How Using the HALT Concept Prevents Alcohol Relapse

Many relapse prevention tools have been created to help people trying to maintain recovery. Originating with the Alcoholics Anonymous (AA) program, H.A.L.T. is one of the AA sayings and is a useful acronym for identifying potential relapse triggers.1

In this article:

What Is H.A.L.T.?

While relapse can seem like it happens in an instant and is out of your control, psychological and physical influences often lead to relapse over time. Some triggers have a more significant impact than others, such as extremely stressful events, and may have a bigger contribution to the chain reaction that leads to relapse. As triggers happen, your behavior may change—such as putting yourself in riskier situations—making yourself more vulnerable to eventual relapse.1

Changes in mental health symptoms, self-confidence, and motivation for recovery can also contribute to relapse if left unaddressed.1

In recovery, you are encouraged to stop—or H.A.L.T.—and pay attention to the smaller, everyday triggers that can lead to non-recovery-focused behaviors and potential relapse. The acronym stands for:1

  • Hungry
  • Angry
  • Lonely
  • Tired

The H.A.L.T. concept is an addiction relapse prevention tool that helps with recovery by teaching you to focus on self-care actions that address the relapse symptoms that are some of the biggest red flags for relapse.1

Hungry

If you feel overwhelmed and are having strong urges to use alcohol, stop and ask yourself if you are hungry. Hunger can refer to two different needs: nutrition and emotional support.2, 4

How Food and Nutrition Can Prevent Relapse

Nutrition is essential in healing the mind and body. Research shows that many individuals recovering from substance use disorders have nutritional deficiencies. Because substance use sends intense signals to the reward centers of the brain, in recovery your brain may signal cravings for alcohol when your body actually needs food. 2 Give yourself the time and mental space to determine if you are hungry.

In addition to the potential for mixed signals, you may feel more intense urges related to alcohol withdrawal if you have not eaten recently and your body needs certain nutrients that support chemical balance in the brain. Therefore, it’s essential to listen to your body to figure out if you are hungry and need to eat and provide nutrition to your body.2

You can restore equilibrium by eating healthy foods rich in vitamins and minerals that reduce the urge to use alcohol. Specific nutrients that your body may need to reduce relapse symptoms include folate, vitamin A, thiamine, and vitamin B6.3

How Meeting Emotional Needs Can Prevent Relapse

If you feel symptoms of hunger, but have provided your body with adequate nutrients, your needs may be emotional.

While in recovery, you can be hungry for emotional support. You must know how to get those needs met to avoid a relapse. Having a support system in recovery can help make sure your emotional needs are being met. Support systems include family, friends, and peers.4

Peer support from other people with alcohol addiction can make you feel a sense of belonging, hope, respect, and empowerment. Working with peers in recovery also gives you a chance to give back to others and your community, both of which can satisfy emotional hunger and prevent a relapse.5

Angry

According to AA, anger increases your risk of relapse. Your anger may directed at anything—including the circumstances that led to your addiction, the requirements of your treatment plan, or even yourself—or can even seem like it is not directed at anything specific. Anger is a natural emotion and a natural part of addiction recovery, but if you do not take the time to work on how you handle it, anger may contribute to impulsive, spiteful, or vindictive behaviors that could include using alcohol. 6

The key to avoiding relapse or other negative behaviors is stopping and understanding your anger before you react. By pausing first, you can discover the correct way to respond. 7

Anger can appear in many forms including feelings of:7

  • Hostility
  • Resentment
  • Frustration
  • Irritation

Programs like AA have conducted studies and found direct links between anger and alcohol relapse. Anger is an emotional stressor and, without the establishment of new coping skills, can lead to a return to past coping skills, like using alcohol. Anger is a significant factor in relapsing, either in the moment or as one of the signs of alcohol relapse in the future. AA created a separate worksheet specifically to understand and cope with the emotion to avoid relapse.7

Ideas used in anger management groups include ways that teach you to take time—to H.A.L.T.—before reacting in anger, such as:8

  • Implementing an anger meter to assess your level of anger
  • Seeking social support
  • Taking a timeout
  • Using deep breathing to relax

You can also create your plan of action to respond to anger more positively on your own or with the help of your care team. Your plan will likely look different from someone else’s and may include: 8

  • Creative activities like painting
  • Exercising
  • Listening to music
  • Talking to a friend
  • Journaling

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Lonely

Loneliness is recognized as a significant risk factor for all stages of alcoholism, including as one of the strongest relapse triggers. A lack of social support is the main contributor.9

If you feel lonely, take the time to figure out why you feel lonely. Is it situational? Has something specific caused a physical separation between you and your social supports? Or is your loneliness more of an internal feeling associated with mental health symptoms like depression, grief, or stress?9 Answering these questions can help you better understand how to resolve the feeling of loneliness.9

Social factors influence recovery from addiction. Research shows certain social aspects are particularly beneficial in preventing relapse, including:10

  • Bonding and support
  • Obtaining abstinence-focused role models
  • Doing service work within a support group like AA

Some steps you may take to overcome loneliness include:

  • Attending an AA meeting or contacting your AA sponsor
  • Participating in a sober activity, such as a community sport
  • Visiting a public social space where you feel comfortable and no alcohol is offered, such as a gym class or coffee shop music event
  • Volunteering
  • Reaching out to a sober friend or family member

Tired

After a long day of work, after exercising, or after spending significant time in a challenging social setting, you will likely feel tired. These types of exhaustion will typically go away after a good night’s rest. Different types of fatigue can be related to physical or psychological health.11

If you feel fatigued over a long period of time, you may be more vulnerable to relapse. Fatigue can reduce your sense of willpower and your connection to the motivations you have for recovery.

Sleep is one of first and best methods you can use to combat feelings of tiredness. Studies have linked alcohol use disorder relapse directly to sleep disturbances. Researchers call it the sleep-related relapse risk. Sleep disturbances commonly happen during early recovery. Therefore, it is crucial to recognize when you feel tired and deal with it appropriately to avoid relapsing.11

Some interventions for getting better sleep to avoid relapse include the following.12

Therapy

Working with a therapist who can teach you relaxation and restorative techniques can benefit your mental and physical health, making you stronger in the fight again relapse. Therapy can be particularly important for individuals whose alcohol use disorder is related to a history of trauma. Cognitive-behavioral therapy (CBT) techniques have been specifically created for those with insomnia.12

Pharmacological Medicines

Your primary care doctor or psychiatrist may prescribe medicine to help you sleep, especially in the early stages of your recovery. Prescribed and over-the-counter options are available for temporary use to ease sleep disturbances.12

Mindfulness Techniques

Some research indicates success improving sleep using holistic methods, including12

Medical Interventions

If you find yourself unable to determine the cause of your tiredness, to manage your feelings of fatigue, or feeling extreme fatigue for an extended period, report your symptoms to your doctor. These symptoms may potentially indicate an underlying medical condition.

H.A.L.T. can help you recognize some of the common triggers of relapse. It’s vital to know other predictors of relapse. Examples include exposure to alcohol exposure, spending time in places where you used to use alcohol, sensory cues that remind you of using alcohol, and stress. Because alcohol alters the structure of your brain, any stimuli associated with drinking alcohol can be a trigger you may need to avoid for addiction relapse prevention.13

If you are struggling with triggers and need treatment to manage them, we can help. Call our treatment specialists 800-839-1686Who Answers?. They are available 24/7.

Resources

  1. Melemis S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332.
  2. Jeynes, K. D., & Gibson, E. L. (2017 October 1) The importance of nutrition in aiding recovery from substance use disorders: A review. Drug Alcohol Dependence, 179, 229-239.
  3. Hoyumpa AM. (1986). Mechanisms of vitamin deficiencies in alcoholism. Alcoholism: Clinical and Experimental Research, 10(6), 573-81.
  4. Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: an examination of general and alcohol-specific social support. The American Journal on Addictions, 16(1), 49–55.
  5. Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s Working Definition of Recovery. 10 Guiding Principles of Recovery.
  6. Walitzer, K. S., Deffenbacher, J. L., & Shyhalla, K. (2015). Alcohol-adapted anger management treatment: a randomized controlled trial of an innovative therapy for alcohol dependence. Journal of Substance Abuse Treatment, 59, 83–93.
  7. Kelly, J. F., Stout, R. L., Tonigan, J. S., Magill, M., & Pagano, M. E. (2010). Negative affect, relapse, and Alcoholics Anonymous (A.A.): does A.A. work by reducing anger?. Journal of studies on alcohol and drugs, 71(3), 434–444.
  8. Substance Abuse and Mental Health Services Administration. (2019). Anger Management for Substance Use Disorder and Mental Health Clients. Participant Workbook.
  9. Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research: J.C.D.R., 8(9), WE01–WE4.
  10. Dingle, G. A., Cruwys, T., & Frings, D. (2015). Social identities as pathways into and out of addiction. Frontiers in Psychology, 6, 1795.
  11. Brower, K. J., & Perron, B. E. (2010). Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances. Medical Hypotheses, 74(5), 928–933.
  12. Brooks, A. T., & Wallen, G. R. (2014). Sleep disturbances in individuals with alcohol-related disorders: a review of cognitive-behavioral therapy for insomnia (CBT-I) and associated non-pharmacological therapies. Substance Abuse: Research and Treatment, 8, 55–62.
  13. Becker H. C. (2008). Alcohol dependence, withdrawal, and relapse. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism, 31(4), 348–361.

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