Tag Archives: relapse

Tag Archives: relapse


Guide to triggers, relapse, and the beginning of recoveryWe can’t predict what’s going to happen throughout the day, and sometimes distressing thoughts, feelings or situations will come up. We may receive bad news about something that meant a lot to us, we may feel a sudden mood shift or our thoughts and feelings may stem from a spontaneous trigger. There are so many questions we could answer about when and where these feelings occur, and, for those in addiction recovery, these distressing sensations could lead to relapse. Relapse is a common fear for many in recovery and, although it’s a normal part of the process, those who relapse tend to view it as a major setback. Relapse is defined by the National Institute on Drug Abuse (NIDA) as a “return to drug use after an attempt to stop”. If you’re in recovery, how can you effectively work through both distress and relapse, should it arise?

Types of Triggers

First, it’s important to have a clear understanding of what can trigger us. The Fix highlights two main types of triggers: external and internal. External triggers are what happens outside of us. These are things we can’t control. Here are some examples:

External Triggers

  • People – running into someone whom you used to abuse substances with, receiving a phone call from someone who used to sell drugs to you, etc.
  • Places – passing by a house you used to get high in, attending a club you used to get drunk at, sitting in your living room where you used to use drugs, etc.
  • Things – finding a bottle of wine in the fridge upon your return home from treatment, noticing some unused painkillers in your significant other’s medicine cabinet, seeing smoking-related objects in a store, etc.
  • Events – holidays, birthdays, times of the day when a person used to abuse substances, etc.

Now that you know more about situational occurrences, you can become more familiar with internal triggers – or, in other words, what happens inside of us. Internal triggers

Internal Triggers

  • Physical sensations – feeling pain, exhaustion, stress, etc.
  • Thoughts – ruminating, holding onto harsh beliefs, etc.

Triggers and Distress Tolerance: Working Through Difficult Emotions

In psychology, distress tolerance is a person’s ability to work through difficult or “impossible to change” situations. Negative (and otherwise unbearable) emotions can make life seem unbearable; and if we’re not careful in managing distress, we may find ourselves in the throes of even more painful emotions. In early recovery, this is especially important as a person is still becoming accustomed to a life of sobriety.

In a 2017 study, published in the journal Addiction Biology, researchers sought to explore how distress tolerance related to relapse when it came to those in the early stages of recovery. They concluded that low distress tolerance is associated with drug-related reward seeking behaviors – which could lead to relapse. One person shared their story of how external triggers led them to relapse after 3 weeks of sobriety. Here is an excerpt from their story, as stated on aagrapevine.org,

“On my third week I relapsed and drank for several days in a row. The final day was a work event. At the end of the event the company provides wine and beer and everyone parties.”

When we’re faced with these tempting circumstances, how should we handle them? It can feel so hard to ignore the cravings to use substances, especially if they seemed to abate some of your distress before – even if only temporarily. What you must remind yourself is what happens after you relapse. How do you feel? What happens around you? For many people in recovery, this alone is a strong motivator to continue on the path of recovery – because to go back would be too painful.

Tools for Recovery

With so many opportunities for distractions, we must balance ourselves with tools that we’ve gained in treatment. Therapy is a strong component of recovery because it allows you to work through some of the things that have been holding you back with a professional who understands which tactics can help reduce your distress. Cognitive behavioral therapy (CBT), for example, is an excellent approach to recovery because it helps us change our thought processes.

12-Step programs, such as Alcoholics Anonymous (AA) are great additions to treatment because they promote structure in recovery, as well as connect you with others who are working towards recovery as well. A 2016 study published in the journal Teaching and Learning in Medicine further suggests the following approaches that have helped many in recovery:

  • Mindfulness and meditation
  • Yoga
  • Breathing exercises
  • Guided imagery
  • And more

In recovery, you have to rely – and use – the tools you’ve been given. It may seem uncomfortable at first, but you will only become more confident in your ability to work through triggering thoughts, feelings and sensations by practicing them when it’s necessary. If you’ve been struggling with triggers, you’re not alone – yet there are many people out there who have strengthened their recovery by getting actively involved in treatment, support groups and more.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

Woman using cognitive behavioral therapy to fight relapse in recoveryIntensive outpatient treatment programs are designed to provide you with the tools and resources you need to work through thoughts, feeling and situations that may trigger us to want to relapse. Even when we’re feeling confident in our recovery, we may find that something unexpected comes up that brings about feelings of sadness, anger, guilt and more. Cognitive behavioral therapy (CBT) is a combination of talk therapy and behavioral therapy and aims to help us identify and manage thoughts, emotions and behaviors that appear from time to time.

Numerous studies have shown just how effective CBT is for relapse prevention; in 2017, researchers provided an overview of the benefits published in the journal Substance Use & Misuse. They provided an overview of the session content that is covered in CBT:

  • Awareness of triggers and cravings
  • Mindfulness in daily life
  • Mindfulness in high-risk situations
  • Acceptance and skillful action
  • Seeing thoughts as merely “thoughts” and nothing more
  • Self-care and lifestyle balance
  • Social support and continuing practice

Relapse often occurs when we’re not mindful. When our emotions are running rampant and our thoughts are racing, we’re likely to make a reactive decision – not a rational one. Sarah Bowen, a researcher from the University of Washington, told a story of a young woman who participated in a CBT-based program. She explained that for this young woman, the coping skills developed through the program taught her that whenever her mind started telling her stories of how she couldn’t go to work the next day or how the rest of her night was going to go, she realized she had a choice. The thoughts she was having only needed to be given importance if she choice to give that to them – and that’s quite a freeing feeling, indeed.

If you’re ready to begin your journey to recovery, speak with a professional from Cumberland Heights today. The time to rejuvenate your mind, body and spirit is now.

Cumberland Heights in Nashville, Tennessee on Music Row is a 12-Step based alcohol & drug rehab program. Cumberland Heights’ Intensive Outpatient Program is designed for individuals 18 and above who may be in the early stages of dependency or are experiencing problems with alcohol or drug use. We offer personalized assessments and treatment plans, as well as convenient evening hours to accommodate your workday schedule. To get started on your recovery journey today, call us at 615-356-2700.

Assessing Our Clients: It’s EVERYONE’S Responsibility

Presenter: Scott J. Watson, MA, LCAC, MAC, SAP, NCC

Location: Cumberland Heights River Road Campus – FLC Auditorium
8283 River Road Pike
Nashville, TN 37209

Date: Wednesday, February 6, 2019
Time: 9:00AM – 12:00PM (Noon)
Credit: 3 credit hours available (NBCC, NADAC approved)
Cost: $10.00

REGISTER NOW

Workshop Information:

Join Heartland Intervention’s Scott J. Watson for an entertaining and insightful look at an often-overlooked component of treatment – Assessment. Scott will cover the basics of initial assessment as well as discuss the importance of ongoing assessment. Participants will learn a few questions to ask as well as explore mental health, addictions, suicidality/self-harm and assessment after relapse. Bring your tough cases and questions for this interactive presentation.

Learning Objectives:

  1. Articulate the value of initial and ongoing assessment for all clients.
  2. Integrate a basic assessment strategy into each client/patient interaction.
  3. Demonstrate an understanding of protective and risk factors when evaluating suicidality/homicidality.
  4. Understand how mental health, addiction and trauma issues can complicate the assessment process.
  5. Participate in the collaborative staffing of several assessment cases.

Women in Recovery: These Connections Could Increase Your Risk for Relapse

There are differences between men and women both in structure and thought process. Addiction recovery is a vulnerable time for either, and relapse is a particularly feared aspect of recovery because it’s often associated with weakness or failure. Despite this falsity, relapse is actually considered a normal part of the process. In fact, it should be perceived as a learning experience, with which a person can gain more insight about what they need to strengthen or change in their treatment, or even what they need to reinforce. Social support is a vital component of recovery success, because it’s what builds up our emotional stamina to push through those hard days – research has shown us that women tend to lean towards social and emotional connections more so than men, which means they can also be highly affected if they connect with people that are not supportive of their recovery.

Residential and intensive outpatient programs (IOPs) are a bit different in terms of what they offer and the overall environment. With residential treatment, women find that their eating and living quarters are in close proxemics to others. IOPs on the other hand can also allow for connections to be made, but individuals can return home each day after their daily program is over. In 2016, researchers sought to explore women’s connections in substance abuse treatment and how it relates to relapse. They also explored what, if any, differences occur between connections in residential programs and IOPs.

After assessing 377 women for their personal network connections within the past 6 months, they found this compelling insight:

  • Women in residential treatment had more substance users in their network and fewer people in their network who provided social support

It was concluded that these women were more susceptible to relapse because of their lack of personal recovery support connections. People who qualify for IOPs tend to have a stable and supportive home environment and have likely been working towards their recovery for some time – it makes sense that women in residential treatment programs may not have as much support, especially if they’re relatively new to their treatment program. What does this mean for women who are in residential treatment programs? What can they do to reduce their risk of relapse?

Social support is incredibly important, and other studies have shown that reducing contact with people who abuse substances is most beneficial for people trying to recover. Distance yourself. Connect with people who support and uplift your recovery goals. Talk to recovery leaders, and become actively engaged in your recovery program. You never know who may have a huge impact on your journey.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

Call us today at 1-800-646-9998 to take the next step towards your happiness and health.

Can Psychoeducation Help Prevent Relapse?

“Knowledge is power.”

Have you ever heard that phrase before? There’s a lot of truth that can be found in it, because the more we know, the more we can act on whatever it is that’s holding us back. Addiction and mental health recovery rely heavily on knowledge, and psychoeducational classes give people in recovery the opportunity to learn more about themselves (and others) through open learning initiatives and discussions. Recovery isn’t just a process of doing – it’s a process of learning, understanding and then implementing the tools that are learned. In fact, a lot of recovery-based organizations provide relapse prevention programs that incorporate psychoeducation, and the following is often talked about:

  • Coping skills to help a person identify, anticipate and avoid or cope with highly stressful situations
  • Information to help a person avoid relapsing after it has happened once
  • Encouragement to really help a person understand that they are capable of changing their behavior

Relapse prevention often involves goals that a person will work towards alongside their support network, and the more they learn about their disorder/addiction, the better they can have control over it. Psychoeducation can also help a person identify some really positive, sobering activities to fill in their schedule. Addiction recovery still comes with stress and cravings sometimes, and it’s vital that a person keep themselves to a strict routine to help change their habits.

In 2015, researchers assessed the efficacy of psychoeducational programs for individuals with schizophrenia; for 8 weeks, individuals attended weekly educational sessions for 60-90 minutes. Overall, the researchers found a lot of benefits to psychoeducation:

  • Participants felt more knowledgeable about their disorder
  • They had greater attention, participation and overall satisfaction in the health services they received because they understood what and why they were receiving certain types of treatment

There’s not much we can do about the issues in our lives if we don’t understand them in the first place. Recovery involves a multitude of life components, including health, relationships, financial stability, nutrition and more – psychoeducation is the tool that sort of pieces all of this together, and helps us make better sense of what we’re going through. Normally in this type of setting, a leader will guide a group of people through activities, discussions and lectures to help people gain new perspectives.

Really take a stand for your recovery today and get involved in some psychoeducation programs. You’ll learn so much and the tools you’ll learn are invaluable.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-campus, we are made up of 2 twelve-step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

Call us today at 1-800-646-9998 to take the next step towards your happiness and health.

The Inside Scoop: Types of Triggers and How They Influence Cravings

One of the most commonly talked about aspects of recovery is relapse. When relapse occurs, we revert back to our old, addictive habits – whether for a brief moment or for a longer period of time. Relapse is often used synonymously with “failure” or “weakness”, but you’d be surprised to know that this isn’t really true. For many, relapse is actually a learning experience where a person can find out what their triggers are, and what steps they can take next time to prevent that behavioral response. Triggers are incredibly important to familiarize yourself with, and it may take trial and error to find them over time. If you can understand your triggers and how they affect your cravings, however, you can get an upper hand on relapse.

A few years ago, researchers did a study to find out a little more about personal cues (thought processes, experiences, triggers, etc.) and how they influence cravings. They found that ultimately, it’s a matter of what really “hits home” for someone – it’s the context of a person, place, or thing that can send someone into a relapse. For example, one person may have specific memories tied to a certain city and state. Even if they’ve moved halfway across the United States, a person who talks about that city and state could trigger that individual because it sparks memories of when they used to live there, when they used to use substances, etc. A person who has never lived in that particular city or state won’t have that same reaction, because they don’t have a special tie to that place.

There are 3 overarching concepts of triggers to watch out for, and you can call them the three E’s:

  • Emotions – guilt, sadness, anxiety, anger, confidence, happiness, loneliness, etc.
  • Environment – returning to a place where substance abuse once occurred for you, hearing a song you used to get high to, etc.
  • Exposure – seeing others using substances at a party, being at a bar, etc.

These types of triggers can really spark up the desire to use substances again, and that’s because your brain has not forgotten the rewarding feelings of abusing substances and its association to those different feelings, places, things or people. Recovery is about re-learning to live without needing to act on those associations, and it takes a lot of hard work – but it’s absolutely worth it because you get your health, happiness and life back.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-campus, we are made up of 2 twelve-step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

Call us today at 1-800-646-9998 to take the next step towards your happiness and health.


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