Today we will touch briefly on the relapse process
highlighting the fact that relapse does not just happen.
We will discuss the warning signs that indicate that a
relapse is approaching leading into a brief overlook at
the warning signs document which the residents
construct prior to leaving treatment.
We will look quite closely at the relapse prevention
plan highlighting important elements to an effective
relapse prevention plan.
THE RELAPSE PROCESS
Relapsing on substance is never a spur of the moment,
“oh it just happened”, event.
It is a process that starts way before the individual
relapses on substance which can be seen in changes in
thoughts, attitudes, emotions, behaviour and
obviously lifestyle and choices.
One is always able to, in hind-sight, see where things
went wrong way before any relapse occurred.
An important factor of developing the graduation
documents (Life-plan, Relapse prevention plan and
warning signs) is to allow the individual and their
supporters the ability to constantly monitor their
progression in recovery.
An important principle of recovery is that if you are
not moving forward you are moving backward. It
means that if we are not paying attention to our
recovery and not doing things to contribute to our
recovery process we may be unconsciously moving
There are certain warning signs of relapse that appear
that make relapse both predictable and preventable.
Please take note of the fact that relapse is predictable
and therefor preventable.
WARNING SIGNS OF RELAPSE
Irritation, frustration and anger are often good indicators
that there has been a shift in attitude and thought, that the
recovering addict is moving away from personal
responsibility and heading toward blame.
These “emotions” are often caused by craving cycles and
therefor need to be monitored closely and if present
addressed immediately. Should a craving cycle not be
identified it can spiral out of control leading the addict to
attempt to externally justify their emotions.
Self-Pity is another good indicator that the relapse process
is underway. Self-pity is an indicator that the recovering
addict is setting up justifiable reasons for relapse.
Denial and defensiveness are tell tale signs that relapse
is imminent. Recovering addicts start to outright deny
the truth about themselves, they do not accept the
need to change their lifestyle and start to question the
fact that they are actually addicts.
They begin to reject all possible help and start
ignoring and avoiding crucial recovery activities.
When questioned they become argumentative and all
the indicators of denial start to appear – rationalizing,
minimizing, blaming, justifying, deflecting, excuse
Action should be taken before it is too late.
Overconfidence reflects the belief that we have cured
the incurable, that we have conquered our addiction
and have nothing more to worry about. We begin to
believe that “we have got this” and begin to neglect the
small things. We become quick to advise others but are
unable to receive criticism or acknowledge any faults
in our own recovery process.
Change in routine and structure is highlighted by
routines becoming haphazard, sleeping patterns
irregular, missing appointments and having too much
idle time. It reflects that the priority of our recovery
has dropped and that we have slipped into a place of
THE WARNING SIGNS DOCUMENT
Toward the end of the treatment process the resident
does step 4 – A searching and fearless moral inventory
In step 4 they address resentments, relationships, self-
obsession, shame and guilt, times they have felt
victimized and their fears.
This work is then processed with their counsellor in a
step 5 – We admitted to God, ourselves and another
human being the exact nature of our wrongs.
This process allows the counsellor to highlight and draw
attention to patterns of behaviours, flawed thinking and
beliefs and other warning signs.
This feedback then gets translated into the warning signs
document by the resident. A document that highlights,
with explanation, the different warning signs that the
individual is prone to display or use as a defence
A good warning signs document will also explain under
each warning sign what that possible causes are and what
the action of rectification is.
There are usually between 50 and 100 warning signs
highlighted and explained within the document. Don’t
panic if your child has more or less.
This document helps with the evaluation of the
recovery process and helps to highlight relapse
behaviour before it is too late.
It is strongly advisable that you get to know this
document well. You are most likely the one person that
will be able to identify these signs when you do
HEAL or your support group is good at identifying
these signs and addressing them – be honest in your
THE RELAPSE PREVENTION PLAN
The relapse prevention plan is a document which outlines
the lifestyle the recovering addict needs to develop.
It defines the boundaries in which the recovering addict
needs to operate within and…
…recovery principles the recovering addict needs to
remember/ adhere to.
It is a document which outlines the accountability measure
put in place for the recovering addict (testing, finances etc)
as well as outlining…..
…..consequences for certain transgressions and more
importantly for relapse bearing in mind that the
consequence is more often than not a precautionary
measure to protect the addict from themselves.
BASIC PRINCIPLES OF RPP
All points need to take into account the principle of
necessity verses accessory (careful decision needs to be
made with regards to access to vehicles, cell phones and
cash taking into account the risk and asking the question –
Is it really necessary?).
All points to the best of your ability needs to be practical
and measureable with levels of accountability and
consequences applied to them.
The relapse prevention plan is a measuring tool and a form
of accountability itself. It is designed by the residents as a
blueprint to a successful long term recovery and should not
The resident and sponsors need to sign into the
document, therefor the sponsor needs to have input in
It is recommended should the resident be returning to
stay with the sponsor/ family that they send house rules
to be added to the relapse prevention plan.
The relapse prevention plan needs to be seen as a legally
binding document that all parties are agreeing to and are
stating, by signing, that they will enforce.
Should the Relapse prevention plan need to be altered it
should be done in conjunction with your support group
and/or the centre.
Regular family meeting should be held to go over these
YOU KNOW THERE IS TROUBLE WHEN….
…..the resident upon returning disregards the relapse
prevention plan stating that they only signed it to get out.
…..the resident already starts to negate the points prior to
leaving over the phone….. “mom they going to tell you I
can’t drink, that is what they have to say because most
residents here have hectic drinking problems but you know
me, alcohol was never my problem”…….
NA says it perfectly when they say “there is one thing above
anything else that will defeat us in our recovery, that is an
attitude of intolerance and indifference to recovery
DEVELOPING THE RPP
Following are a few points which should be discussed
and included in the relapse prevention plan.
Remember that all plans are personalized to suite the
individual needs in accordance to their environment
and support structure.
The stricter you can be on yourself (as the resident)
the better. The resident and the family know the
persons addiction best of all and should attempt to
pre-empt how the addiction will resurface and put
measures in place to prevent that.
Routine and structure
One needs to outline the potential routine and
structure to your day to day living – this should be
defined by developing a “mock schedule” – weekly
scheduling should also form part of the relapse
prevention plan to take care of principles of proper
prior planning and to enforce accountability.
Elements of physical, mental and spiritual components
of recovery needs to be present and balanced and the
weekly commitments (church, support group, quiet
time etc) need be feasibly achievable.
It is all about balance.
Balancing spiritual, psychological and physical
components of recovery.
Balancing family time, quiet time, social time, work
time, recovery time, relaxation time and on and on.
The minute your balance starts to topple so does your
recovery – there are times that this is inevitable you
need to monitor and rectify as quickly as possible.
If you feel your recovery is becoming flat – change the
structure, change the routine and realign the balance –
Please note that boredom is NOT a bad thing in fact we as
addicts need to learn to be bored.
Addiction is full of excitement – nothing is going to excite
us quite like our addiction specifically not on the daily/
hourly basis like our addiction.
Boredom is combatted by effective weekly planning. When
you are bored is not the time to start looking for things to
do- it will only disappoint.
If you plan ahead you should be fine. Be aware that you
should plan your social activities a week in advance to avoid
seeking things that will combat your boredom.
Testing and medication
Testing is none-negotiable. It is not a matter of trust but of
standard protocol. Testing should be done regularly
irrespective of whether things are going good or bad.
Testing is only effective if done properly if the resident is
able to cheat the test become invalid.
If the resident is on prescribed medication I would advise
that the taking of such medication be monitored along
with the daily taking of anta-buse.
There are certain medications that should not be taken as
they will produce a false positive on test results and may
also induce cravings.
Cars and cell phones
This is a big area where the principle of accessory
verses necessity should be applied.
Does the resident need a cell phone, if so, does it need
to have all the gadgets and internet access – the
simpler the safer.
Unlimited access to the residents vehicle should be
avoided and the resident should be slowly introduced
to using his or her vehicle.
Vehicles should be fitted with a tracker however please
do not use the tracker as an accountability tool.
Residents should not have access to funds (Necessity verse
Bank accounts should be avoided (Income should be paid
into sponsors accounts where possible).
Creating of debt should be avoided for the first two years.
Cash books with receipts need to be managed on a weekly
basis with budgets and cash requests given weekly
(maximum amounts of request needs to be defined).
Principles of paying back debts needs to be addressed and
principles of saving and budgeting.
On the basis that residents should give up their old friends
and social networks access to things like Facebook should
be prohibited while the Resident develops new friends and
Making use of apps like BBM and Whatsapp are dangerous
as we often find residents spend a large portion of their
spare time chatting away to who knows who – this is clearly
not healthy and often leads the resident to temptation.
Boundaries become weaker and fraternisation and
unhealthy alliances start to develop.
It takes anywhere from 6 months to 1 year to start to see
new relationships and social networks developing.
Friends with recovering addicts
A very dangerous affair and should be avoided or
managed effectively especially for the first two years.
Friends from SCRC who have been in treatment with
you more so – the relationship has been developed in
an unnatural environment.
If the chance of relapse is so high, then the more
recovering addicts that band together the greater the
chance of them all taking each other down.
They also end up “counselling” each other forming
their own support group and not making use of groups
like HEAL effectively.
This is a big controversial subject here at South Coast
The Resident should not get involved in a romantic
relationship for at least 1 year after leaving treatment.
Should the Resident already be in a relationship then
the dynamics and patterns of this relationship need to
be changed which is done through careful structuring
around the management of that relationship.
Getting involved in a romantic relationship
prematurely is often a major contributing factor to
This is crucially important. As addicts we cannot trust
ourselves, or nicely put, our addiction. We cannot trust our
motives or decision making ability as the subconscious
current of addiction continues under the surface.
The set up to relapse comes unknowingly. Often we are not
aware that we are manipulating or setting ourselves up (we
will discuss this shortly under wise counsel).
We need to be held accountable to the commitments we
make in the relapse prevention plan (that is what points
need to be practical and measurable).
We need to be drug tested, we need to prove where we have
spent money, that where we say we are and whom we are
with is actually true
If we taking Anta-buse it needs to be witnessed
otherwise it is pointless.
We need to be smart here for example it is no good to
have a bank account with thousands of Rand’s in and
say it is ok because I do not have the card – we can
always walk into the bank.
Accountability should be carefully chosen and the
right people need to hold us accountable for the right
Remember this is not about trust or mistrust, these
measures should be in place when things are going
Aftercare and support
This is another non-negotiable.
You cannot expect to continue growth in recovery, to
maintain focus on your recovery as a priority in your
life, if you are not attending a weekly support group.
AA and NA are wonderful formats however they very
seldom hold accountable to your actions.
The beauty about support structures like HEAL and
Might Wings is that the group format is interactional,
confrontational and really push you toward self-
From a parent perspective you too need to be in a
The support group helps you deal with your recovery
process and empowers you and equips you with the
tools and confidence to support your “addict”.
You too need a platform that can guide you and
provide wise counsel and of course hold you
accountable to your part in the recovery process.
HEAL and Might Wings provide this platform for you
specifically providing education and support through
the treatment process and empowering you thereafter.
I was “born” in SCRC and Bread in HEAL.
Finding a church and getting involved in a cell group
affiliated to that church is another important aspect.
Remember yesterday when we talked about forming
new social networks.
While attending NA or AA daily may work for some it
does not promote a life of balance.
Please note that in order for these structures to provide
effective aftercare support they need to know exactly
who you are, where you come from and better have a
copy of your graduation documents.
Please note that you may need to shop for churches.
If I can never cure the incurable disease, if there is in
deed a subconscious current of addiction waiting for
an opportunity to surface or better yet trying to set up
an opportunity for relapse then surely I need a base
that can monitor my decision making – I need a wise
This point here has saved my life, has saved my family
and my marriage many many many times. I would not
be working at SCRC if it were not for this.
A wise counsel comprises of at least three individual
“units”, preferably with a good understanding of
addiction, having 5 units is also good.
Your parents are one unit, your support group is 1 unit
(1 vote), you sponsor/ facilitator, your pastor and
You should submit yourself to this counsel in any and
all major life decisions. Propose your idea, your
intention and then let them decide – a unanimous vote
is what you are looking for, anything less and you
should walk away.
Be sure to choose people that are going to tell you what
you do not want to hear they are usually the ones that
You can always manipulate one or two people, three to
five not so much especially when there is a group on
Parents if you are going to be advising your children or
spouses your better halves the you too should have a
Please be sure that if SCRC is one that you maintain
regular feedback and not just call 6 or 7 months later
asking for advice.
First and foremost consequences are not a punitive
measure but a protective measure.
When things are not going well, start to limit access to
cash, to vehicles, tighten up on the routine etc.
Some consequences are put in place to remind the
addict of humility, gratitude, giving back etc.
It is important that you decide what is going to happen
in the event of a relapse – remember that this is an
emotionally charged situation and there needs to be a
clear cut plan.