly improves your chance of a successful recovery in the long-term. It helps you ease back into your life without giving in to your triggers. The support you receive from an aftercare program will help you stay focused and maintain your sobriety.
When Relapse Occurs
In spite of your best efforts, relapse can still occur. It doesn’t mean you’re a failure. Maybe a serious life event caused you to give in to your urges. Maybe you’ve been struggling with other medical or mental issues. Or, maybe you didn’t have a plan for relapse prevention that prepared you for the cravings and urges.
In any case, what’s important is what you do next. Don’t chalk it up to a total loss and let your substance use get out of control again. Go back to treatment and start again. Not at the beginning, because you’ve already made great strides. This time follow the advice listed above. Every time you try, you take a little more knowledge about what it takes to manage your cravings and urges.
If you or a loved one needs addiction treatment, contact Riverside Recovery Center. Our team of physicians and behavioral health clinicians are committed to redefining treatment and recovery. We offer outpatient drug and alcohol rehab that lets you get the help you need without taking you away from your work. If inpatient or residential treatment is indicated, we can refer you to the appropriate clinic. Our goal is to help you have a lasting recovery.