Relapse Prevention Plan

Relapse Prevention Plan
An important component to staying healthy and meeting the stated goal of substance use (moderation or abstinence) is to have a prevention plan before the urge to relapse occurs. Writing a prevention plan that identifies your stressors and possible solutions will help you to live a life which supports your values in the presence of overwhelming urges to fall back on previous behavior.
Name ___________________________________ Date _______________

My substance of choice (be specific, e.g. hydrocodone, Xanax, vodka)
________________________________________________________

I plan to prevent relapse/slip by using the following strategies (be specific, include attending meetings, talk to: sponsor, therapy, …show more content…
Activities that I should avoid in order to increase my chances of maintaining my commitment to value-based living recovery:

These are the names of people who I can ask for support who agree with my choice of value-based life recovery:
Name Phone number
__________________________________ ___________________
__________________________________ ___________________
___________________________________ ___________________
These are the names of people who will not be supportive of my decision to live a value-based life and/or engage in behavior that goes against my recovery:
Name Phone number
__________________________________ ___________________
__________________________________ ___________________
___________________________________ ___________________

Changes I am willing and able to make to cope with the urge to be with “old friends”:

This is my list of pros and cons about using _______________ (write your preferred substance)
Pros Cons

These are my early warning signs before I relapse:

These are the activities I enjoy …show more content…
These are the stressors and uncomfortable feelings in my life, how they make me feel, and what I can do about them:
Stressor / Feeling Strategy to cope with this stressor
______________________ ___________________________________________ ___________________________________________ ___________________________________________
_____________________ ___________________________________________
___________________________________________
___________________________________________
_____________________ ___________________________________________
___________________________________________
___________________________________________

When I experience a strong urge to use (write preferred substance) ______________ or other substances that threat my value-base living recovery I will contact:

If I do, in fact, relapse, I will immediately