adore79

How Relapse Happens

Relapse does not happen without warning, and it does not happen quickly. The gradual movement from abstinince to relapse can be subtle and easily explained away or denied. So a relapse often feels as if it happens suddenly. This slow movement away from abstinince can be compared to a ship gradually drifting away from where it was moored. The drifting movement can be so slow that you dont even notice it.

Interrupting Relapse Drift

During recovery people do specific things that keep them abstinent. These activities can be called "mooring lines." People need to understand what they are doing to keep themselves abstinent. They need to list these morring lines in a specific way so they are clear and measurable. These activities are the "ropes" that hold recovery in place and prevent relapse drift from happening without being noticed.

Maintaining Recovery

Use the Morring Lines Recovery Chart to list and track the things that are holding your recovery in place. Follow these guidlines when filling out the form:

Identify four or five specific things that now are helping you stay abstinent (for example, working out for 20 min, 3 times a week.)

Include items such as exercise, therapist and group appointments, scheduling activities, 12-step meetings, eating patterns.

Do not list attitudes. They are not as easy to measure as behaviors.

Note specific people or places that are known triggers and need to be avoided during recovery.

You should complete your morring lines recovery chart weekly. Place a checkmark next to each mooring line that you know is secure and record the date. When two or more items cannot be checked, it means that relapse drift is happening. Sometimes events interfere with your mooring lines. Emergincies and illnesses cannot be controlled. The mooring lines disappear. Many people relapse during these times. Use the chart to recognize when you are more likely to relapse, and decide what to do to keep this from happening.

adore79

You have learned new behaviors that keep you in recovery. These behaviors are the mooring line that keep your recovery steady and in place. It is important to chart the new behaviors and check every week to make sure the lines are secure. Dropping one or more of the mooring lines allows you to drift toward relapse.

Use the chart below to list activities that are important to your continuing recovery. If there are specific people or things you need to avoid, list those. Check your list each week to make sure you are continuing to stay anchored in your recovery.

Astro

Fel, thanks for sharing this information with our members!

adore79

Guilt is feeling bad about what you've done.

What are some things you have done in the past that you feel guilty about?




Feeling guilty can be a healthy reaction. It often means you have done something that doesn't agree with your values and morals. It is not unusual for people to do things that they feel guilty about. You can't change the past. It is important to make peace with yourself. Sometimes that means making amends for things you've said and done.

Remember the following:

It's all right to make mistakes.
It's all right to say, "I don't know," "I dont care," or "I don't understand."
You don't have to explain youself to anyone if you're acting responsibly.

Do you still feel guilty about the things you listed? What can you do to improve the situation?




Shame is feeling bad about who you are.

Do you feel ashamed of being dependent on substances?

Do you feel you are weak because you couldn't or can't stop using?

Do you feel you are stupid because of what you have done?

Do you feel that you are a bad person because you are involved with substance use?

Recovery is always a hard process. No one knows why some people can stop using substances once they enter treatment and decide to be abstinent and other people struggle to maintain abstinence. Research shows that family histories, genes, and individual physical differences in people play a role. Being dependent on drugs or alcohol does not mean you are bad, stupid, or weak.

What we do know is taht you cannot recover by:
Trying to use willpower
Trying to be strong
Trying to be good

Two things to make recovery work are
Being smart
Working hard

Everyone who is successful at recovery will tell you "it was the hardest thing I ever did." No one can do it for you, and it will not happen to you.

adore79

Ask any group of people who are new to recovery why they want to stop using right now and you will get many different answers:

I was arrested, and it's either this or jail.
My wife says if I don't stop, we are finished.
Last time I used I thought I was going to die; I know I'll die if I use again.
They are going to take the children from us unless we stop.
I've been using for 20 years now; it's time to change.

Which of the people quoted is most likely to be successful in recovery? It seems logical to think that people who want to stop using for themselves and not because someone else wants them to are more likely to do well in treatment. However, that may not be true. Research shows that the reasons people stop using don't predict whether they will be able to lead substance-free lives.

What does make a difference is whether they can stay substance free long enough to appreciate the benefits of a different lifestyle. When debts are not overwhelming, relationships are rewarding, work is going well, and health is good, the person in recovery wants to stay abstinent.

Fear will get people into treatment, but fear alone is not enough to keep them in recovery.

Motivation for Recovery:

List some of your reasons for entering treatment (for example, medical problems, family pressure, job problems, depresssion.)




List some of your reasons for continuing to work on your recovery today.




Do you feel that your reasons for initially stopping substance use are the same as your reasons for staying abstinent today? Why or why not?

adore79

During substance dependence

Not being truthful is part of substance dependence. It is hard to meet the demands of daily living (relationships, families, jobs) and use substances reguarly. As you become more dependent on the substance, the activities that are necessary to obtain, use, and recover from the substance take up more of your life. It becomes more and more difficult to keep your life on track. People who are substance dependent often find themselves doing and saying whatever is necessary to avoid problems. Telling the truth is not important to them.

In what ways were you less than truthful when you were using substances?






During Recovery

Being honest with yourself and with others during the recovery process is crititcally important. Sometimes being truthful is very difficult for the following reasons:

You may not seem to be a nice person.
Your counselor or group members may be unhappy with your behavior.
You may be embarrassed.
Other people's feelings may be hurt.

Being in treatment without being truthful may make everything you are doing a waste of time.

How has truthfulness been difficult for you in recovery?





Being partly honest is not being truthful. Do you ever:

Decide to let someone believe a partial truth?
Tell people what they want to hear?
Tell people what you wish were true?
Tell less than the whole truth?

Attending groups, attending meetings, going to a hospital, and going to a counselor are wastes of time and money without truthfulness.

Recovery from addiction is impossible without truthfulness.

hope3

Thank-you Adore for starting this thread. I did an outpatient and joined AA.

I am grateful for both...

Good stuff.

Hope3

adore79

Why is relapse prevention important?

Recovery is more than not using drugs and alcohol. The first step in treatment is stopping drug and alcohol use. The next step is not starting again. This is very important. The process for doing it is called relapse prevention.

What is Relapse?

Relapse is going back to substance use and to all the behaviors and pattersn that come with it. Often the behaviors and patterns return before the substance use. Learning to recognize the beginning of a relapse can help people in recovery stop the process before they start using again.




What are addictive behaviors?

The things people do as part of abusing drugs or alcohol are called addictive behaviors. Often these are things that addicted people do to get drugs or alcohol, to cover up substance abuse, or as part of abusing. Lying, stealing, being unreliable, and acting compulsively are types of addictive behaviors. When these behaviors reappear, people in recovery should be alerted that relapse will soon follow if they do not intervene.

What are your addictive behaviors?





What is addictive thinking?

Addictive thinking means having thoughts that make substance use seem OK. Some examples follow:

I can handle just one drink.
If they think I'm using, I might as well.
I have worked hard. I need a break.

How have you tried to find excuses to use substances?




What is Emotional buildup?

Feelings that don't seem to go away and just keep getting stronger cause emotional buildup. Sometimes the feelings seem unbearable. Some feelings that can build are boredom, anxiety, sexual frustration, irritablility, and depression.

Have you experienced a buildup of any of these emotions?





The important step is to take action as soon as you recognize the danger signs.

Which actions might help you prevent relapse?

Calling a counselor
Calling a friend
Talking a day off
Talking to your family
Going to a 12-step or outside mutual-help support meeting
Exercising
Talking to your spouse
Scheduling time more rigorously
Other:

adore79

Have you ever found yourself saying any of the following?

My problem is my meth use. Alcohol (or marijuana) is not a problem for me.
Having a beer or glass of wine is not really drinking.
I drink only when I choose to. My drinking is not out of control.
I don't really care about alcohol. I drink only to be sociable.

If you entered the program to stop using stimulants, you may have wondered why you were asked to sign an agreement stating your willingness also to stop using other substances, including alcohol. For many reasons, total abstinence is a necessary goal for people in recovery:

Followup studies show that people who use stimulants are eight times more likely to relapse if they use alcohol and three times more likely to relapse if they use marijuana than people who do not use these substances. You can reduce you chances of relapsing greatly by maintaining total abstinence.

Places and people associated with drinking often are the very places and people who are triggers for substance use.

When you're learning to handle problems without taking stimulants, using another drug or alcohol to numb the uncomfortable learning process is harmful for two reasons. First, such use prevents you from directly confronting your stimulant use problem. Second, it puts you at risk of becoming dependent on alcohol or another substance while you try to overcome your dependence on stimulants.

Remember, if it's more difficult to stop drinking than you expected, maybe you are more dependent on alcohol than you think.

adore79

How has substance use affected the trust between you and people you care about?





If you tell someone you're not using and the person doesn't believe you, does it make you feel like using? Do you think, "if people are going to treat me as if I'm using, I might as well use"?



People who are substance dependent find it difficult to have open, honest relationaships. Things are said and done that destroy trust and damage relationships. Substance abuse becomes as important as or more important than other people.

When substance stops, the trust does not return right away. To trust means to feel certain you can rely on someone. People cannot be certain just because they want to be. Trust can be lost in an instant, but it can be rebuilt only over time. Trust will return gradually as the person who violated the trust gives another person reasons to trust again. One or both people may want the trust to return sooner, but it takes time for feelings to change.

How do you cope with suspicions about drug use?


What can you do to help the process of reestablishing trust?




Recovery is a long process. Regaining lost trust is part of the process. It may be one of the last changes to occur.

adore79

Be smart, not strong

"I can be around drugs or alcohol. I'm sure I don't want to use, and once I make up my mind, I'm very strong."

"I have been doing well, and I think it's time to test myself to see whether I can be around friends who are using. It's just a matter of willpower."

"I can have a drink and not use. I never had a problem with alcohol anyway."

Staying abstinent has little to do with how strong you are. People who maintain abstinence do it by being smart. They know that the key to not drinking and not using is to keep far away from situations in which they might use. If you are in an environment where drugs might appear (for example, at a club or party) or with friends who are drinking and using, chances of using are much greater than if you weren't in that situation. Smart people stay abstinent by avoiding trigger and relapse situations.

Don't count on being strong. Be smart.

How smart are you being? Rate how well you are doing in avoiding relapse. (circle the appropriate number.)


1= Poor 2=Fair 3=Good 4=Excellent

1. Practicing thought stopping 1 2 3 4
2. Scheduling 1 2 3 4
3. Keeping appointments 1 2 3 4
4. Avoiding triggers 1 2 3 4
5. Not using alcohol 1 2 3 4
6. Not using drugs 1 2 3 4
7. Avoiding using people 1 2 3 4
8. Avoiding using places 1 2 3 4
9. Exercising 1 2 3 4
10. Being truthful 1 2 3 4
11. 12-step or other meetings 1 2 3 4

Add up the circled numbers. The higher your total, the better your recovery IQ. The best possible recovery IQ is 44.

I scored

This is your recovery IQ. What can you do to improve your recovery IQ?

adore79

The entire handbook that is being written here can be found at:

http://www.kap.samhsa.gov/products/m...s_handbook.pdf


Just reading the handbook should probably not be used as a replacement for actually going to IOP, since a lot of what you gain from IOP comes from talking and discussing things with other people.

adore79

Relapse Justification 1

Once a person decides not to use drugs anymore, how does he or she end up using again? Do relapses happen completely by accident? Or are there warning signs and ways to avoid relapse?

Relapse justification is a process that happens in people's minds. A person may have decided to stop using, but the person's brain is still healing and still feels the need for the substances. The addicted brain invents excuses that allow the person in recovery to edge close enought to relapse situations that accidents can happen. You may remember a time when you intended to stay substance free but you invented a justification for using. Then, before you knew it, you had used again.

Use the questions below to help you identify justifications invented by your addicted brain. Identifying and anticipating the justifications will help you interrupt the process.

Someone else's fault

Does your addicted brain ever convince you that you have no choice but to use? Does an unexpected situation catch you off guard? Have you ever said any of the following to yourself?

An old friend called, and we decided to get together.
I had friends come for dinner, and they brought me some wine.
I was in a bar, and someone offered me a beer.
Other:

Catastrophic events

Is there one unlikely, major event that is the only reason you would use? What might such an event be for you?

My spouse left me. There's no reason to stay clean.
I just got injured. It's ruined all of my plans. I might as well use.
I lost my job. Why not use?
There was a death in the family. I can't get through this without using.
Other:

For a specific Purpose

Has your addicted brain ever suggested that using drugs or alcohol is the only way to accomplish something?

I'm gaining weight and need stimulants to control my weight.
I'm out of energy. I'll function better if I use.
I need drugs to meet people more easily.
I can't enjoy sex without using
Other:

Depression, anger, loneliness, fear

Does feeling depressed, angry, lonely, or afraid make using seem like the answer?

I'm depressed. What difference does it make whether I use?
WHen I get mad enough, I can't control what I do.
I'm scared. I know if I use, the feeling will go away.
If my partner thinks I've used, I might as well use.
Other:

Whay might you do when your addicted brain suggests these excuses to use?

adore79

Emotional Triggers

For many people certain emotional states are directly connected to substance use, almost as if the emotion causes the substance use. It seems to people in recovery that if they could avoid ever feeling those emotions (for example, loneliness, anger, feeling deprived), they would never relapse. These emotional triggers should act as warnings or "red flags" for clients.

The most common negative emotional triggers are the following:

Loneliness: It is difficult to give up friends and activities that are part of a a substance-using lifestyle. Being separated from friends and family leaves people feeling lonely. Often friends and family members who do not use are not ready to risk getting back into a relationship that didn't work earlier. The person in recovery is stranded between groups of friends. The feeling of loneliness can drive the person back toward using.

Anger: The intense irritablility experienced in the early stages of recovery can result in floods of anger that act as instant triggers. A person in that frame of mind is only a few steps from substance use. Once a person uses, it can be a long trip back to a rational state of mind.

Feeling deprived: Maintaining abstinence is a real accomplishment. Usually people in recovery feel justifiable good and proud about what they have been able to achieve. Sometimes people in recovery feel as if they have to give up good times and good things. Recovery seems like a jail sentence, something to be endured. This reverses the actual state of recovery: substance use begins to look good and recovery seems bad. This upside-down situation quickly leads to relapse.

It is important to be aware of these red flag emotions. Allowing yourself to be flooded with these powerful negative emotions is allowing yourself to be swept rapidly toward relapse.

Have some of these emotional states been a trigger for you in the past? Which ones?




Are there other negative emotional states that are dangerous for you? What are they?




One of the goals during the recovery process is learning to separate thoughts, behaviours, and emotions so that you can control what you think and how you behave. It is important to recognize and understand your emotions so that your actions are not always dictated by your feelings.

Many people find that writing about their feelings is a good way to recognize and understand their emotions. You don't need to be a good writer to use this tool. People who do not like to write and who have never written much in the past still can learn valuable things about themselves by putting their feelings into words. Follow the simple instructions, and try a new way of getting to know yourself:

1. Find a private, comfortable, quiet place and a time just for writing. Try to write each day, even if you can write only for a few minutes.

2. Begin by taking several deep breaths and relaxing.

3. Write in a response to a question that you have asked yourself about your feelings (for example, "what am i feeling right now?" Why am i angry?" "why am I sad?").

4. Forget spelling and punctuation; just let the words flow.

Writing about your feelings makes them clearer to you. It also can help you avoid the emotional buildup that often leads to relapse.

adore79

Relapse justification 2

Once a person decides not to use drugs anymore, how does that person end up using again? Do relapses happen completely by accident? Or are there warning signs and ways to avoid relapse?

Understanding and anticipating the justifications help you interrupt the process. Use the questions below to help you identify justifications you might be susceptible to.

Substance dependence is cured

Has you addicted brain ever convinced you that you could use just once or use just a little? For example, have you said any of the following?

I'm back in control. I'll be able to stop when I want to.
I've learned my lesson. I'll only use small amounts and only once in a while.
This substance was not my problem-stimulants were. So I can use this and not relapse.
Other:

Testing Yourself

It's very easy to forget that being smart, not being strong, is the key to staying abstinent.

Have you ever wanted to prove you could be stronger than drugs? For example, have you said any of the following?

I'm strong enough to be around it now.
I want to see whether I can say "no" to drinking and using.
I want to see whther I can be around my old friends.
I want to see how the high feels now that I've stopped using.
Other:

Celebrating

You may be encouraged by other people or your addicted brain to make an exception to your abstinence. Have you ever tried to justify using with the following thoughts?

I'm feeling really good. One time won't hurt.
I'm on vacation. I'll go back to not using when I get home.
I'm doing so well. Things are going great. I owe myself a reward.
This is such a special event that I want to celebrate.
Other:

What might you do when confronted with these excuses to use?

24hrsAday

i am an alcoholic and i might die if i choose to drink!