Relapse Prevention
What stage of relapse often begins before substance use actually happens?
Emotional relapse.
What is the difference between an internal trigger and an external trigger?
Internal triggers come from emotions/thoughts/memories; external triggers come from people, places, objects, or situations.
What is meant by “progress not perfection” in recovery?
Recovery is about growth and consistency, not being perfect or never making mistakes.
What is the difference between healthy coping skills and avoidance behaviors?
Healthy coping addresses emotions/problems safely; avoidance ignores or escapes them temporarily.
According to the disease model, addiction involves a defect that causes what?
Symptoms.
What is the difference between emotional relapse, mental relapse, and physical relapse?
Why can positive emotions sometimes trigger relapse?
People may associate celebration, reward, excitement, or confidence with past substance use.
What is the purpose of making a personal inventory in AA?
To identify harmful behaviors, patterns, resentments, fears, and personal responsibility.
Why is emotional regulation important in recovery?
Because unmanaged emotions like anger, anxiety, shame, or sadness can increase cravings, impulsive behaviors, and relapse risk.
What part of the brain is associated with conscious choice, morality, and responsibility?
The frontal cortex.
Why can overconfidence in recovery become dangerous?
It can lead to ignoring supports, skipping meetings, minimizing relapse risk, and poor decision-making.
What is a “euphoric recall”?
Remembering only the positive parts of substance use while minimizing or forgetting negative consequences.
Who is the founder of Alcoholics Anonymous?
Bill Wilson
What grounding technique involves identifying things you can see, hear, and feel?
The 5-4-3-2-1 grounding technique.
What happens to the brain’s pleasure set point with increased drug use?
It resets higher, making normal pleasure harder to feel.
What is “relapse justification”? Give the definition and 2 examples.
Rationalizing or creating excuses to return to substance use.
Examples: “I can handle just one,” “I deserve it,” “Nobody will know.”
How can stress chemically increase relapse risk?
Stress increases cortisol and activates the brain’s reward system, which can intensify cravings, impair decision-making, and increase impulsive behaviors linked to substance use.
What is the difference between abstinence and recovery?
Abstinence is not using substances; recovery includes emotional, behavioral, and lifestyle changes.
How can cognitive restructuring help prevent relapse?
It helps identify and challenge distorted thoughts that may lead to cravings, hopelessness, or unhealthy behaviors.
Why can therapy and coping skills become more effective over time?
Because the frontal cortex functioning slowly improves during recovery.
What is Post-Acute Withdrawal Syndrome (PAWS)? Give the definition and 3 examples.
Ongoing emotional, mental, and physical symptoms that can continue after acute withdrawal ends and increase relapse risk.
Examples: mood swings, irritability, sleep problems, brain fog, anxiety.
Why is exposure to high-risk situations without preparation dangerous in early recovery?
Because coping skills and emotional regulation may not yet be strong enough to manage cravings or triggers effectively.
What are examples of “principles before personalities” in recovery?
Examples include honesty, accountability, respect, humility, open-mindedness, and fairness being prioritized over personal feelings, conflicts, or favoritism toward individuals.
Why is distress tolerance considered an important recovery skill?
It helps individuals manage discomfort, cravings, and intense emotions without turning to substances.
Why do everyday activities often stop feeling rewarding during addiction?
Because the brain becomes conditioned to the high dopamine release from substances and normal rewards no longer feel strong enough.