Recovery guide

How to write a relapse prevention plan

A relapse prevention plan lists your relapse warning signs, coping skills, people to call, and what you will do if a lapse happens.

A relapse prevention plan is a page you write while you are steady. It is about a return to alcohol or other drug use. It is not a personal safety plan for a suicide or mental-health crisis, and it is not emergency care. If you may harm yourself or someone else, call or text 988 in the United States or Canada, or contact local emergency services.

How a relapse prevention plan differs from a crisis safety plan

A personal safety plan, in the form described by suicide-prevention researchers, is for a crisis: warning signs of danger to yourself, ways to make the environment safer, and crisis lines. A relapse prevention plan is for substance use. It names relapse warning signs, triggers, coping skills, and what you will do if a lapse happens. You can keep both. Use the safety plan when the risk is a crisis. Use this plan when the risk is a return to use.

The stages of relapse

Steven Melemis, in the Yale Journal of Biology and Medicine (2015), describes relapse as a gradual process with three stages: emotional, mental, and physical. He writes that the goal is to notice the early stages, when changing course is more possible.

Emotional relapse. During this stage, people are not thinking about using. They remember the last relapse and do not want to repeat it, but emotions and behavior are setting up a later return to use. Denial is common because using is not the conscious thought. Melemis lists these signs: bottling up emotions; isolating; not going to meetings; going to meetings but not sharing; focusing on other people’s problems; and poor eating and sleeping habits. He describes the common thread as poor self-care. Meetings are one item on his list, not a requirement that every plan include a 12-step meeting.

Mental relapse. Part of the person wants to use, and part does not. Melemis lists: craving; thinking about people, places, and things tied to past use; minimizing or glamorizing past use; bargaining; lying; thinking of ways to control using; looking for a chance to use; and planning a return to use. He also notes that thoughts of using become a warning sign when they grow more frequent or more insistent.

Physical relapse. This is when a person starts using again. Melemis notes that some researchers separate a lapse, the first drink or use, from a relapse, a return to uncontrolled use. He writes that one use may quickly lead to more use. A lapse is serious. It is not a reason to hide the next step you already wrote down.

Relapse warning signs checklist

Use this as a starting checklist, then cross out anything that is not true for you and add signs you have actually noticed. Melemis’s lists are the source of the first two groups. They are not a score.

Emotional warning signs:

• Bottling up emotions
• Isolating
• Skipping support you usually use, or attending and not speaking
• Focusing on everyone else’s problems
• Poor eating or sleeping

Mental warning signs:

• Craving
• Thinking about people, places, or things tied to past use
• Minimizing or glamorizing past use
• Bargaining (“I can control it this time”)
• Lying about plans or use
• Looking for a chance to use, or planning a return to use
• Thoughts of using that are getting more frequent or more insistent

How to write the plan

Write this when you are not in the middle of a craving. Keep it where you will find it: a note on your phone, a card, or the first page of a journal. Update it when a sign or a phone number changes.

1. Triggers. Name the situations that have come before use for you: a time of day, a feeling, a place, a person, or a conflict. Identifying triggers in recovery is optional detail, not a test you have to pass before the plan counts.
2. Coping skills. List two or three you will actually do. That might be urge surfing, a grounding exercise, leaving the room, eating, or a short walk. A skill you will not use does not belong on the card.
3. People to call. Write names and numbers, more than one. Say what you want from them: listening, a ride, or company. A request is not a guarantee they can answer.
4. If a lapse happens. NIDA says a return to drug use after trying to stop does not mean treatment has failed. It can be a sign to resume, change, or start care. Your line can be as plain as: tell one person, do not stay alone with the rest of the substance, and contact a clinician if you may be in withdrawal or danger.
5. If you are in crisis. Call or text 988, or contact local emergency services. Open your personal safety plan if you have one. This relapse plan does not replace that.

A simple fill-in outline

Copy this and fill the blanks. Short and specific is more useful than complete.

• Early warning signs I have actually had: ______
• Triggers and high-risk situations: ______
• Coping skills I will use first: ______
• People I will contact, with numbers: ______
• If a lapse happens, my next step is: ______
• If I might harm myself or someone else, I will call 988 or local emergency services.
• My crisis safety plan, if I have one, is stored: ______

Where this fits with other tools

A daily check-in can show a warning sign while it is still small. An urge log can record a trigger without deciding what it means. The page on what to do during cravings is for the moment an urge is loud. What to do after a relapse is for the hours after a lapse. This plan is the page you hope to open before either of those.

If you are in immediate danger, do not rely on a written plan alone. Call or text 988, or contact local emergency services.

This guide shares general recovery information and is not medical advice or a substitute for professional care. My Recovery Support is supportive technology, not emergency or clinical care. If you are in immediate danger, contact local emergency services or call or text 988 (Suicide & Crisis Lifeline).