The creation of this relapse prevention plan is meant to be an aid in your recovery. But please listen up, because this is important: "THE BEST PLAN IN THE WORLD DOES NOT MEAN A THING UNLESS YOU PUT IT INTO ACTION."
Sorry about that, I didn't mean to shout. There is a reality to be addressed here, though, and that is that a number of people relapse with a beautifully constructed plan that they never used or put into action.
Having a great plan that is not used, or acted upon is the same thing as having no relapse prevention 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 has this commonality. They almost universally say "I stopped going to meetings and working my program." If you aren't fans of 12 step groups, that last statement is synonymous to saying, "I stopped acting on a plan of action."
Now that we're all clear, here's our step-by-step guide to help you prepare yourself in case you find yourself at the brink of losing your sobriety.
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 has become generally accepted that the majority of people with addiction have another co-occurring mental health diagnosis. In fact, there are whole groups of mental health diagnosis that began as "substance induced." Take away the substance and sometimes you may lessen mental health issues.
Social: Addiction affects our social lives in many ways. Addiction is a disease of isolation, and in order to continue using, we break more and more family, friendship, and social ties. It wreaks havoc with 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 of looking at how addiction affects us spiritually, is that we have started to act against our moral principles and values. We find ourselves doing things we never would have imagined.
If we can agree that addiction affects us in these different life areas, then perhaps it makes sense to develop a plan to address each of them. 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 using.
Relapse Prevention Plan Work Sheet
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. A lot of people have a desire to stay sober if it is convenient and not too hard, or does not 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 the long-term consequences. Think in terms of the emotional and physical toll it will take on you, and the effects your actions will have on your family and friends. How difficult will it be for you to reengage in recovery should you lapse or relapse?
C. Identify your top 5 relapse warning signs and put them in order of importance.
1. (Example: I started withdrawing from people and getting lonely)
2. (Example: I began asking myself, "Is this all there is?")
D. For each of the items identified in the previous section, write out the problems they generated for you or those around you.
1. (Example: Withdrawing from people – I stopped going to fun things and started to believe nobody understood me…)
2. (Example: "Is this all there is?" – I began to question if the amount of happiness that I had was worth all the effort.)
E. Now for each of the problems you've identified on #3, list some action you can take to prevent the problem from expanding and getting worse. It is important to make sure that your solutions are specific, achievable, timely and measurable, if possible.
1. (Example: Withdrawing from people – I can go visit my family this weekend. I can go to a 12 Step meeting at 8:00 p.m. tonight.)
2. (Example: "Is this all there is?" I can write a list of 10 things that I am grateful for right now that I did not have when I was using. I can make a list of goals and see if their realistic, then write out exact steps to achieve each one.)
F. List any resources you may need to help you deal with each of the problems listed on #3, and begin to set up any groundwork needed.
1. (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 that I have an open invitation to visit. I'll have to call the local AA office and find out where the local meetings are.)
2. (Example: "Is this all there is?" one of my goals is to take some courses the local community college. I 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 that you're thinking about the emotions you're feeling and 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 device a prevention/action plan.
One of our most basic instincts is the desire to be physically well. There are certain areas that we can address to help improve our physical well-being. Write down the action you will take to address it and the time frame you will have it done by.
A. Have you had a thorough physical checkup, including blood work with a hepatitis screen?
Hepatitis is a very real 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. All my doctors simply missed it.
B. Are you eating in a healthy manner? Do you need to change your eating habits?
Drinking alcohol, or using drugs, for an extended period of time can severely interfere with the intake of vitamins, especially vitamin B. It is a great idea to take a multivitamin every day and eat food that will nourish 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, but physical exercise also releases natural feel-good chemicals in the brain.
D. Are your sleep habits regular?
If you are not sleeping regularly, you will obviously be tired. However, this can cause an inability to think clearly, and be more susceptible to depression and anxiety which are clearly 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 is not uncommon to hear from people in sobriety regarding properly taking their 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 for the duration your doctor has recommended. 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 with anti depressants as they don't all work for everyone and sometimes require trial-and-error before finding something that works for you.
A. Is there a possibility you may benefit from a consultation with a psychologist psychiatrist?
It is 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 along with the addiction issues.
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.
A. Boredom and isolation have been identified consistently as being contributing factors to relapse. List 5 activities, or things you can do, to help with these problem areas, and when you will start them.
B. There's a high probability that our relationships with our family have suffered. List for concrete actions you can initiate that may help repair family some relationships.
C. List three things you can do to protect yourself when you find yourself in social situation where alcohol is being served, or drugs are being used.
1. (Example:Make sure I have away and out, drive my own car, or go with a friend so I can leave if I need to.)
2. (Example:Practice a standard answer for refusing drugs or alcohol such as" no thanks" or "the doctor said I can't drink any more", whatever, be concise and direct in saying no.)
3. (Example: Give them all a real good eye roll and say "That is soooo last year.")
A. List any behaviors you have developed that need to be corrected that go against your sense of values or ethics when you were using are still with you. How will you correct them?
1. (Example: I became sneaky and dishonest. I will stop doing things that I need to lie about. I'll take responsibility for my actions.)
2. (Example: My in action sometimes hurt people, Earl lot of things I did not do – stepped up to the role of being a man, husband, and father. Be less selfish with my time.)
B. If you feel spiritually distanced from your Higher Power, ask yourself who moved? What concrete action steps can you take to move spiritually closer to your spirituality and/or Higher Power
1. (Example: I can start mediating and trying to connect by praying daily.)
2. (Example:I can try to go to church, or find one that I like.)
3. (Example:I could try helping someone out by...)
C. How can I improve my relationship with each of the following:
2. My family
3. My Higher Power
4. The community of people around me
You are now done with your relapse prevention discussions and exercises. Together, we have looked at the meaning of the process of relapse, relapse warning signs, and relapse triggers and cues. We have constructed an individualized relapse prevention plan. I hope this was of value to you.
Again, as a reminder, I'd like to emphasize that having a great plan that is not utilized or acted on 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.
Don't forget to obtain a clean copy that you can print out: SoberRecovery Relapse Prevention Plan.