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10 Things to Know about Relapse

I didn’t write this, but I found it a while back and am searching for the author. It has been helpful to a number of friends, with thanks to countless professionals who care so deeply about our teens.

Teens in early recovery are extremely vulnerable to relapse. It can be hard to understand why a teenager would work so hard to achieve sobriety only to fall back into drug use−but that’s the power of addiction.

Studies suggest that between 50 to 90 percent of addicts relapse at least once in the first four years of sobriety, and most relapse many times. Triggers for relapse can be as mundane as hearing a certain song on the radio or as significant as hanging out with friends from the old drug crowd.

Although relapse is considered normal and predictable, knowing the common triggers for relapse and having an action plan can help teens and their families guard against any slip-ups. Here are a few common relapse triggers to watch out for:

Being in social situations or places where drugs are available

Unless teens remain on guard, their thoughts will likely turn back to old behavior patterns when they are around the people or places associated with their past drug use. Old friends who still use drugs will use peer pressure, teasing and subtle manipulation to get a teen in early recovery to return to their “fun” old self. These friends may not be ready to confront their own drug use and will not respond positively to someone who questions their habit or forces them to take a look at their own behavior.

Each adolescent has their own set of high-risk friends, places and situations that they must sacrifice for the sake of their sobriety. In drug rehab, teens can practice ways to cope with those triggers, make new friends who don’t use drugs and find sober activities they can enjoy.

After maintaining their sobriety for a time, many teens want to “test” their willpower by going back to certain places or social situations. This can be risky and seldom makes teens feel more secure in their recovery.

Reverting to old friendships can be a trigger or warning sign of substance abuse relapse. Photo: Shutterstock

Isolation or Old Friendships

While it’s risky to stay in touch with old friends who use drugs, it’s equally risky to be socially isolated. Teens in early recovery need to closely follow the relapse prevention plan they created during drug rehab. This plan likely includes attending 12-Step meetings and therapy sessions to get support from other people in recovery and to have someone they can go to when the urge to use arises. Without this support system, teens start to feel alone in their struggles, which may make them want to start using again.

Being around drugs or using any mood-altering substance

Being around drugs of any kind can trigger a craving to use.  Even the sight, smell or sounds associated with a drug can bring back memories of the way drugs made the teen feel, as well as an overwhelming desire to use again. Most teens in early recovery will need to get rid of all paraphernalia, photos or any other item related to drugs or alcohol in order to avoid temptation.

A common pitfall for teens is thinking they can use drugs, as long as they avoid what used to be their drug of choice. So if they were hooked on painkillers, they figure it’s safe to drink alcohol. The reality is that addiction to one drug easily transfers to another drug (and even other compulsive behaviors like video game addiction, gambling and spending). If a teen has abused drugs before, they will likely need to abstain from all mood-altering substances for the rest of their life.

Stress

Many teens first start using drugs to cope with stress brought on by school, relationships or home life. Although adolescents learn new coping skills in drug rehab, it is common to revert back to old methods when life gets tough.

Before drug rehab, when conflicts arose, drugs or alcohol would allow the teen to escape the situation. Now, the teen must practice new ways of coping, such as taking a walk, calling a friend, journaling or some other form of healthy expression.

Establishing a daily routine, including getting up at a certain time or joining a club that meets regularly, may help teens maintain a sense of control in their lives. While predictability can help, teens will eventually have to learn to accept that they cannot control everything.

Over-confidence

Self-confidence and an optimistic outlook are protective factors against relapse, but over-confidence is one of the most common reasons for relapse. The 12-Step principles remind teens that humility and an admission of powerlessness over addiction are essential for lasting recovery. But after staying sober for a period of time, some teens are so proud of their accomplishments that they don’t think they need to follow their relapse prevention plan anymore. They stop attending meetings and become less vigilant in monitoring their emotions and cravings.

Complacency

A close cousin to over-confidence is complacency. Some teens in early recovery start to take their sobriety for granted. They become complacent, assuming if they’ve been able to maintain their sobriety for a certain amount of time, they no longer need to monitor their mental state, attend meetings or follow their relapse prevention plan with the commitment they started with.

In many cases, teens begin to wonder if they can use only occasionally or have just one drink without returning to their addiction. They want to prove to family and friends that they no longer have a problem. Unfortunately, complacency often leads to relapse.

Mental or physical illness or pain

Addiction frequently goes hand in hand with mental illnesses such as depression and anxiety. Something that aggravates an underlying mental illness can also trigger the desire to use drugs or alcohol. Teens with co-occurring disorders require dual diagnosis treatment that addresses both their substance abuse and psychiatric illness. After formal treatment ends, they also need to carefully monitor their state of mind through journaling, therapy and other forms of self-reflection.

Physical illness is also problematic, particularly if a doctor prescribes painkillers or other drugs as a form of pain management. Teens who self-medicate a mental or physical illness may find themselves becoming dependent on drugs of relief. For this reason, self-care is essential. A healthy diet, exercise and adequate sleep will help guard against exhaustion and physical illness.

Though it may seem counter-intuitive, positive life events and emotions can also trigger relapse.  For example, getting straight A’s, falling in love or getting into a good college could be cause for celebration and reignite the desire to use drugs.

Reminiscing about drug use or telling “war stories”

If an adolescent spends time thinking obsessively about how it felt to be high or telling “war stories” to friends about past drug use, this is an indication that relapse is imminent.

Boredom

Without drugs, many teens in recovery don’t know what to do with their free time. A bored teen is a teen who is asking for trouble. Drugs are exciting; there are other activities and hobbies that are equally thrilling without the high level of risk. Teens can get involved in rock climbing, white water rafting, or some other adventure sport. They can also keep busy with school activities, clubs, sports, exercise or hanging out with sober friends.

Self-pity

We all want life to go out way, but even the most fortunate among us won’t always get what we want.  Many teens fall into the trap of self-pity; feeling impatient that recovery isn’t happening fast enough, wondering why they have to deal with addiction and rehab, and questioning why other people can go out for a drink with friends and they can’t. They begin to feel entitled to have a drink or use drugs because they’ve been sober and worked so hard.

Though it isn’t fair, this is the reality of addiction. It’s better to accept the good and bad life deals rather than feeling like a victim.