You have read about what happens to your body and mind as a result of addiction and some simple ways to begin immediately to improve your health. This chapter will provide strategies to reduce craving, manage cues, and provide you with some specific ways to prevent lapse and relapse.
Based on relapse prevention research, it has been found that relapse is not generally triggered by physical cravings for drugs, alcohol and cigarettes. So what determines when people relapse? A determinant is a factor that causes or influences something. A determinant of relapse can be something that’s inside or outside of you (Marlatt, & Donovan, 2005). A determinant can be a skill that you possess or lack. It can be the experience of an emotion such as anger. For example, an angry person has poorer recall of a disagreement than a calmer person. Anger can be called a determinant of memory. A depressed person experiences reduced motivation to exercise. Depression can be called a determinant of motivation. An anxious person worries about social interactions and avoids meeting people. They become lonely or isolated. Anxiety, therefore, can be a determinant of social interactions.
The determinants that are inside you can be strengthened to reduce risk of relapse. Self-confidence is one example. People who leave addiction behind have an awareness and belief in their ability to manage high-risk situations for using. Self-confidence is more than a display of courage. It is having the coping skills required to succeed. Other examples of internal determinants are (Marlatt, & Donovan,2005):
• Your expectations of using or not using. If you expect to use, you will. If you expect not to use, you won’t.
• Your level of motivation to maintain abstinence and achieve goals. Increased motivation leads to decreased risk of relapse.
• Coping skills such as problem-solving and conflict resolution. These basic skills help you manage your life and reduce risk of relapse.
• Skills to manage negative emotions such as anger, sadness or anxiety are very important. If these emotions are not recognized and positively managed, they can lead to relapse.
• Craving recognition and coping skills. Craving is the experience or desire for the effects of drugs or alcohol and if unrecognized and not managed will lead to relapse.
In summary, the internal determinants that influence whether you will maintain abstinence include (Marlatt, & Donovan, 2005):
• Your level of self-confidence in managing high risk situations and life problems.
• Your expectations of using or not using.
• Your level of motivation.
• Your coping skills.
• Your experience of negative emotions such as anxiety, anger,
• Your management of craving.
These determinants of lapse and relapse can be positively influenced once you learn to recognize them and take action to develop the required coping skills.