Relapse = Recurrence of the disease that had gone into remission/recovery

 Help patients understand relapse as a process and event, and learn how to
identify the early warning sign

 Help patient identify high risk situation and develop cognitive and
behavioural coping responses

1. Being around people, places, and situations previously associated with your drug
and/or alcohol use.

2. Substituting any other mood or mind-altering substances other than “drug of choice.”

3. Feeling bored, lonely, angry, horny or tired and dwelling on past mistakes.

4. Having “euphoric recall” regarding getting high, hearing or telling war stories.
Romanticizing the “good times.”

5. Severe stress at home or on the job.

6. Exhaustion or fatigue.

7. Creeping doubts that you have an alcohol/drug problem and believing you can
“control” use or have “just one.”

8. Self-pity. Feeling sorry for yourself or getting impatient if things don’t go your way
or in accordance to your “time-table.”

9. Continuing other addictive behaviors such as compulsive gambling, compulsive

sexuality, overeating, oversleeping, and over-working.

10. Having a lot of cash on hand.

How to COPE?

1. Plan ahead. Plan ahead. Plan ahead. Have structure in your life!!!

2. If you find yourself in a dangerous situation, GET OUT! Don’t wait or act helpless.
Don’t make excuses for being there. GET OUT!

3. Avoid high-risk places (bars, parties, etc). It’s NOT about “testing” yourself.

4. Avoid people who you used with or who will influence you to use.
5. Talk openly and honestly with others about cravings, etc.

6. Have at least 5 phone numbers of supportive people you can call when confronted
with danger.

7. Make sure you have sober support with you when facing unavoidable high-risk
situations.

8. Have an escape plan or have alternative activities ready in case plans fall through.

9. Be aware of personal relapse triggers and high-risk situations.

10. Think positively in the face of danger. Go to a meeting!

 Help patient enhance communication skills, interpersonal relationships

and social networks
  Stress Management
o Avoid, Alter, Adapt, Accept

There is a belief among many that drug addicts take drugs as a means of self-
medication. Among opiate addicts, there is a belief that drug usage is ultimately for
anxiety reduction. Thus, one can find many research and position papers that discuss
the importance of anxiety reduction in treating the opiate dependent.

Anxiety reduction among drug dependents through several approaches such as:

 Spiritual approach
o There are many ways to help a person reduce his or her anxiety. Among
them are meditation and yoga as well as centering prayer. With respect to
the latter, centering prayer is a spiritual technique in which a person
focuses on a religious name, such as a prophet or God, closes his or her
eyes, and repeats the name many times silently. As he or she does that,
the tension leaves one’s body. Of course, a person would have to believe
in God to use the centering prayer.

 finding employment for recovering drug dependents

o Many drug abusers are unable to find or keep employment because of the
lack of basic behaviors necessary for employment. Therefore, before one
can implement vocational training and placement programs, attention
must be focused on correcting these deficit behaviors.

Methadone replacement therapy