A using episode (either drug or alcohol) could be defined as either a relapse or return to use. For the individual, it is possible that at some point they may move from one to another. What helps distinguish the difference is prior to the using episode is how would they categorize themselves(relapse or return to use), and how they view the using episode after the fact. It is common for a person to start building up to a change in commitment about being abstinent. For example, a week prior to use they are committed to avoiding use. However, through a series of events, they change their commitment and use. There are some areas listed below to help distinguish where a person may currently be in regards to abstaining from drug and alcohol use.
RELAPSE
Thoughts: “ I don’t want to use,” “I want to stop” “ my use is a problem,”
Behaviors: Making an active commitment to avoid use, conscious of using situations.
Motivation: High. Does not want to use.
Attitude after use: “ I was making an effort to stop and messed up, “ I did not anticipate problems.”
Emotions after use: Feel guilty
DECISION TO USE
Thoughts: “Using is no problem,” I want to cut back but not stop,” “it is okay to use every now and then,” “my use is not a problem.”
Behaviors: No changes from when first using, actions geared more toward hiding use then stopping use.
Motivation: Low.
Attitude after use: “I got caught,” “ No big deal.”
Emotions after use: Irritated. Awkward
When an using episode occurs, it is important to evaluate where you see yourself. If you view yourself presently as seeing the episode as a relapse, effort would need to be focused on relapse prevention. If you see yourself in the decision to use column, effort would be used to reexamining the costs and benefits to use, including what brought you into therapy in the first place.
