Avoid Marijuana Relapse: Identify High Risk Situations and Prepare Coping Strategies

Prevent marijuana relapse by identifying high risk situations.

Here's an obvious truth: you are more likely to feel tempted in high risk situations, so by avoiding as many of these situations as you can, you reduce your risk of early relapse.

This is a classic relapse prevention technique, but unfortunately, you can never avoid exposure to all the people, places, and activities that remind you of marijuana, and since internal states can also trigger cravings (ever feel like smoking when feeling frustrated, or celebratory?) you are guaranteed to face temptation.

However, since you know what’s coming, you can prepare for the inevitable:

• By thinking now about situations that could induce cravings – and by preparing specific coping strategies to manage these situations - you reduce the odds of early relapse.

Read on:

1. To learn about the types of situations that can increase cravings.
2. To learn about some common cravings management and relapse prevention strategies.
3. To do a simple written exercise identifying your personal high risk situations, and to prepare coping strategies in advance.

What Causes Temptation?

High risk situations can be internally caused – such as by negative emotions or stress, or externally caused, such as by exposure to drug paraphernalia or social pressure from people you used to smoke with. Consider the following common relapse triggers; which of these are riskiest for you?¹

• Environmental cues - People places and things that remind you of getting high. In the earliest days, environmental cues can lead to cravings. Minimizing your exposure to these ‘triggers’ can reduce your temptation.
• Routines and habits – As with environmental cues, you can reduce the danger of routine induced cravings by changing your habits.
• Negative emotional states – Do you use marijuana as a way to cope with anger, stress, sadness and other negative emotional states?
• Positive emotional states – Do you automatically reach for marijuana when feeling very good and wanting to enhance your good feelings, or when faced with a sudden celebration?
• Interpersonal conflict – Do you get high as a way to cope with fights or arguments with others?
• Social pressure – Do friends and family pressure you, even subtly, to smoke with them?

Ways to Handle High Risk Situations

There are many different ways to handle high risk situations and it’s best to have a few strategies up your sleeve for use as needed. Read the list of suggestions below, and think about which you'll make use of in your quit attempt.

• Get out of the situation as quickly as you can.
• Distract yourself by engaging in another activity.
• Reduce your exposure to marijuana cues – for example by throwing away drug paraphernalia, avoiding people you smoke with (at least for a little while) and avoiding activities you associate strongly with getting high.
• Make use of a relaxation technique, such as deep breathing or progressive muscle relaxation.
• Writing in a journal.
• Conquer stress or negative feelings with aerobic exercise.
• Call a supportive friend and talk about your feelings and cravings.
• Ask a supportive friend for company or support.
• Review an index card you’ve prepared that lists your reasons for quitting and the negatives of continuing to use marijuana.

Cautions

Don’t test yourself – Don’t test your resolve with deliberate exposure to temptation. It’s a common impulse that too often leads to relapse.

Also, as a general rule, remember HALT – don’t let yourself get too Hungry, Angry, Lonely or Tired – all of these states increase your risks of relapse.

List Your Risky Situations (and Responses)

It’s a good idea to spend a few minutes (now?) writing down your personal risky situations, and listing at least a couple of responses for each. You don’t have to go overboard with this, but writing out responses for 5 or 10 or scenarios:²

1. Helps commit you to a course of action – when you write out your plan, it’s harder to deny or rationalize-away its existence.
2. Helps you feel prepared and in-control.
3. Reduces surprise-confusion…you don’t have to think about what to do when surprised with a trigger, you just have to follow your written plan. 

High Risk Association Examples

Here are some common trigger-inducers. Circle any of the following that you associate strongly with marijuana. For each category, write out any additional strong associations that come to mind (you will use these in a minute, when coming up with a specific plan to overcome your triggers.)³

• People – Certain friends (who?) certain family members (who?), your dealer, co-workers, neighbors, (_________list any other people who you believe could trigger marijuana thoughts or cravings.)
• Places – Your home, a friend’s home, the park, a certain neighborhood, your car, (________________list any other places you believe could trigger marijuana cravings.)
• Things – Marijuana paraphernalia, marijuana posters, certain types of music, (________________anything else?)
• Routines and behaviors  - Getting home from work, when going out with friends, when playing video games, before movies, at concerts, before bed, (when else ___________________?)
• Negative Feelings – When stressed after work, when angry with your partner, when feeling sad, when feeling nervous or uncomfortable in a social situation, when feeling jealous, left-out or inadequate, when feeling bored, (what other negative feelings make you want to get high_______________________________?)
• Positive Feelings – When feeling like celebrating, when feeling happy, when feeling sexually aroused, (what other positive feelings make you crave marijuana___________?) 

Now list out your own 5 or 10 highest risk situations, with at least 2 specific response plans for each. For example:

1. Challenge – When I get home after work I always smoke a joint.
2. Responses – Instead of going straight home after work, I’ll run some errands and get exercise instead. Or, since I know I’ll be tempted as soon as I get home, I will prearrange to call my friend Dan at 4:30 every day, and he can offer support and encouragement to help me get past my cravings.

Now write out your own top 5 or 10 challenges and responses.

1.       _____________________________________________________________________

2.       _____________________________________________________________________

3.       _____________________________________________________________________

4.       _____________________________________________________________________

5.       _____________________________________________________________________