The Brain & Addiction
This part of the brain is responsible for planning, judgment, impulse control, and decision-making, and often functions less effectively during active addiction.
What is the prefrontal cortex
What is the difference between an internal trigger and an external trigger?
Internal triggers are emotions, thoughts, or physical sensations. External triggers are people, places, objects, situations, or events.
Name four emotions that are often mistaken for anger.
Fear
Embarrassment
Shame
Hurt
Loneliness
Rejection
What is a boundary?
A boundary is a healthy limit a person sets to protect their physical, emotional, mental, and spiritual well-being. Boundaries communicate what behaviors are acceptable and unacceptable and help create safe, respectful relationships. Healthy boundaries are about controlling your own actions—not controlling someone else's behavior.
Name three coping skills.
This neurotransmitter is heavily involved in motivation and reward. Drugs often cause a surge of it, making substance use seem more rewarding than everyday activities.
What is dopamine
What does HALT or PPP stand for?
Hungry
Angry
Lonely
Tired
or
Pause
Process
Proceed
Why is emotional awareness considered a relapse prevention skill?
Because identifying emotions early allows people to cope before emotions become overwhelming and increase relapse risk.
Name three characteristics of a healthy relationship.
Bonus: Explain why one of these is especially important in recovery.
What is the difference between coping and avoidance?
Healthy coping addresses the problem or manages emotions in a constructive way while moving toward recovery goals.
Examples:
Avoidance temporarily escapes discomfort without addressing the underlying issue.
Examples:
Key Point: Coping promotes healing. Avoidance delays healing and often makes problems worse over time.
Explain neuroplasticity and describe one healthy activity that strengthens new neural pathways.
Neuroplasticity is the brain's ability to reorganize and create new neural pathways through repeated experiences. Examples include exercise, therapy, meditation, learning new skills, recovery meetings, or practicing healthy coping strategies.
A person begins skipping meetings, isolates from sober supports, stops exercising, and starts thinking they have recovery "figured out." Which stage of relapse is this?
Emotional relapse.
What is emotional regulation?
The ability to recognize, understand, and manage emotions without reacting impulsively.
Name three warning signs of emotional dependency.
Examples include:
Clinical Point: Emotional dependency can become a substitute addiction when a person seeks emotional relief from another person instead of developing healthy coping skills.
Explain the difference between abstinence and recovery.
Abstinence means not using alcohol or drugs.
Recovery is a lifelong process of improving overall health and well-being by changing thoughts, behaviors, relationships, coping skills, and lifestyle—not just stopping substance use.
Recovery often includes:
Someone can be abstinent without actively engaging in recovery.
Why do cravings often become less intense over time when someone consistently avoids substance use and practices healthy coping skills?
Old neural pathways weaken while healthier pathways strengthen through repetition, reducing the brain's automatic association between triggers and substance use.
Describe the three stages of relapse.
Give three healthy coping skills for anxiety that do not involve distraction.
Deep breathing
Meditation
Exercise
Grounding
Talking with support
Prayer
Journaling
Why do healthy relationships improve long-term recovery outcomes?
Healthy relationships:
Research consistently shows that people with strong sober support systems have lower relapse rates and better long-term recovery outcomes.
Why is routine important during early recovery?
A healthy routine:
Clinical Point: Repetition strengthens neural pathways. The more consistently healthy behaviors are practiced, the more automatic they become.
Name three brain functions commonly impaired by long-term substance use.
A client drives past their dealer after an argument with their partner. Walk through the relapse process from trigger to possible substance use, then identify two interventions that could interrupt the cycle.
Should include trigger → thoughts → craving → decision → use, with interventions like calling a sponsor, leaving the area, grounding techniques, attending a meeting, exercising, or using coping skills.
Explain the difference between reacting emotionally and responding intentionally.
Reacting emotionally is an immediate, automatic response driven by intense emotions rather than thoughtful decision-making. It often occurs without pausing to consider the consequences and is influenced by the brain's survival system (amygdala). Emotional reactions can include yelling, walking away, using substances, sending an angry text, or making impulsive decisions that may be regretted later.
Responding intentionally involves taking a moment to pause, recognize what you're feeling, and choose a behavior that aligns with your recovery goals and values. This type of response engages the prefrontal cortex—the part of the brain responsible for reasoning, problem-solving, and impulse control. An intentional response might include taking deep breaths, using a grounding technique, calling a sponsor, asking for a break from the conversation, or calmly expressing your feelings.
Your friend says:
"If you don't hang out with me tonight, you're not a real friend."
Identify:
Manipulation tactic:
Healthy boundary response:
"I value our friendship, but I'm choosing to prioritize my recovery tonight. A real friend will respect my decision."
Other acceptable responses:
Describe your relapse prevention plan using:
Answer (Example):
Bonus Discussion: Why is it important to have a relapse prevention plan before you need it? (Answer: Because decision-making and impulse control are often impaired during high-stress situations or cravings, making it harder to think clearly in the moment.)