Addiction Relapse Prediction Scale Worksheet
It is essential that you think through the situations that are most likely to put you in the danger zone for a slip or relapse. The Relapse Prediction Scale below lists many situations that might trigger strong urges to drink or use. Look at the items one by one, and imagine yourself in the situation described. Try to feel, hear, and even “taste” yourself in the situation, and decide whether or not the urge to drink or use is there and, if so, whether it is strong or weak.
Then rate the strength of the urge and the likelihood of drinking or using on a scale of 0 to 4 (0 is no urge at all, 4 is an irresistible urge). Feel free to add items specific to your situation to the end of the list.
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Relapse Prediction Scale |
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Situations that Might Trigger Strong Urges |
Strength of Urge |
Likelihood of Using |
Situations that Might Trigger Strong Urges |
Strength of Urge |
Likelihood of Using |
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1. I am in a place where I used alcohol or drugs before. |
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29. I am out gambling. |
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2. I am around people I have used alcohol or drugs with before. |
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30. I am watching sports. |
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3. I just got paid. |
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31. I am getting dressed up. |
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4. I see coworkers drinking or using. |
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32. I am under pressure at work. |
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5. I am leaving work. |
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33. I am thinking about having sex. |
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6. It's Friday night. |
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34. I am angry at my spouse or partner. |
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7. I am at a party. |
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35. My spouse/partner is bugging me about my drinking or using. |
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8. I am thinking of the last time I used. |
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36. My family is bugging me about my drinking or using. |
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9. I feel bored. |
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37. I was just told I have positive urine. |
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10. I feel great. |
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38. I didn't use, yet my urine was positive. |
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11. I see a lover or ex-lover. |
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39. I am watching an alcohol or drug-related movie. |
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12. I am having a drink. |
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40. I feel anxious. |
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13. My friend is offering me some alcohol or drugs. |
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41. Someone just criticized me. |
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14. I feel sad. |
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42. I haven't used for a long time. |
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15. I see a prostitute. |
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43. I feel tense. |
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16. I am out looking for sex. |
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44. Someone I care for is terminally ill. |
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17. I feel sexy. |
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45. I am in pain. |
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18. I remember how good a high feels. |
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46. I feel burdened. |
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19. I am angry. |
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47. I am at a bar having a good time. |
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20. I feel stressed out. |
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48. I had a fight with my family. |
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21. I feel guilty. |
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49. I'm tired of my life. |
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22. I just used drugs. |
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50. |
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23. I just broke my abstinence. |
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51. |
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24. I am getting ready for work. |
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52. |
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25. I am tired. |
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53. |
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26. I am frustrated. |
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54. |
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27. I see an anti-drug poster. |
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55. |
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28. I see a pipe. |
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56. |
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Enterhealth creates individualized alcohol addiction treatment and drug addiction rehabilitation plans because we know your unique situation calls for an effective one-of-a-kind solution.
Contact Enterhealth today at 800.388.4601 to schedule an admission or email us at info@enterhealth.com for more information.
