Stages of Addiction
The functioning addict – Major life areas have yet to be impacted by your addiction. You may find yourself building a tolerance to your substance of choice and it is becoming less pleasurable. You may also notice your using behaviour becoming more secretive.
The non-functioning addict – This is when your substance use has an impact on your major life areas such as, personal relationships, employment/school, family, legal, housing, mental/physical health, self care etc.
The process of addiction is progressive as the consequences of your addiction become worse over time leading to an increase in personal distress.
Substance Use Continuum
|Able to relax reward escape in other ways||Can use to relax reward escape, but has other methods as well||Regular use for relax reward escape||Regular use in no longer satisfying need for relax reward escape||Relaxing, rewarding no longer important|
|Coping by means other than alcohol & drugs||Coping with alcohol & drugs, but have other ways as well||Alcohol & drugs helps to cope with problems, stress||Alcohol & drugs contributes to & causes problems; can still be used to cope, provide temporarily relief||Alcohol & drugs are contributing & causing significant problems|
|No, or mild mental health symptoms, or under control||No mental health symptoms or under control||Starting to use alcohol & drugs to self-medicate for mental health symptoms||Mental health in distress or in crisis. Medicating with alcohol & drugs||Mental health in crisis, & some symptoms caused by alcohol & drugs (i.e. psychosis)|
|Life areas in balance||Normal stress in life areas||Life areas causing stress||Some crisis in life areas||Life areas unmanageable|
Stages of Relapse
Emotional relapse – you are not thinking about using, however your emotions and behaviours are setting you up for a possible relapse in the future.
The signs of emotional relapse are:
- Mood swings
- 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. Relapse prevention at this stage means recognizing that you’re in emotional relapse and changing your behavior. 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.
Coping with Emotional Urges
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 – feel as if there is 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/fantasizing about using. But in the later phase you’re definitelythinking about using.
The signs of mental relapse are:
- Thinking about people, places, and things you used with
- Glamorizing your past use
- Hanging out with old using friends
- Fantasizing about using
- Thinking about relapsing
- Planning your relapse around other people’s schedules
At this stage it gets harder to make the right choices as the pull of addiction gets stronger.
Coping 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. Go to the gym. If you just sit there with your urge and don’t do anything, you’re giving your mental relapse room to grow.
Distract. 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, 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 or stressed you tend to do what’s familiar and wrong, instead of what’s new and right. When you’re tense or stressed 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. Calling 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. 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.
You don’t recover from an addiction by stopping using only. 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 successful you will be.
Here are the 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:
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 support group and engage in hobbies 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. 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.
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 in addiction use drugs and alcohol to relieve tension and stress. 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.
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’tlike 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. When you’re completely honest you don’t give your addiction room to hide. When you lie you leave the door open to relapse.