Remission Maintenance

After the substance dependent individual stops abusing his or her drugs or alcohol, the goal then becomes preventing relapse. Many men and women with long-term sobriety use words like maintenance and remission. Substance Use Disorder is a disease of the brain. The psychiatric Diagnostic and Statistical Manual 5th edition (DSMV), states that 3 months or more of continual recovery constitutes partial remission. 12 months or more of sobriety indicates complete full remission. Longterm sobriety or recovery consists of placing the disease of addiction in remission and keeping it there.

This is where a remission maintenance plan comes into play. The substance dependent has lost the ability to control or stop their drug use, so it becomes critical to avoid relapse back into drug use and all the negative consequences that come with it.

Understand relapse as a process, not an event. The Relapse process starts long before the drug or drink are actually taken. Extended periods of agitation, restlessness, confusion, and a feeling of being “off track” are all indicators that your recovery could be in danger. Not talking about your feelings, increasing anxiety and a feeling of being overwhelmed can all be warning signs. If these warning signs are not dealt with, old thinking and behavior patterns often resurface. Manipulation, dishonesty, wanting to be in control can be examples of a recovery program that needs tending. The AA program calls it “stinking thinking.” Eventually one will either get their recovery back on track or get so frustrated and deluded that they begin using drugs/alcohol again.

Below is a sample remission maintenance plan:

1. Increase participation in healthy activities.What healthy activities can you increase?

2. Understand and address social pressures to use substances.What boundaries need to be set?

3. Develop a supportive remission maintenance network (e.g., with significant others). Make a list of those people in your remission maintenance network.

4. Recognize relapse warning signs, including internal and external triggers. Write a list of your internal and external triggers.

5. Combat memories of drug abuse-associated euphoria. Develop and learn how to play the whole tape (and then what)

6. Reinforce recollections of negative aspects of drug use.Make a list of the negative aspects of drug/alcohol use.

7. Avoid people, places, and things that might trigger drug use. Create a list of people, places and things that might trigger drug/alcohol use.

8. Develop a list of pleasurable and rewarding alternatives to drug use.