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To Forum Doc.- What techniques/methods can you recommend to avoid relapse?

Dr. Horvath,

I hear horror stories of relapse and want to do everything I can to avoid this. Can you share any successful techniques or proven methods for us to utilize to avoid relapse?

49 Responses
Avatar universal

So what did you do when you started to feel those temptations creep back in?

My dad told me recently that he has a whole bottle of Vicodin, that he was going to bring me, since he knows about my long struggle with back pain. I told him no, I didn't need them, but

Man it seems like a war inside of me - should I - shouldn't I? The thing that I keep running through my head is everyone's admission that detox the second time is a lot harder.

I value your advice a lot.

Avatar universal
Hi--I've never posted to you but I think I can answer your question.  I have a really good book on recovery called Staying Sober: a Guide for Relapse Prevention by Gorski and Miller.  Here are the steps they espouse for relapse prevention planning:
     1. STABILIZATION: Get control of yourself
     2. SELF-ASSESSMENT: Find out what is going on in your head, heart, and life.
     3. RELAPSE EDUCATION: Learn about relapse and what to do to prevent it
     4. WARNING SIGN IDENTIFICATION: Make a list of your personal warning signs
     5. WARNING SIGN MANAGEMENT: Learn how to interrupt warning signs before you lose control
    6. INVENTORY TRAINING: Learn how to become consciously aware of warning signs as they develop
    7. REVIEW THE RECOVERY PROGRAM: Make sure your recovery program is able to help you manage your warning signs
    8. INVOLVEMENT OF SIGNIFICANT OTHERS: Teach others how to work w/ you to avoid relapse
   9. FOLLOW-UP: Up-date your relapse prevention plan regularly.

    This  listing involves a lot of supplementary reading--I can't possibly go into detail about each entry in a post.   But these nine catagories can at least point you  in the right direction as far as where to begin. They are vague because everyone's plan must be personally devised.  What's  good for you might be totally inapplicable to the next person.  
    Staying sober will be a life-long challenge.  To attempt something uninformed is asking for disaster.  We spent an unGODly amout of time on our addictions; it seems only fair that we spend at least that amount of time on our recovery.  Read, Read, Read.  Get books and refer to them often.  Decide which ones make sense to you and which ones to pitch into the garbage.  Then read some more.
      An after-care group, a therapist and some kind of recovery (12-step or other) is optimal.  Every effort increases the odds of staying sober.  It  WILL take effort, but I know we're all worth it!!    :-)   Peace and Good Luck---Peaz
Avatar universal
you are not alone, my friend.  that's the REAL problem.....not relapsing.  it's so hard not to when you know those pills will take the pain away or take the edge off, you know?  i don't know of any advice to give you on that, because i have not even begun to master it.  at this point in my life, i believe it will ALWAYS be an addict, i will ALWAYS have this probelm, so i've just got to do what i can to be as responsible as i can.  i am a FIRM believer that addiction is a disease, and we should try ourselves like it is.  treat it, do what it takes to take care of pain but don't abuse, be responsbile...sort of like the way other people take care of their diseases (diabetes & other conditions).  i know there are some who would disagree with me, but i truly believe it's a disease and that's the approach that should be taken.  just my two cents worth, i guess!  hell, i'm just taking it ONE DAY AT A TIME.  that's all i can do.  life for me right now is HELL, and i'm just trying to scrape by each day.  my sincere love and respect for you.  we don't get treated with too much dignity by society, so as for me, you have my utmost respect and highest regards.  sincere love and peace to you.
Avatar universal
Finished what's going on? You have my email, let me know how things are!
Avatar universal
Avatar universal
Greetings all,

It seems we are all having one of those days. I am in day 12 cold turkey with the thomas recipe. I was on 400mgs oxy and 120mgs of percs daily for 14 months. I ran out of clonidine two days ago, along with valium.  I went to the docs, it seems he would be happy I am not pestering him for pain pills.  He has known me for 10 years, instead I ask him to write out two scripts for 5 mgs vals and clondine, only enough for two weeks, now this is a doc who has given me 90 oxy 20s and 90 percs for a sore back.  Instead, he calls in his addicnoligist, recently hired.  Now I am telling you, I was in major withdrawls and was in no mood to talk to a book educated additionwhatever,yet Iexplained the recipe and how well it has worked.

She took her notes and then told me I should really be on methadone, been there done that in 88, it took four months to be free of all WD symptoms. So she give me 15 valium, clonidine and told me four more times that methadone is your solution. She wants to see me back on monday.  

I go to the pharmacy and this little dweeb who has the power tells me, I will have to wait three days to fill .  I told him, guys like you I used to kick your ass in high school and I am in no mood to wait three days. Sorry sir was all he could say. So I left.  This morning I have been mean to my wife, jacked her up for nothing.  Thank God ,She understands what I am going through.
Please no advice about it will better in a day or two.  With my history, 22 years of opiate abuse legal and illegal, it will take three to four weeks to feel human again.  No matter what I don't pick up, I found a perc yesterday and flushed it with out a thought off taking it.  My kids and wife are going to get the best Christmas present I can give them and that is me being clean and staying clean.  I will go to an NA meeting this afternoon. I am getting to old for he trauma of WD.

I am really wondering if doctors, drug companies, pharmacies want patients to get well or to just stay addicted. Coming off this oxy is like coming off of heroin or long term use of methadone.  However, it is all about the money.  To the few good Doctors who are out there, thank you, we are all indebted you. To you other doctors who use cattle call methods at your offices, pass out meds that destroy peoples lives without even educating yourselves to the reality of harm you solely are causing.  There is a special place in Hell for you.  I hope it is an enternity of being in withdrawls. May God forgive you for selling out your God given talents.  Oh, yeah, don't know what I would have done without you people on this board.  As David Bowie once sung, WE CAN BE HERO'S FOR JUST ONE DAY.
Peace and Strength

Avatar universal
I have just read my post and there are comments and opinions that do not benifit the board.  I gotta tell you I have not felt the pain, anxiety and anger I have now for over 20 years.  NOT TO MINIMIZE IT'S OWN HELL, BUT MAN I WISH I WAS COMING OF PERCS, HYDRO, NORCOS ECT.  I wouldn't wish this on my worst enemy, well maybe one or two. Thats the first sense of humor I had in 36 hours. One thing I am glad I am doing is doing this cold turkey, with the recipe. I just need to use it for 2 more weeks.  I am keeping a journal and I never want to forget this hell.  I respect those who can taper and if I had a choice I would do it.  But I have tried that method 50 times and I have always failed. I am to much of an addict and do not have the self control, even if someone was doling them out. God Bless those of you that are doing it. Your in my prayers, please keep me in yours. rex1, oxic,vicojen,southernbelle, body mech, methman and the rest of you, I am so grateful you people are on this board because I doubt I would have got past day four without being able to log on at 2 in the morning and know I was not alone.
Strength and Honor
Avatar universal
Email me, I have a copy of Jack Trimpeys book I can send you.  The only thing I ask in return is that you send it to another board member when you are done reading it. I am suggesting this book because Jack Trimpey is the only one with a truely different approach.  Twelve step books, spirital approaches and even Rational Recovery, although they seem to work, have been worn to death.


In reality my struggle and the struggle of many others is much more difficult than abstainance.  It is trying to take medication responsibly with a history of addiction.  

I have asked this before. What is your long term plan to deal with pain now that you are clean?  Keep in mind these types of pain problems tend to get worse, not better with age. Early recovery up to a year is very easy. It gets harder after that.
Avatar universal
You'll make it bud, hope your evening is better!
Avatar universal
just wanted you to know i care for you, i understand.  i'm currently seeing a psychiatrist.  it's amazing how much our mental state has to do with our addiction.  i really believe our disease is so misunderstood...i hate that.  and it's just society that makes us feel like **** about this.  other people, the news, doctors who missed their calling and probably should have chosen another career path in life, jealous people, critical people.  all those things i just mentioned are what tells us we are addicts.  i believe with all my heart that it's a disease that most people know nothing about.  it's really sad.  how is it other people can be so normal, while we struggle every day?  anyway, i just want you to know i was thinking about you...we're in this together.  ALL things are temporary, too.  Even this struggle and battle we fight every day---it's only temporary.  LOVE and PEACE to you, I mean it!
Avatar universal
I am not sure I actually have pain - that's the thing I am still trying to determine. I am in pain right now but is it real or withdrawl pain?

History: In 1998, I had some minor low back pain. (I had gone to physical therapy two years earlier for it, and done some exercises but no drugs other than Motrin.)I also had quite a lot of anxiety over a new job I had started where I had to do a lot of public speaking - needless to say - very phobic, clinically phobic!

Long story short, I did have real pain, but probably not the kind that required Vicodin. Well, I tried some Vicodin and it completely eliminated the low back pain, but guess what? It worked great on my anxiety too.

The back got worse, but how much worse I am not sure, because there was never a day when I wasn't on Vicodin. But most days it really hurt and over the next 4 years, I tried swimming, excercise, PT, Chiro, and finally had some epidural shots which worked wonders on the low back. The upper back though between the shoulder blades "shunted" to protect the low back, according to the back doc and some joints may have become frozen. Its hurting right now, but how much of the pain is the fact that I want a Vicodin?

But I still wanted the drugs - I was full on addicted at this point.

Now the question is "Do I have a true medical condition, or just the craving for the drugs that is causing my current pain?"

If it is real pain, then I would likely need to wait a month or so to confirm that, but will use the following methods to deal with pain:

Swim - twice a week
Run/Walk - No hills or dales - twice a week
Stretch - daily
Thomas Recipe
Zanaflex for nightime

If after a month or so, the pain goes away, then I will likely treat the drugs the same way I have treated alcohol for the last 7 years. If I go in a little, I will be all the way in...again.

Pain sucks...but drug abuse is worse...

Avatar universal
actually, the only technique for staying clean that consistently works is to sleep 24 hours a day. If you're a goner like me, every thought, every image is one big fat "cue." I wake up, the daylight says "Use -- now!" And the day just goes on from there ...

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