The Difference Between a Slip and a Relapse

[abcowboy]

Taken from an addictions rehab society:

The Difference Between a Slip and a Relapse

The Dangers of Relapse
Picking up alcohol or drugs again is always a bad choice for people in recovery. The extent of the damage caused by this will usually be determined by the speed by which people can quit again. Some individuals will be able to stop right away while others will rapid fall back into their addiction. In some cases those who return to their abuse will never manage to stop again – this means that their return to addiction is likely to be a death sentence. It is vital that those who relapse understand that they can still build a successful life in recovery. The sooner they can stop again the better it will be for them.

The Difference between a Slip and a Relapse
A slip is considered to be a less serious occurrence than a relapse. Both events are negative, but they differ in the degree of impact they will have on the life of the individual. Slips are when people pick up alcohol or drugs after a period of sobriety but stop again almost right away. They might have had one night where they returned to their former behavior but realized right away that it was a mistake. As soon as they sobered up they were able to return to life in recovery. A slip is often a spur of the moment event and not something that the individual has been planning.

A relapse is far more serious than a slip because it means that the individual has returned to their former addiction. The word relapse means to fall again. It often starts off as a slip, but then progresses from there. This relapse may last for days or it could be longer than this. It may mean that the current attempt to escape addiction has been completely abandoned. The individual might never have another opportunity to give up alcohol or drugs. The person who relapses can easily end up right back where they started if they don’t stop quickly. The fact that the individual has experienced life away from alcohol or drugs may mean that addiction is more painful than ever.

How a Slip Turns Into a Relapse
Even a brief return to substance abuse is a big mistake for people trying to recover from addiction. A slip is a setback, but it doesn’t have to progress into a full-blown relapse. It is understandable that people will feel guilty and a bit ashamed of their slip, but feeling this way can also be highly dangerous – it also benefits nobody. They may convince themselves that all is lost and so the only option is to resume their addiction like before. This type of thinking is not only highly destructive, but it is also completely wrong. A slip can be the turning point in recovery because it indicates that people have been doing something wrong. If these individuals can learn from the incident it may mean that their recovery will be stronger than ever before.

How to Avoid a Slip Turning Into a Relapse
If people have a slip it means that their recovery is now on very shaky ground. In order to avoid a full-blown relapse they will need to take action such as:
* The most important thing is for the individual to not engage in any further alcohol or drug abuse. The thinking of the person who has slipped can be treacherous. They may believed that as they have already taken alcohol or drugs there is no reason not to use some more – the idea that they might as well be hung for a sheep as a lamb. They will promise themselves that they will stop tomorrow, but they can use the same justifications then. It is vital that people stop any further substance abuse right away.
* Those who belong to a support group should seek assistance right away. If they have a sponsor they can get in contact with this person for advice and support. They should get to a meeting as soon as possible. People do feel embarrassed that they’ve slipped, but it is crucial that they admit to it.
* In order to avoid relapse the individual needs to redouble their efforts in recovery. Staying sober has to once again become the priority in their life, and they need to be willing to do whatever it takes to stay free of addiction. They will need to learn more about the relapse process and relapse triggers, and how to avoid these.
* Slips often occur when people are bored in recovery. It is therefore advisable that they look at this and think of productive ways to fill their time.
* A slip always happens for a reason and if the cause is not found then it is likely to occur again. The individual needs to conduct an honest assessment of their recent behavior to see where they have gone wrong.
* Those people who have past recently through a rehab should make use of the aftercare services available.

Dealing with Relapse
Even if people have fully returned to their addiction they can still call a halt to their decent. The longer they leave this the harder it will be. Feelings of shame and failure are to be avoided because these just feed the addiction. The important thing is to look to the future. The time already spent in recovery will not be wasted so long as the individual can once again put a halt to the abuse. Perhaps the reminder of how bad things can be in addiction will mean that they are more motivated to stay sober in the future.

[abcowboy]

Four Dispositions That Trigger Recovery Relapse

For the alcoholic/addict that is working a recovery program there can be four main dispositions that present formidable challenges which can trigger relapse. Relapse is an individual preface, and depending on the personality of the recovering alcoholic/addict, their relapse triggers might be different from others. The four that I discuss here represent the broadest of relapses and represent "Kryptonite" to anyone in recovery no matter how long or how strong their program is.

1. Recovery Expectations:
Expectations that either fall short or are unfulfilled can open the flood gates to relapse. Expectations can be unrealistic, and the alcoholic/addict can get swept up with what they think is a fast or easy recovery, which develops into a honeymoon period reflecting a happy work environment and fairy tale relationships. When events or people don't turn out to be what the alcoholic/addict "expected," they don't know how to deal with their frustration or disappointment hence, they turn to the only way they know to comfort themselves; getting high or intoxicated.

Relapse is common when the alcoholic/addict has not had enough recovery under their belt through 12-step meetings, sponsorship, counseling or their own personal determination to rely on an arsenal of "tools" to ward off the relapse demon. With an addictive personality, the pendulum swings so far in either direction that there is no middle ground of normalcy. Life to them is often black or white. The highs are too high, and they represent a false state of contentment. Eventually, those highs can't stay so lofty, and the alcoholic/addict needs to learn to work with, understand and accept expectations that may fall short of their intended mark.

Conversely, the lows can get so low that the alcoholic/addict doesn't know how to crawl out of the hole, dust themselves off and move on. They are very hard on themselves and don't trust that it will be "okay" if they are patient and take their time to re-group; hence they often resort to their addiction. Taking away the pain of reality with alcohol or drugs is the only thing that the alcoholic/addict has known for quite some time. It has for years been a "Pavlovian" response to stressful or difficult life situations. As the alcoholic/addict matured, they might never have learned how to "roll with the punches". In lieu of these experiences, the alcoholic/addict escaped to their addiction and therefore stunted their emotional growth.

As the recovery process gets underway, the alcoholic/addict realizes what they missed through all the years of substance abuse, but often doesn't have the patience to wade through the discomfort of this new emotion and therefore retreats (or relapses) to their safe haven of addiction. Their expectations of falling right in step with the rest of society can fall short as they have not literally clocked in the life hours as others have because they were intoxicated or high as others dealt with relationships, careers and family.

2. Resentments:
When the alcoholic/addict harbors resentment toward a person or place, (whether a current resentment or one from 20 years ago) the resentment can be so overwhelming that in order to stop the internal anger or frustration, the alcoholic/addict needs to self-medicate in the hopes of turning off the "noise."

In order for recovery to be strong and for relapse to no longer be an option, these resentments must be dealt with through 12-step meetings, sponsorship, and counseling. If not resolved, these resentments feed upon the alcoholic/addicts inner turmoil until busting free in the form of relapse or reckless actions. As a counselor working in a rehabilitation recovery program, all too often I have heard my clients share that because they were resentful towards a girlfriend, family member or institution they thought "who gives a f***" and went out and used or drank.

To the "normie" these resentments may cause a pimple or two, and usually our actions and emotions stay in check and we work through them and move on. The residual effect may produce some discomfort or even anger, but the outcome is rarely as detrimental as it is for the alcoholic/addict. The "pity-pot" to the alcoholic/addict is a handy way of keeping their resentment alive. "Oh, woe is me, no one understands me, I'm doing the best I can, but I guess it's not good enough, etc..." The alcoholic/addict can find great comfort on their "pity-pot" and if enough pity is spent on the pot, then lo and behold, they have found their right to drink or use. They believe their own press which tells them that they are no good or a failure, and the only thing that will dull the pain or make it go away is alcohol or drugs.

There is nothing you can do as the family member or friend to help the alcoholic/addict deal with their resentment. Remember, some of their resentment might be about you for something you did or did not do yesterday or years earlier. These resentments need to be worked through with a sponsor from a 12-step recovery program who has dealt with their own resentments and a professional counselor.

3. Boredom:
I believe the statement goes..."An idle mind is the devils play ground." This is true for both the "normie" and the alcoholic/addict. Often boredom can be a contributing factor in the world of addiction. However, many "normies" find themselves eating too much, gambling, shopping to excess, etc. ... because of boredom. Various addictions and their degrees of severity impact everyone's life differently.
Routine and concrete scheduling is a life-saver for the alcoholic/addict. Knowing where one has to be and when; being accountable to someone or something else provides a safe framework for the newly recovering alcoholic/addict to live with and depend upon.

4. Fear:
Is the fear imagined or real? Most fear that anyone experiences (whether you are an alcoholic/addict) or not, is imagined. Basically, it is fear of the unknown - of distrusting an outcome and not feeling in control of what may or may not happen. People can be gripped with fear and it can cripple their ability to make important changes in their life. Although they may be very aware that their current lifestyle is unacceptable, overwhelming fear of changing what they have known for so many years keeps them from taking steps toward a better life.

I heard a woman share about her fear of getting clean and sober. She stated that she was afraid of not knowing who she would be once she embraced an alcohol-free life; after all, she had grown very accustomed to her alcoholic self and was anxious about a new identity. After years of sobriety, she professed that she liked and respected herself more now than she ever could have imagined.

Getting beyond fear requires a lot of strength and trusting in a belief that a "higher power" will take care of you. It does not matter if one practices a formal religion or not. I believe that as long as there is some kind of spiritual belief then self-confidence and faith will grow and with that, our fears start to dissipate.

[lex]

Good stuff abcowboy- very glad you posted it! How are you doing these days?

[abcowboy]

I'm doing pretty darn good lex, thanks for asking! And I see you are too, congrats again! I read this info on another addiction website and shared it on the forum I'm at now. I don't want to disrupt the flow here at MWO but thought that some of those still trying to find a sticky quit might benefit from it as well. You take care ya hear, and keep on keepin' on eh! Adios my friend!

[lex]

You too ab!

[little beagle]

Thanks Cowboy. Very useful.

[Tabbers (a.k.a. KTAB)]

Thanks for sharing AB Cowboy, just what I need to read right now. Delighted you are doing so well.

[Pavati]

Thanks, Cowboy. Great to see you swing by, and glad to hear all is well.

[abcowboy]

Relapse Prevention from Addictions and Recovery

The Stages of Relapse

Relapse is a process, it's not an event. In order to understand relapse prevention you have to understand the stages of relapse. Relapse starts weeks or even months before the event of physical relapse. In this page you will learn how to use specific relapse prevention techniques for each stage of relapse. There are three stages of relapse

Emotional relapse
Mental relapse
Physical relapse

Emotional Relapse
In emotional relapse, you're not thinking about using. But your emotions and behaviors are setting you up for a possible relapse in the future.
The signs of emotional relapse are:

Anxiety
Intolerance
Anger
Defensiveness
Mood swings
Isolation
Not asking for help
Not going to meetings
Poor eating habits
Poor sleep habits
The signs of emotional relapse are also the symptoms of post-acute withdrawal. If you understand post-acute withdrawal it's easier to avoid relapse, because the early stage of relapse is easiest to pull back from. In the later stages the pull of relapse gets stronger and the sequence of events moves faster.

Early Relapse Prevention
Relapse prevention at this stage means recognizing that you're in emotional relapse and changing your behavior. Recognize that you're isolating and remind yourself to ask for help. Recognize that you're anxious and practice relaxation techniques. Recognize that your sleep and eating habits are slipping and practice self-care.

If you don't change your behavior at this stage and you live too long in the stage of emotional relapse you'll become exhausted, and when you're exhausted you will want to escape, which will move you into mental relapse.

Practice self-care. The most important thing you can do to prevent relapse at this stage is take better care of yourself. Think about why you use. You use drugs or alcohol to escape, relax, or reward yourself. Therefore you relapse when you don't take care of yourself and create situations that are mentally and emotionally draining that make you want to escape.

For example, if you don't take care of yourself and eat poorly or have poor sleep habits, you'll feel exhausted and want to escape. If you don't let go of your resentments and fears through some form of relaxation, they will build to the point where you'll feel uncomfortable in your own skin. If you don't ask for help, you'll feel isolated. If any of those situations continues for too long, you will begin to think about using. But if you practice self-care, you can avoid those feelings from growing and avoid relapse.

Mental Relapse
In mental relapse there's a war going on in your mind. Part of you wants to use, but part of you doesn't. In the early phase of mental relapse you're just idly thinking about using. But in the later phase you're definitely thinking about using.

The signs of mental relapse are:

Thinking about people, places, and things you used with
Glamorizing your past use
Lying
Hanging out with old using friends
Fantasizing about using
Thinking about relapsing
Planning your relapse around other people's schedules
It gets harder to make the right choices as the pull of addiction gets stronger.

Techniques for Dealing with Mental Urges
Play the tape through. When you think about using, the fantasy is that you'll be able to control your use this time. You'll just have one drink. But play the tape through. One drink usually leads to more drinks. You'll wake up the next day feeling disappointed in yourself. You may not be able to stop the next day, and you'll get caught in the same vicious cycle. When you play that tape through to its logical conclusion, using doesn't seem so appealing.

A common mental urge is that you can get away with using, because no one will know if you relapse. Perhaps your spouse is away for the weekend, or you're away on a trip. That's when your addiction will try to convince you that you don't have a big problem, and that you're really doing your recovery to please your spouse or your work. Play the tape through. Remind yourself of the negative consequences you've already suffered, and the potential consequences that lie around the corner if you relapse again. If you could control your use, you would have done it by now.

Tell someone that you're having urges to use. Call a friend, a support, or someone in recovery. Share with them what you're going through. The magic of sharing is that the minute you start to talk about what you're thinking and feeling, your urges begin to disappear. They don't seem quite as big and you don't feel as alone.

Distract yourself. When you think about using, do something to occupy yourself. Call a friend. Go to a meeting. Get up and go for a walk. If you just sit there with your urge and don't do anything, you're giving your mental relapse room to grow.

Wait for 30 minutes. Most urges usually last for less than 15 to 30 minutes. When you're in an urge, it feels like an eternity. But if you can keep yourself busy and do the things you're supposed to do, it'll quickly be gone.

Do your recovery one day at a time. Don't think about whether you can stay abstinent forever. That's a paralyzing thought. It's overwhelming even for people who've been in recovery for a long time.

One day at a time, means you should match your goals to your emotional strength. When you feel strong and you're motivated to not use, then tell yourself that you won't use for the next week or the next month. But when you're struggling and having lots of urges, and those times will happen often, tell yourself that you won't use for today or for the next 30 minutes. Do your recovery in bite-sized chunks and don't sabotage yourself by thinking too far ahead.

Make relaxation part of your recovery. Relaxation is an important part of relapse prevention, because when you're tense you tend to do what’s familiar and wrong, instead of what's new and right. When you're tense you tend to repeat the same mistakes you made before. When you're relaxed you are more open to change.

Physical Relapse
Once you start thinking about relapse, if you don't use some of the techniques mentioned above, it doesn't take long to go from there to physical relapse. Driving to the liquor store. Driving to your dealer.

It's hard to stop the process of relapse at that point. That's not where you should focus your efforts in recovery. That's achieving abstinence through brute force. But it is not recovery. If you recognize the early warning signs of relapse, and understand the symptoms of post-acute withdrawal, you'll be able to catch yourself before it's too late

[Matthew6]

Awesome post Cowboy, only wish I would have reread it a week ago. It's like a script I followed to the letter.

The four Dispositions of relapse, I nailed 1,2 and 4. I scored 100% on the stages, exactly as described.

Thank you for the effort required to post this.

[abcowboy]

The First Rule of Recovery, from Addictions and Recovery

The First Rule of Recovery

You don't recover from an addiction by stopping using. You recover by creating a new life where it is easier to not use. If you don't create a new life, then all the factors that brought you to your addiction will eventually catch up with you again. You don't have to change everything in your life. But there are a few things and behaviors that have been getting you into trouble, and they will continue to get you into trouble until you let them go. The more you try to hold onto your old life in recovery, the less well you will do. Here are the three most common things that people need to change in order to achieve recovery.

Avoid High-Risk Situations
Some common high-risk situations are described by the acronym, HALT:
• Hungry
• Angry
• Lonely
• Tired

How do you feel at the end of the day? You're probably hungry because you haven't eaten well. You're probably angry because you've had a tough day at work or a tough commute home. You may feel lonely because you're isolated. You don't have to be physically alone to feel lonely. And you're tired. That's why your strongest cravings usually occur at the end of the day. Here's another way of looking at high-risk situations:
• People. (People who you use with or who are related to your use. People who you have conflicts with, and who make you want to use. People who you celebrate with by using. People who encourage you to use either directly or indirectly.)
• Places. (Places where you use or where you get your drugs or alcohol.)
• Things. (Things that remind you of your using.)

How can you avoid high-risk situations? Of course, you can't always avoid these situations. But if you're aware of them, they won't catch you off guard, and you can prevent little craving from turning into major urges. Take better care of yourself. Eat a healthier lunch so you're not as hungry at the end of the day. Join a 12 step group so that you don't feel isolated. Learn how to relax so that you can let go of your anger and resentments. Develop better sleep habits so that you're less tired. Avoid your drinking friends, your favorite bar, and having alcohol in the house. Avoid people who you used cocaine with, driving by your dealer's neighborhood, and cocaine paraphernalia. Recovery isn't about one big change. It's about lots of little changes. Avoiding those high-risk situations helps you create a new life where it's easier to not use. Make a list of your high-risk situations. Addiction is sneaky. Sometimes you won't see your high-risk situations until you're right in the middle of one. That's why it's important that you learn to look for them. Make a list of your high-risk situations and keep it with you. Go over the list with someone in recovery so that you can spot any situations that you might have missed. Make the list and keep it with you. Some day that list may save your life.

Learn to Relax
There are only a few reasons why people use drugs and alcohol. They use to escape, relax, and reward themselves. In other words, people use drugs and alcohol to relieve tension.
The first rule of recovery is that you must change your life. What do you need to change? If you understood the previous paragraph, then you need to change the way you relieve tension. Everyone needs to escape, relax, and reward themselves. Those are essential coping skills for a happy life. But addicts don't know how to do those things without using. If you manage to stop using for a while, but don't learn how to relax, your tension will build until you'll have to relapse just to escape again. Tension and the inability to relax are the most common causes of relapse. I know relaxation will help. I have treated thousands of patients. Many of them have told me that relaxation has changed their life. There is only one reason why people don't relax – because they think they're too busy to relax. It goes something like this, "I know it makes sense, but I've got so many other things I have to do." Ask yourself how much time you spend on your addiction. If you add up all the time it takes to get your drug, use it, deal with its consequences, and plan your next relapse, you'll realize that relaxing for twenty to forty minutes a day is a bargain. Relaxation is not an optional part of recovery. It's essential to recovery. There are many ways to relax. They range from simple techniques like going for a walk, to more structured techniques like meditation. Meditation is an important part of that mix because the simple techniques don't always work. If you're under a lot of stress, you may need something more reliable like meditation. Use any of these techniques, or any combination. But do something everyday to relax, escape, reward yourself, and turn off the chatter in your mind. Numerous studies have proven that relaxation reduces the use of alcohol, tobacco, and marijuana.

Be Honest
An addiction requires lying. You have to lie about getting your drug, using it, hiding its consequences, and planning your next relapse. An addiction is full of lying. By the time you've developed an addiction, lying comes easily to you. After a while you get so good at lying that you end up lying to yourself. That's why addicts don't know who they are or what they believe in. The other problem with lying is that you can't like yourself when you lie. You can't look yourself in the mirror. Lying traps you in your addiction. The more you lie, the less you like yourself, which makes you want to escape, which leads to more using and more lying. Nothing changes, if nothing changes. Ask yourself this: will more lying, more isolating, and more of the same make you feel better? The expression in AA is – nothing changes if nothing changes. If you don't change your life, then why would this time be any different? You need to create a new life where it's easier to not use. Recovery requires complete honesty. You must be one-hundred percent completely honest with the people who are your supports: your family, your doctor, your therapist, the people in your 12 step group, and your sponsor. If you can't be completely honest with them, you won't do well in recovery. When you're completely honest you don't give your addiction room to hide. When you lie you leave the door open to relapse.
One mistake people make in the early stages of recovery is they think that honesty means being honest about other people. They think they should share what's "wrong" with other people. But recovery isn't about fixing other people. It's about fixing yourself. Stick with your own recovery. Focusing on what you don't like about others is easy because it deflects attention from yourself. Honesty won't come naturally in the beginning. You've spent so much time learning how to lie that telling the truth, no matter how good it is for you, won't feel natural. You'll have to practice telling the truth a few hundred times before it comes a little easier. In the beginning, you'll have to stop yourself as you're telling a story, and say, "now that I think about it, it was more like this..." Show common sense. Not everybody is your best friend. And not everybody will be glad to know that you have an addiction or that you're doing something about it. There may be some people who you don't want to tell about your recovery. But don't be reluctant to tell the people close to you about your recovery. You should never feel ashamed that you're doing something about your addiction.

The Chance to Change Your Life
Your addiction has given you the opportunity to change your life. Changing your life is what makes recovery both difficult and rewarding. Recovery is difficult because you have to change your life, and all change is difficult, even good change. Recovery is rewarding because you get the chance to change your life. Most people sleepwalk through life. They don't think about who they are or what they want to be, and then one day they wake up and wonder why they aren't happy.If you use this opportunity for change, you'll look back and think of your addiction as one of the best things that ever happened to you. People in recovery often describe themselves as grateful addicts. Why would someone be grateful to have an addiction? Because their addiction helped them find an inner peace and tranquility that most people crave. Recovery can help you change your life. After 5 years of abstinence relapse is rare. A study followed 268 Harvard University undergraduates, and 456 non-delinquent inner-city adolescents. The men were followed every two years by questionnaire, and every 5 years by physical examination. At some point during their lives, 55 (21%) of the college men and 150 (33%) of the inner-city men met the criteria for alcohol addiction. The study concluded that after 5 years of abstinence relapse is rare.

[abcowboy]

Thought I'd bump this up for the benefit of those returning/struggling. Hope it helps..

[Rusty]

Re: The Difference Between a Slip and a Relapse

Thank you for bumping this valuable thread, Cowboy!

[mario]

Re: The Difference Between a Slip and a Relapse

Thanks, Its nice to read back.

[Lost Soul]

Re: The Difference Between a Slip and a Relapse

Thanks for bumping ABC, really useful information, I don't think we can ever be over prepared when AL is concerned :happy2: