By Mya Ragan, CDCA, Counselor, Springfield Treatment Services in Ohio
Develop Durable Techniques and Stick with Them
Anyone with an alcohol use disorder (AUD) or a substance use disorder (SUD) should know relapse is a reality.
It can happen to anyone, no matter how long they’ve been sober.
In fact, we once had an older gentleman speak at a community support meeting about the importance of staying on your program and sticking to your recovery plan. He was deadly serious, because he considered it a matter of life and death. He warned people new to recovery and people with years in recovery the same thing: stick to your program, because relapse happens.
His story was hard to hear, but very instructive
He was in his early 70s. He has alcohol use disorder (AUD), but that’s not what they called it when he first got sober, back in 1980. He was an alcoholic. He went to meetings every day and stood up in front of the group and said the words, “Hi, I’m [Bill], and I’m an alcoholic.”
Bill did everything right. He got a sponsor, got sober, and turned his life around. He stayed sober for over thirty years. Imagine that: thirty years of living one day at a time – successfully. He got sober in his early 30s, but then, in his mid-60s, he slipped. His slip turned into relapse. His relapse turned into a years-long bender. He drove his spouse away, who divorced him. He drove his kid’s way, who stopped talking to him. His friends stopped returning his calls. He lost his job and burned through his retirement savings on frivolous pursuits, mostly fueled by alcohol.
Then he hit bottom and got back into the program. At the meeting when he spoke, he told us he’d just received his two-year sobriety chip. He was legitimately excited and proud, but humility ruled: he’d already had over thirty years of sobriety and knew that his two years – and any subsequent years – depended on one thing: sticking to his program every day.
Find Something You Love and Keep Doing It
Let’s be clear: not everyone who slips and relapses goes on a six-year skid where they lose everything, including their friends, family, and retirement savings.
But it can happen – and small things can set big things in motion.
That’s why you have to know your triggers, and plan for the hard days.
Because on those hard days, your most powerful triggers seem to be hiding around every corner. Like they’ve been waiting for you to let down your guard before they pounce.
Let’s clarify what we mean by triggers.
Triggers are external stimuli that lead to patterns of thought and behavior that can lead to relapse. Everyone has their own set of triggers. Here are the most common:
People who are triggers can be friends, certain family members, and people you used to drink or use drugs with.
Places that are triggers can be neighborhoods where you used to drink or use drugs, specific bars you used to frequent, or even things peripherally related to those locations. We know a person who in recovery who says their strongest cravings hit when they see the highway sign for the exit they used take to go buy drugs on the way home from work. It wasn’t even the actual exit: it was the one that said “Exit 59: 2 Miles.” For some reason, it triggered cravings, and since it was their only realistic route to and from work, they had to learn to deal with it.
By this we mean things you hear or smell. For some people, specific odors lead to cravings, for others, it’s songs on the radio.
Typically, triggers lead to feelings that can lead to relapse, but for some, the feelings themselves are enough. Some people want to drink when they’re sad. Others, when they’re angry. And some, when they’re happy.
That last example is important. You can’t avoid feeling emotions, so if emotions are your triggers, then in order to avoid relapse, you need to learn to deal with them in a productive manner that does not increase the risk of relapse.
And that’s what all triggers do: they increase your risk of relapse, by way of your thoughts and emotions. That’s why a big part of recovery is learning to manage your triggers. Some call it relapse prevention, while others call it trigger management.
By any name, it involves the process of learning to encounter and experience your triggers without them leading to relapse. It may be one of the most valuable tools you learn during recovery. If you know anything about addiction, you know it can save your life.
For many people in recovery, one of the most effective techniques for managing triggers is one of the simplest: exercise.
The Power of Exercise
Exercise, whether it’s working out on fancy weight machines at a gym, doing pushups and lifting paint cans in your garage, going to Zumba classes you never thought you’d step foot in, or simply spending an afternoon doing yardwork or home project, is a cornerstone of recovery for some people. Some tell us it’s the only thing that makes them feel better. That’s true particularly at start of their recovery journey, and especially on the tough days., especially in the beginning – and especially on bad day.
We totally understand, because we know one thing: exercise is an effective component of a treatment and recovery plan that works on many levels.
People who use exercise as a core of their recovery lifestyle talk about the importance of their exercise routine all the time. Here’s what they say: once they get past all their internal resistance and deal with the excuses their mind tries to offer, once they get into their thing – whatever their thing is – everything starts to change. The intrusive thoughts start to fade. Before long, they feel good. The more time they put in, the better they feel. In the word of one of our recovery peers:
“Just get me on that spin bike for an hour and I’m human again.”
But don’t misunderstand us: your exercise does not have to be athletic. All it has to do is be strenuous enough, in the right amounts, to elicit the neurochemical changes we discuss below.
That’s why exercise works: it changes your brain – and we’ll tell you how.
Exercise Alters Brain Chemistry
Decades of research reveal working out changes the neurochemical environment in your brain for the better. In other words, while exercise improves your physical strength and resilience, it also has positive effects on brain hormones, neurotransmitters, and how your brain works.
Here’s what exercise does.
- Boosts the amount of norepinephrine circulating in your brain. Norepinephrine is a hormone that plays an important role in modulating stress.
- It decreases the among of circulating cortisol in your brain and body. Cortisol is known as the stress hormone. Here’s how exercise affects cortisol:
- Low intensity: Low intensity exercise is an activity of about 3-4 on an exertion scale of 1-10. This level of exercise leads to a modest, but measurable, reduction in cortisol.
- Moderate intensity: Moderate intensity exercise is an activity of about 5-6 on an exertion scale of 1-10. This level of intensity leads to a significant reduction in cortisol.
- High intensity: Moderate intensity exercise is an activity of about 6-8 or 7-9 on an exertion scale of 1-10. This level of intensity leads to the most significant reduction in cortisol.
- Boosts the amount of serotonin circulating in your brain. Serotonin is a neurotransmitter known to be protective against depressive thoughts.
- Exercise leads to a series of chemical reactions that allow tryptophan, which is involved in serotonin production, to enter the brain, and increase levels of serotonin.
- Boosts circulating dopamine. Dopamine is a neurotransmitter that’s directly involved in motivation, reward, and pleasure.
- In the short-term, exercise increases dopamine levels. In the long-term, regular exercise leads to increased overall dopamine production. This means that if you exercise regularly, you wake up every day with more dopamine in your brain than if you don’t exercise regularly.
- Helps improve critical decision making processes. Evidence indicates:
- Moderate exercise, like aerobic workouts, boost executive function. Executive function refers to the process by which your brain sorts and acts on incoming information and stimuli.
- High intensity exercise leads to major improvements in executive function. High intensity exercise includes weight lifting, and explosive exercises like box jumps – common in CrossFit – or sprinting.
- A mixture of both moderate- and high-intensity exercise leads to the most significant improvements in executive function.
Daily Habits, Recovery, and You
If you’re in recovery, you know about the tough days.
Those days when everywhere you look, you see your triggers.
That’s why it’s critical to have an effective trigger-management strategy baked into your daily routine. By that we mean it’s something you plan to do anyway, whether you’re having a tough day or not. For instance, when you make one of your most effective strategies a part of your morning – whether that’s exercise, or something like journaling, practicing a musical instrument, or reading recovery-related material – you’re ready when you go out into the world and encounter potential triggers.
To use a boxing term, you’re on the front foot. You’re ready in mind, body, and spirit, to counter whatever punches the world throws at you. To use a mindfulness term – in case you don’t relate at all to boxing – you’re grounded, centered, and ready to encounter any experience the world throws at you with peace, calm, and perspective. In either case, you’re ready for those triggers, you won’t let them lead to relapse, and you know you have the strength, skill, and resiliency necessary to stick to your program and stay in recovery – because you do it every day.
To anyone in recovery, whether it’s from opioid addiction, alcohol addiction, or something else, we recommend considering a daily exercise routine. Give it a shot: if you like it, you have something that helps you stay in recovery and keeps your body healthy and strong. And if you don’t like it, that’s valuable information, too: you know you need to keep looking until you find the tools that work for you, and make sure you use them every day.