Editorial Team

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MODULE 9:

9 What are Relapse Triggers?

According to the NIDA,1 between 40 – 60% of people recovering from a substance use disorder (SUD), such as alcoholism, will relapse at some point during their addiction recovery. Although you may think that around half is not a good success rate, it is very similar to the rates of relapse for other chronic diseases, eg. asthma, hypertension, and Type I diabetes.

Many professional addiction specialists hold the view that “relapse is a normal part of the recovery process”; an unavoidable occurrence, known as a relapse trigger, will prompt the recovering individual’s uncontrollable need to resume their drinking.

Bearing in mind that there are many successfully recovered alcoholics who have never relapsed even the once during their recovery, relapse triggers still do present a significant danger to continued recovery. Those in recovery, therefore, need to have coping strategies and mechanisms available to use should they be confronted by something that may trigger a return to alcohol use.

These coping skills should form part of an ongoing and updateable plan of action, known as a relapse prevention plan, that helps each individual to remain sober and alcohol-free during their own recovery.

1. Relapse Prevention Plan

Relapse prevention plans are plans of action for the newly-sober individual. These plans are normally written by addiction therapists or case managers in conjunction with the individual, and then given when drug and alcohol treatment is completed. Relapse prevention plans provide a sense of protection during the difficult period of early recovery.

Elements of a Relapse Prevention Plan

  • Personal goals for self-improvement
  • Known relapse triggers and potential challenges
  • Coping tools and strategies to deal effectively with stress and for minimizing personal triggers
  • Daily life and self-care plans
  • Support system / network
  • Accountability

Relapse Prevention: Self-Care

The most important aspect of any successful alcohol addiction recovery is self-care – anyone in recovery needs to look after themselves as well as they possibly can. This involves nutrition – eating a healthy and balanced diet, and exercise – regular ways of ensuring fitness, such as walking, cycling, team sports, or hiking. Working out in a gym is great exercise, but it’s not essential – any aerobic-type exercise on a regular basis is fine.

2. Identifying Relapse Triggers

Relapse triggers can be either external in origin, such as people, places and even objects, or they can be internal in origin, such as strong feelings and negative emotions, like anger and jealousy.

External Triggers

For those in recovery from AUD, external triggers are people, places, activities and objects that evoke particular thoughts or cravings associated with previous alcohol use. Research has shown that these types of triggers create subconscious cues, which are clearly dangerous because they reinforce cravings, but the individual is unaware of it.

People Places
  • Friends
  • Certain neighborhoods
  • Co-workers
  • A friend’s home
  • Employers
  • Bars and clubs
  • Family members
  • Hotels
  • Spouses or partners
  • Worksites
  • Neighbors
  • Music concerts
Things Situations
  • Drinking paraphernalia
  • Meeting new people
  • Furniture
  • Going out with friends
  • Magazines
  • Being alone in the house
  • Movies
  • Vacations
  • Television
  • Family celebrations
  • Cash / credit cards
 

Internal Triggers

Internal triggers – feelings, thoughts or emotions – are definitely harder to deal with than external triggers. With a person or a place or an object, even a situation, an individual can simply walk away, and put some distance between themselves and their trigger. With an internal trigger, that’s simply not possible. Additionally, the spectrum of internal triggers is literally never-ending; here are some of the more common internal relapse triggers:

Negative Feelings & Emotions Normal Feelings & Emotions Positive Feelings & Emotions
  • Fear
  • Anxiety
  • Guilt
  • Anger
  • Hate
  • Jealousy
  • Shame
  • Depression
  • Loneliness
  • Boredom
  • Insecurity
  • Nervousness
  • Embarrassment
  • Pressure
  • Tiredness
  • Frustration
  • Neglect
  • Relaxation
  • Celebratory feelings
  • Excitement
  • Happiness
  • Passion
  • Strength
  • Confidence
  • Exhaustion
  • Feeling “normal”
  • Sexual arousal

The 4 Most Common Alcohol Relapse Triggers

  1. Stress: Considered the most common trigger to addiction relapse, stress that is not managed effectively, and so left to worsen, is a recovering alcoholic’s worst enemy. In fact, chronic and acute stress have been shown to be primary reasons for the start of excessive alcohol use. Adopting self-help strategies like relaxation techniques, eg. mindfulness, meditation, and yoga, can be highly effective ways of successful stress management.
  2. Intense Negative Emotions: As we have seen, internal triggers cannot be simply walked away from – they have to be dealt with in some way. Intense negative feelings, thoughts and emotions need particular care, and, for most people, can include anger, jealousy, hate, and shame.
  3. Physical Illness / Mental Health Disorder: Anything that affects your overall well being, such as pain and discomfort or depression, can act as a trigger, and is also likely to make other triggers much harder to deal with.
  4. Relationship Issues: There is a saying in addiction recovery circles: “Relationships = Relapse.” It’s a saying for good reason. The breakdown of an important personal or romantic relationship, especially in the early stages of recovery, is a heart-felt trigger to be avoided. In fact, it is advisable in early recovery not to begin any new intimate relationships, as issues that arise can make the recovering alcoholic try anything to alleviate the new emotional pain, such as resuming alcohol abuse.

3. Dealing with Cravings

Cravings for alcohol are a normal symptom of early alcohol addiction recovery, and recovering alcoholics need to learn how best to deal with them. These are common methods for dealing with cravings:

  • Exercise
  • Deep breathing
  • Expressive writing
  • Mindful meditation or yoga
  • Relaxation, eg. nature walks, listening to music, working in a garden, etc.
  • Speaking with the members of the support network

4. “What Should I Do If I Relapse?”

If you do relapse and break your sobriety, it is certainly not a sign of failure. It is simply a sign that something within your recovery wasn’t working, and needs to be addressed. As mentioned earlier, many addiction experts believe that relapse is an essential part of recovery.

If you experience a relapse, inform your support network as soon as you can, and listen to their advice. You may also want to speak with your doctor or the center that provided your addiction treatment program for their advice, too.

The most important thing to remember is that a relapse is not the end of your recovery – just a clear sign that you, your support network, and your medical team, need to reassess your recovery plan, and make the necessary adjustments.

References:

  • 1 National Institute on Drug Abuse (NIDA). Alcohol webpage. 2021. Available at Drugabuse.gov.

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