According to Dr. Steven Melemis, the author of an article in the Yale Journal of Biology and Medicine titled, “Relapse Prevention and the Five Rules of Recovery,” one of the main reasons people seek treatment is relapse prevention. In his 30 years of working in the field of addiction, both in treatment centers and private practice, he observes, “By the time most individuals seek help, they have already tried to quit on their own and they are looking for a better solution.”[1]
While acknowledging there are a wide range of factors that could contribute to a person with a substance use disorder relapsing on drugs or alcohol, here are the five rules Melemis proposes[2] that can fortify your recovery and significantly decrease the likelihood of your relapsing.
1) Change your life. Melemis boils this down to one simple (but not necessarily easy) shift of perception: “Recovery involves creating a new life where it is easier to not use.” For him, following this maxim involves identifying and replacing negative thinking patterns (a.k.a., “stinking thinking”), avoiding people, places and things one typically would associate with drinking or using drugs, and learning and practicing these 5 rules. (As you’ll see, the other rules briefly explained below incorporate practicing healthy, guiding recovery principles in all one’s daily affairs.)
2) Be completely honest. Lying to others and eventually lying to ourselves (however consciously or unconsciously) could be considered necessary for an addict—in order to keep up with or feed the gnawing, relentless obsession and compulsion to drink or use. This rule says, when you practice telling the truth—no matter what, no matter how extremely challenging it may be—you develop a set of muscles that’s essential to one’s recovery. Surely, in early recovery shame and guilt can be an obstacle, especially when one needs to acknowledge he/she has spoken untruly, hidden something from someone or avoided “being real” about an important matter. However, by correcting such and being forthright in all your exchanges with others (except when it would harm someone), your recovery is strengthened immeasurably.
3) Ask for help. While the vast majority of people with a substance use disorder may initially try to recover on their own, research has shown a combo-platter of getting treatment—via a licensed and certified substance abuse program—and regular participation in a self-help group (e.g., Narcotics Anonymous, Alcoholics Anonymous, etc.) is the most effective means of establishing and maintaining recovery from drugs and/or alcohol.[3] Both of these recommended recovery resources first require you to ask for their help. Again, it’s a simple, but not necessarily easy, rule: it takes courage to “surrender,” to say, “I can’t do this (recover from my addiction) on my own… Will you help me?” Fortunately, once you’ve asked for help, the care, support and experience-based guidance can immediately start flowing your way.
4) Practice self-care. Finding healthy alternatives to the impulse/compulsion to “escape, relax or reward oneself” (which, according to Melemis, is why most people use drugs[4]) is of primary importance to maintaining one’s recovery. Establishing a regular routine of self-care fits this bill perfectly. One of the key dimensions of self-care emphasized by Melemis is “mind-body relaxation.” He points out a number of studies have demonstrated mind-body relaxation techniques like meditation and the practice of mindfulness are effective at decreasing drug and alcohol use, plus as long-term relapse prevention measures.[5]
5) Don’t bend the rules. So often in early recovery, we can feel the urge to resist change or the suggestions being offered by those with years or decades of recovery experience, if not training in how to most effectively treat addiction. According to Melemis, this rule is to remind you “not to resist or sabotage change by insisting that you do recovery your way.”[6] If you’re looking for loopholes in recovery or catch yourself trying to find “an easier, softer way” (as they say in Alcoholics Anonymous), you’re very likely seeking to bend the rules.
In summary, trust the process and keep the recovery you have growing stronger by adhering to these 5 rules, and by open-mindedly and willingly moving in the direction that’s been laid out for you in treatment and/or by the self-help/12 Steps groups you’ve been encouraged to join.
[1] Melemis, S.M. “Relapse Prevention and the Five Rules of Recovery.” Yale Journal of Biology and Medicine. Sept. 2015.
[2] Ibid.
[3] Kelly JF, Stout R, Zywiak W, Schneider R. A 3-year study of addiction mutual-help group participation following intensive outpatient treatment. Alcohol Clin Exp Res. 2006; Pagano ME, White WL, Kelly JF, Stout RL, Tonigan JS. The 10-year course of Alcoholics Anonymous participation and long-term outcomes: a follow-up study of outpatient subjects in Project MATCH. Subst Abus. 2013
[4] Melemis SM. I Want to Change My Life: How to Overcome Anxiety, Depression and Addiction. Toronto: Modern Therapies; 2010.
[5] Shafil M, Lavely R, Jaffe R. Meditation and the prevention of alcohol abuse. Am J Psychiatry. 1975; Bowen S, Witkiewitz K, Clifasefi SL, Grow J, Chawla N, Hsu SH. et al. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry. 2014.
[6] Melemis, S.M. “Relapse Prevention and the Five Rules of Recovery.” Yale Journal of Biology and Medicine. Sept. 2015.
