Relapse Prevention Form

Name

First NameLast Name

Relapse prevention is possible, even when cravings or situations feel overwhelming. However, if you relapse, not all is lost. It may just emphasize the importance of developing a strong relapse prevention strategy. This worksheet will help you do just that.

Relapse may happen in stages, which can occur weeks or even months before returning to use.

Emotional relapse: Thoughts and behaviors that may lead to relapse. Such as avoiding conflict, “bottling up emotions,” feeling stressed, lack of sleep, or social withdrawal.

Mental relapse: At this stage you might experience thoughts of using and feel conflicted whether to pick up or not.

Physical relapse: The action of returning to substances.

List the people or situations that might trigger you to want to use. For example, old drinking buddies, pay day, a fight with your partner, etc.

What are some of the things I can do to overcome these stressors? For example, find a distraction, go to a meeting, meditate, go for a run, talk to a friend, etc.

Some of my coping strategies include

What are some of the consequences of relapse? For example, I might lose my job, or kids.

List some of the ways you maintain your recovery. For example, weekly therapy, recovery meetings, going to the gym, spending time with your recovery community, etc.

Name some of the ways you destress.

When I want to use, my support people are

Affirmations: Remember:

Feelings are not facts, and they will pass.
How far you have come and how much you’ve accomplished in your recovery journey.
The life that is possible since you’ve been in recovery.

Remember the consequences of relapse: Playing through what may happen because of relapse, like losing a relationship or job, or experiencing legal ramifications, may be a sufficient deterrent to return to use.

Identify triggers: These might be emotional or thought-based triggers, such as feeling angry, sad, or depressed, believing those thoughts, or feeling overwhelmed by external cues, like a stressful job. Triggers may lead to social isolation, less engagement in recovery activities, and increased cravings.

Plan for emergencies: Speak to your sponsor, therapist, or counselor to develop a plan for high risk situations, such as the loss of a loved one, an accident, or illness. Situations like these can cause overwhelming emotions. Remember some solutions for those situations like: attending a meeting, speaking to your counselor or therapist, calling your treatment center, calling a trusted friend, or removing yourself from the situation and distracting yourself.

Strengthen regular coping strategies: These should address everyday activities that help to keep stress at bay and enhance well-being, such as regular exercise, attending regular recovery meetings, eating nutritious food, mindfulness meditation, and getting enough sleep.

Develop a strong recovery community: Recovering together enhances the likelihood of staying in recovery. Your community may be close friends and family that know about your recovery, perhaps a recovery mentor or trusted friend, counselor, therapist, pastor, or anyone else in the community that can support your journey.

Maintaining health: Addressing mental and physical health problems quickly can reduce the risk of relapse. One strategy for this relapse plan may be to register with a provider and book regular visits.

Relapse Prevention

What are your triggers?

Relapse Prevention