Relapse Prevention

This page introduces information about relapse prevention and dealing with situations where you might be tempted to break your goals around chemsex. After you have read through the information there are some exercises for you to work through, thinking about strategies for managing these situations. You may find it helpful to have a notebook to use as you work through the exercises, or you could use the function on a phone or tablet.

What is Relapse Prevention?

Relapse Prevention, focuses on the steps that you can take, or tools that you can implement to stop a relapse event from occurring. If you have already made changes to your chem use, and chemsex engagement and have experienced times when it has been difficult for you to stick to your goals but overcome these times, then you have probably already initiated some form of relapse prevention.

When we think of a lapse, we generally see this as a one-off time of not sticking to our goals. A using event may happen, but you quickly recover and return to focusing on getting back on track. A relapse, however, is when you return to full time chem use, and it may be more difficult to return to the goals that you had previously decided on.

Some themes and questions for you to think about and reflect on are:

Can you identify a time when you had a lapse or relapse from your goals around chem use? What led up to this event?

Did you have any psychological tools available that you could have used to to top this from happening? If so then what stopped you from using them?

What support did you access to help you through this experience? What was helpful?

Triggers & Cravings

What’s the difference between a trigger and a craving?

A trigger is an object or emotion that prompts an individual to think about using substances.

A craving is defined as an urge to use or continue using substances.

Generally a craving will start the process of a using event, and if you experience cravings you may start to take steps to using chems by going online, or contacting a dealer.

Triggers are…

...People that may have been part of your substance use experience.

Therefore it can be a healthy choice to leave old using friends behind.

...Places where you may have used substances.

Therefore staying away from places that you used can limit this.

...the experience of difficult feelings & emotions.

Therefore noticing how you are feeling when you think about using chems will support you in knowing when you are unsafe.

Often substances may have been used to regulate feelings & emotions, therefore you may need to engage in practices that can support regulation such as Mindfulness, Meditation etc. Talking about how you feel to friends, or engaging in counselling/therapy to explore feelings & emotions can also support how you regulate.

The Cycle of Chem Use

The different phases of the the Cycle of Use are:

An event that occurs whereby you become triggered to use chems, or engage in chemsex...
Feeling triggered may lead to experiences of cravings…
Cravings may lead to the engagement of rituals i.e watching porn, contacting a dealer etc
Rituals may lead to a using event, whereby you use chems, or engage in chemsex…
A using event may lead to a negative mood state, or difficult emotions…
A negative mood state, or difficult emotions may lead to feeling triggered, and the the cycle may in fact start all over again.

The main aim of relapse prevention is concerned with triggers & craving, and therefore important to intervene BEFORE the ritual stage is initiated.

Some Simple Techniques to Help You Deal With Cravings

Connect with others - talk about what’s going on for you.
Do some form of physical activity - go for a walk, or a run.
Avoid your thoughts - get up, jump up and down, listen to music etc.
Decision delay - put any actions off until a later time.
Urge surf - ride the thoughts out.
Write down the pros & cons before you make a decision.
Engage in positive self talk i.e. “I can cope with this, I have in the past and I can in the future”

ABC’s

ABC’s is a SMART tool that you can implement when times get tough, when you feel triggered, or are experiencing cravings.

The A stands for - The Actualising thoughts (of using chems)

The B stands for - The Behaviour that may follow the thinking.

The C stands for - The Consequence to the behaviour.

The last part of the ABC’s contains The reframe which may support you in making a choice that supports your general wellbeing and mental health.

ABC’s Example

A - “I want to use some chems and have some chemsex”

B - Go online, call a dealer, get some chems.

C - Spend money, no sleep, feel like shit tomorrow, feel like a failure.

D (reframe) - I can go online and get some chems and have some chemsex, but I will spend money, I won’t sleep, I’ll feel like crap tomorrow, and I’ll feel like a failure because I have not met the goal of non chem use that I set for myself.

Unrealistic Thinking

Exploring your thinking when times get difficult for you, can support you in making the right choice, and help you stick to any goals you have in place around your chem use and chemsex engagement.

Unrealistic Thinking Examples

Unrealistic: Urges are excruciating or unbearable

Reality: Though truly uncomfortable, urges are never really unbearable.

Unrealistic: Urges make me use.

Reality: Using always represents a choice.

Unrealistic: Urges will just keep getting worse until I give in.

Reality: Urges peak and then die down

Dealing with Irrational Thoughts

...means changing the irrational into something more rational

Dealing with Irrational Thoughts Examples:

Irrational: My thoughts are making me want to use..

Rational: Even though I am having strong urges to use, I have resisted before and I can resist again by...

Irrational: If I use some chems, I will feel better.

Rational: Even though using helps me to escape my feelings, I will probably feel worse afterwards because of the comedown and the fact I have lapsed with the goals I have set myself.

Exercises

Think about some of the thoughts you have had in the past, now apply it to the ABC’s.

D (reframe)

Think of some Irrational Thoughts you have experienced in the past. Then try and turn them into something more rational, accepting & healthy.

Irrational -

Rational -

Irrational -

Rational -

Irrational -

Rational -

Irrational -

Rational

Relapse Prevention