What Happens if I Relapse?

Rehab is just the first step in making long-term changes to your lifestyle. Because many people choose to go to rehab in response to a crisis, it’s easy to approach this process with a sense of urgency. In the moment, that urgency is warranted. However, when you’re so focused on the short term, it can be difficult to imagine a better future. People tend to catastrophize, picturing themselves going through crisis after crisis, and this emotional spiral can lead to poor decision-making.

Preparing for hard times is helpful, but catastrophizing is not. You are a dynamic, learning, growing person. And the more time you spend focused on healing, the more tools you will develop to navigate any hardship that comes your way.

After rehab, it’s natural to be concerned about relapsing. And that’s understandable, because relapses do happen. But they’re not the end of the world. By the time you leave rehab, you’ll be prepared to work through these setbacks. Nearly 75% of people who experience addiction ultimately recover.¹ This includes people who experience relapses.

The process of preventing a relapse begins the moment you enter rehab. Addiction treatment providers understand that your goal isn’t just to complete the program, it’s to successfully reenter the world and live a sustainably healthy life. Your experience of rehab will prepare you for what comes next.

Relapse is a valid concern for many clients. That’s why so many good-quality rehabs focus on giving you the tools you need to work through it.

What Causes Relapse?

Stress

Stress is a natural part of life, and research shows that people with a history of addiction may be more sensitive to stress. Even positive events can be stressful,² like getting a promotion or planning a wedding. The goal isn’t to eliminate these triggers, but to manage them in a healthy way.

Following rehab, stress can make you vulnerable to relapse.³ That’s because there’s a well-understood link between stress and addiction⁴—and this is especially true of chronic stress. Many people first turn to substances in response to difficult life situations. And without strong coping mechanisms, it’s easy to fall back into those unhealthy patterns. During rehab, you’ll learn how to manage your responses to stressful situations.

Although mindfulness is something of a buzzword these days, it’s also an effective tactic for coping with stress. This and other emotion regulation techniques taught in rehab can help you focus on the issue at hand, instead of getting lost in a series of overwhelming reactions.

Unexamined Trauma

Don Lavender, Program Director of Camino Recovery in southern Spain, explains the impact of unresolved trauma on relapse:

“The biggest contributor to relapse is stress, and the biggest contributor to stress is unaddressed or unresolved trauma.”

Trauma can result from any number of things, and no two people have the same experience. One person might develop PTSD from a car accident, while another walks away with no lasting psychological effects. Ongoing trauma, such as an abusive relationship or a toxic living situation, can result in complex PTSD (CPTSD), which has slightly different symptoms than PTSD.

With either of these conditions, it’s quite common to develop triggers. A trigger is an experience that evokes feelings of the original trauma, which are often disproportionate to the present moment. For example, open flames might trigger a person with PTSD from a house fire. When they see a burning candle, they may feel a sense of fear and urgency or even rush to put out the flame. In life, this isn’t always an appropriate response. That’s why, in healing from PTSD and CPTSD, clients are encouraged to pinpoint their triggers and develop more effective coping mechanisms.

Substance abuse is a common response to triggers⁵ like these. When you feel frightened or hurt, substances can short-circuit your emotional state. However, mind-altering substances are just tools, and each one of them has a specific effect. And when substances are the only tool you have available, it makes sense that you would try to use them to fix emotional problems. That’s why rehab is designed to give you more tools, so you can always use the right one for the task at hand.

How to Plan Ahead

Rehab is designed to give you the resources you need to not only guard against relapse, but to deal with it when it happens. Many people have concerns about transitioning out of rehab and back into their regular lives. It’s important to remember that rehab is not a vacation; it’s more like a class. You won’t be expected to go back to your old routine when you finish the program. In fact, your experience in rehab will help you decide how to change that routine in order to prioritize your long-term health.

By the time you decide to go to rehab, you probably already know that your habits need to change. Your team of healthcare providers understands this, and they want to help. The process of planning for your reentry into the wider world begins the moment you enter the program, says Rowland Tweedie, the Health and Fitness manager at Paracelsus Recovery:

“Often I tell clients their job, in that initial period after the treatment, is them: it’s their health, it’s their wellbeing. We should plan that…It’s important to have local support in place.”

Planning for life after rehab is different for everyone, and your providers will help you come up with strategies that fit your needs. Some clients find it helpful to create an emotional first aid kit, in which they write down strategies to employ in the future. It can be difficult to think clearly during times of extreme stress, and this is one way to remind your future self of the tools you have available. For example, an emotional first aid kit might include the following:

• The phone number of your therapist or sponsor
• A list of activities you enjoy, like cooking or exercising
• A list of distress tolerance skills you learned in therapy, such as listening to a song you love, lighting a scented candle, or holding an ice cube in your hand
• A comfort object, like a soft pillow or a worry stone, that you can pick up and hold in the moment
• A mantra you can repeat to yourself during meditation

Rehab is a valuable opportunity to learn from experts, and many programs include educational components. You might learn about the root causes of addiction, including biological predispositions, risk factors in your upbringing, and co-morbid diagnoses. Many rehab centers offer skills coaching, equipping you with healthy habits intended to improve your quality of life. You might learn how to exercise properly, how to cook, or even how to paint. Craving management classes provide strategies for working through any urges you experience in the future.

This type of learning is extremely important, and you’ll ideally come away from it with many useful coping strategies. However, finishing rehab doesn’t mean you’re simply “fixed.” When you exit the program, you’ll begin a whole new learning process. The environment of a rehab facility is very different from the wider world, and it will take you time to reacclimate. There will be times when you’re overwhelmed and unsure of how to react to a new situation. Each of these moments is an opportunity to put your new skills into practice.