One of the many things that bugs me about relapse prevention is that, when it comes to addiction, using is the norm and not using is the lapse. It’s normal to use and not using is the difficulty within a substance addiction. Because of the “normalcy” of using, it’s important to prevent and manage the desire and the circumstances that lead to “picking up.”
Therefore, I offer the five (5) steps to prevent a relapse:
- Stop, look, and listen. The first thing to do when a lapse occurs is to stop the ongoing flow of events and to look and listen to what is happening. The lapse is a warning signal indicating that the client is in danger.
- Carry out Lapse Management Plan. After a slip, renewed commitments should be turned into a plan of action to be carried out immediately. Anyone can help users identify Emergency Action Plans, which may include a crisis hotline telephone number, an alternative activity, or a trustworthy friend.
- Keep Calm. Just because the user slipped once does not indicate failure. One slip does not have to make a total relapse. Look upon the slip as a single, independent event, something that can be avoided in the future. A slip is a mistake, an opportunity for learning, not a sign of total failure.
- Renew Commitment. After a lapse, the most difficult problem to deal with is motivation. A person who uses may feel like giving up and may need reminding of the long-range benefits to be gained from this change. Substance abusers should be encouraged to reflect optimistically on their past successes in being able to quit the old habit, instead of focusing pessimistically on current setbacks.
- Review the situation leading up to the lapse. Look at the slip as a specific unique event. The following questions may help clarifying the lapse episode: What events led up to the slip? Were there any early warning signals that preceded the lapse? What was the nature of the high-risk situation that triggered the slip? Each of these questions may yield valuable information concerning sources of stress and high-risk situations for the client. The fact that a slip occurred often is an event that tells you that something is going on that needs attending to.
These aren’t hard and fast rules, but if enacted, they do work. At least, they’re better than doing nothing.