Understanding Common Relapse Triggers

a man talking to a doctor about relapse triggers

Last week, we discussed overconfidence and entitlement as factors in relapse. Today, we’ll explore other things that commonly function as “triggers” in tempting someone to return to the familiar bottle, needle, or other sources of chemical comfort. First, though, a couple of facts about relapse triggers that everyone should remember:

  • Relapsers are in particular danger of overdosing. A person who has been a regular user, then gone without for several weeks or months, is likely to immediately resume the most recent habitual dosage—although the body’s physical tolerance for the substance will have decreased during the abstinence period. It’s like starting out to run five miles because you used to do it ten years and forty pounds ago; the sudden stress may prove more than the body can take.
  • No one is immune to relapse, any more than your income level, education, or ethnicity made you immune to addiction in the first place. It’s true that different groups are statistically more vulnerable to certain types of addiction/relapse—street drugs and beer for the inner city, prescription drugs and champagne for the wealthy—but when it comes to a number of risk factors, substance abuse problems are very much an equal-opportunity entity.

Reminders of the Substance Abuse Life

For those recently adjusted to the “new normal” of sobriety, something as simple as seeing a billboard for your formerly favorite beer may set off nostalgic cravings that remember only the “good old days” and forget all the problems drinking caused you. You may not be able to completely avoid all reminders of a legally sold substance, but you can reduce the risk by minimizing overall media exposure and avoiding the “stomping grounds” where you always ordered that drink. And be especially careful about anniversaries and at special events where the problem substance was a standard part of activities. 

Lingering Aspects of Substance Abuse Days

While many reminders of old times are met by sheer accident, others are effectively sent “come tempt me” invitations. A surprising number of former addicts never bother to erase the bar or dealer from their contact lists, or to clear out the wine glasses or meth pipes from their homes. This is as foolish as pulling a trigger to see if the gun is loaded. Do a full purge of everything associated with substance abuse.

Unmet Expectations

Naturally, you’re disappointed when a job offer falls through. Of course, it hurts when someone repays your best efforts with ingratitude and criticism. Yes, anything from a flat tire to a major hurricane can hit at the most inconvenient moments. When things don’t go as well as you’d hoped, it’s seriously tempting to turn to the “old friend” of substance abuse; at least it has a record of meeting your expectations. (But see above on the increased risk of overdose at this stage.) 

Frustration and Self-Pity Are Common Relapse Triggers

It’s only a small step down from the disappointment of unmet expectations to a full-blown bout of “mad at the world” or “poor me”—an even bigger risk zone for turning back to comfort chemicals. It’s good to prepare for the danger by planning, with a coach or therapist, ways to manage these feelings—and other negative emotions such as loneliness or fear. 

Emotional Stress

Even those not particularly prone to negative emotions have limits on how much overall stress they can take. Consider if you need to make any temporary or permanent lifestyle/priority changes to reduce tension and overwhelm, especially in areas that were contributing factors to the original addiction. 

Fatigue or Poor Health

Inadequate sleep, poor eating habits, and a sedentary lifestyle (not to mention actual physical health and mental health disorder) lower resistance to both emotional stress and physical pain, and thus to the temptation of relapse. Find a good doctor for regular checkups and healthy-habit recommendations. 

Physical Pain

A surprising number of addictions start as legitimate prescriptions, usually in the form of opiates originally prescribed for chronic pain. Even experienced doctors can underestimate the risk of handing out chemical relief indiscriminately: patients who experience initial pain relief from medication are in increased danger of developing not only physical addiction, but psychological dependence, hyperalgesia (abnormally heightened sensitivity to pain), and kinetophobia (fear of movement). If pain-relief medications were your substance problem, and the physical pain is still an issue, talk to a doctor experienced in specifically non-chemical pain relief before you make another move. (Dr. James Flowers, CEO of Kemah Palms, is an expert in coping with pain through mindfulness, exercise, stress management, and healthy eating. If you missed seeing Dr. Flowers discuss this topic on Great Day Houston last Monday, April 4, the clip is available here or here.) 

Elation and Celebration

While most of the above relapse triggers are associated with negative emotions, euphoria can be as risky. When everything seems to be going great or everyone is celebrating, it’s easy to convince yourself (if you remember to think at all) that nothing you do could spoil your “top of the world” standing. (People in that situation are vulnerable to more than chemical temptations, as many an unplanned pregnancy or court date can attest.) It’s a good idea to avoid any celebration where alcohol and drugs might flow freely. When you do have something to celebrate, do it with other committed-to-sobriety people. 

One more thing: don’t use another potentially addictive substance—which can include television, social media, or working late, as well as alternative chemicals—as a major recovery tool! Another harmful addiction is no improvement on a same-substance relapse.

Relapse Prevention Therapy at Kemah Palms Recovery

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