What is Addiction Relapse?
Relapse occurs when an individual that was previously sober from drugs or alcohol returns to regular drug use or alcohol use. Relapse is different than a brief lapse in judgment where a person slips up and uses a substance a single time. Instead, addiction specialists define relapse as a total return to previous substance abuse.
Addiction—also known as substance use disorder—is a treatable but chronic disease. As with any chronic illness, there is a chance for symptoms to resurface. However, a relapse of any disease doesn’t mean that the treatment was unsuccessful.
Individuals who struggled with past alcohol abuse or drug addiction can get back into addiction treatment after a relapse and remain successful in their overall recovery plan.
Why Does Relapse Happen?
Relapse can occur at any phase of a person’s sobriety but is most common in the early stages of addiction recovery. Individuals in the early recovery process deal with cravings and a range of new emotions.
Recovering brains are also adjusting to the shift in chemicals and can cause a person not to feel fully like themselves until the brain has healed. Any of these factors can trigger a possible relapse.
It is crucial to remember that relapse is NOT a failure and likewise doesn’t mean that the overall treatment isn’t working. Addiction is a chronic disease, and relapse is always a possibility.
Types and Stages of Relapse
Relapse is more of a process than a singular event. Medical professionals break down the stages of relapse into three categories: emotional, mental, and physical.
Relapse Stage 1: Emotional Relapse
Emotional relapse happens first. Many individuals that struggle with substance use disorder also have mental health struggles, poor coping skills, or simply have gotten used to numbing out any negative emotions.
During the earliest stages of emotional relapse, the individual may not consider relapse consciously. However, subconsciously they may begin to crave an outlet for their emotional pain.
Relapse Stage 2: Mental Relapse
Mental relapse usually follows after an emotional relapse. The individual will become aware of their internal conflict and desire to use substances as a coping strategy. They will feel torn between using drugs or alcohol and remaining sober.
During the mental relapse stage, the individual may begin to justify drug or alcohol use to themselves. They may also minimize previous substance abuse, convincing themselves that it “wouldn’t be so bad” if they returned to alcohol or drug use.
Relapse Stage 3: Physical Relapse
Physical relapse is the final stage of relapse, occurring when the person returns to using drugs or alcohol. During the physical relapse stage, some individuals will realize that they cannot control themselves or stay sober and return to complete drug or alcohol abuse.
There is also a colloquial term known as “freelapse,” where individuals accidentally consume drugs or alcohol without their knowledge. Sometimes a freelapse can lead to a full-blown physical relapse.
Ten Most Common Reasons for Relapse
People relapse for many different reasons, but some causes tend to be more common.
The ten most common reasons for relapse include the following causes.
1. Withdrawal Symptoms
During the early stages of recovery, many recovering addicts will go through the detox process and experience withdrawal symptoms. Others who try to quit on their own (aka going “cold turkey”) are likely to experience withdrawal symptoms. Many people return to substance abuse due to the discomfort of many withdrawal side effects.
Ideally, recovering addict quitting their substance abuse will opt for a medical detox to go through the withdrawal process with medical intervention to help them remain sober.
2. Emotional Distress
Many addicts have a hard time coping with difficult emotions, and for many, drug or alcohol use became a way for them to run away from negative feelings. When a person is in recovery, things may feel positive initially.
However, life has ups and downs. Sometimes, a major “down” episode can put a recovering addict at risk for relapse because they don’t know how to cope with how they feel.
3. Mental Health Issues
Like emotional turmoil, mental health issues can contribute to relapse—especially if those issues are left untreated. Many recovering addicts also have underlying behavioral health concerns that may require additional, separate treatment.
While substance use disorder is a problem in and of itself, mental illness can contribute to an individual struggling to cope with their emotions or a particular situation.
A relapse can occur because the person is too cocky or overconfident about their sobriety. They may put themselves in risky situations or around troublesome people, thinking that they won’t have any issues avoiding drugs or alcohol.
In reality, anyone in recovery is at risk for relapse. Acting as though relapse is impossible could put someone in danger of slipping up and falling back into old habits.
5. Reminders of Previous Use
Sometimes even little, subtle things can trigger relapse by reminding the person of previous instances of substance abuse. The clinking of glasses may bring up memories of drinking, and credit cards might remind them of cocaine use.
Many different and unexpected things might trigger cravings, so it’s essential not to be overconfident about your sobriety.
6. Boredom and Loneliness
Lacking a solid support system can significantly increase a person’s chance of relapse, and that’s why 12-step programs and other support groups can be so beneficial to a recovering addict. Having a support network of peers who understand what you’re going through can help hold you accountable for your sobriety.
Additionally, generally lacking things to focus your time and attention on can lead you down the path of considering returning to substance abuse. Many aftercare programs focus on creating new habits and hobbies to help people stay busy after completing an addiction treatment program.
7. Toxic People
Not all company is good company after completing rehab. Old friends or even family members that are still using/drinking or that enabled your drug and alcohol use in the past can trigger a relapse.
It’s important to set boundaries with family and friends in the early stages of recovery, including healthy friends and family members. Clear boundaries will help your loved ones support your sobriety and help you avoid temptation.
8. Lack of Self-Care
Believe it or not, practicing good hygiene and healthy habits contribute to maintaining sobriety. When we stop taking care of ourselves, we inherently tell ourselves that we aren’t worthy of respect and dignity.
If someone begins to believe that they are not worthy of basic human care, they can eventually fall into the trap of thinking that they’re worthless overall, so what would be the harm in returning to substance abuse?
There’s a reason why addiction treatment programs recommend not getting into serious or intimate relationships in the first year of sobriety. First of all, it can be challenging to navigate the dating scene when alcohol is often present on dates.
Second, relationships are not always easy. Uncomfortable feelings may arise from rejection, arguments, tension, and other related issues that can trigger a relapse.
10. Familiar Places
Recovering addicts should also avoid familiar spots where previous drug or alcohol use occurred. Sometimes being back in the same environment can subconsciously trigger a relapse.
Sober homes and halfway houses offer a positive potential living alternative for individuals that may feel triggered by their old neighborhoods or living situations.
Risk Factors of Addiction Relapse
Anyone in recovery has the potential to relapse, but certain factors make the risk of relapse much higher than others. Risk factors are different high-risk situations that may contribute to relapse.
Any of the following experiences present a higher risk for relapse:
- Conflict with others
- Being exposed to triggers
- Peer pressure
- Physical pain
- Limited support system
Believe it or not, sometimes positive emotions may also put someone at risk for relapse. Celebrations like birthdays may involve alcohol, and someone unprepared may reason that partaking “just this once” won’t be an issue.
When recovering addicts are in a good mood, they may want to enhance that feeling. They may turn to alcohol or drugs to keep their good feelings going.
Relapse Warning Signs
Are you concerned about a friend or a family member’s sobriety? There are some potential warning signs of relapse to look out for that may indicate they have relapsed or are in the early stages of emotional or mental relapse.
Common relapse warning signs might include:
- A sudden shift in behavior. Significant behavioral changes might be a cause for concern for a recovering addict. If someone starts isolating themselves more or skipping their sobriety group meetings or other changes in behavior, it can be a red flag. If the person also loses interest in hobbies, personal care, or other interests, they may be considering or have already relapsed.
- Romanticizing about or diminishing past substance abuse. Recovering addicts struggling with sobriety may also look at their past drug or alcohol abuse differently. They might speak positively or fondly of times they spent drinking or doing drugs, neglecting to acknowledge their substance abuse’s negative toll on their lives. Some individuals may also recall past drug/alcohol use with a sense of denial that it was ever “that bad.” By disregarding the way drugs and alcohol hurt them in the past, recovering addicts set themselves up to return to substance abuse because they’ve convinced themselves of a different reality.
- Doubting the recovery process. Having genuine doubts about whether the recovery process works can be a potential warning sign of current or future relapse. Someone that isn’t fully committed to their recovery is more likely to return to previous alcohol or drug abuse.
In terms of addiction relapse, it’s important to remember that substance use disorder is a chronic disease. It might surprise you to learn that other chronic relapsing disorders include asthma and high blood pressure.
The National Institute on Drug Abuse (NIDA) reports a 40-60% relapse rate for individuals with substance use disorders. In comparison, asthma and high blood pressure have a 50-70% relapse rate.
While 40-60% may seem like a high number of relapses, it is not an indicator of long-term sobriety. In fact, a reported 60% of people can remain sober after two years in recovery. After five years of sobriety, the chances of relapse decrease to only 15%.
What to Do Right After a Relapse
If a relapse does happen, the first thing to focus on is safety. The individual who has relapsed may need medical care depending on how much of the substance they consumed. Sometimes when addicts relapse, they try to use the same amount of drugs or alcohol they had used before getting sober. However, this can often lead to a potentially life-threatening overdose.
If there is a potential for overdose, especially if overdose signs are present, seek medical attention immediately.
Once you take safety into account, here are some additional steps to take after a relapse has occurred:
- Reach out for help. You may feel the urge to self-isolation following a relapse. Ways to keep from self-isolation include reaching out to family, friends, and support groups. These advocates can remind you relapse is a setback, not failure.
- Attend a support group. Talk about your relapse with peers who can relate and understand. They can also give you advice on how to bounce back and share what they did if they experienced a relapse themselves. Local meetings like Alcoholics Anonymous (AA) are available daily, so you should be able to attend one right away.
- Establish (new) boundaries. After a relapse, you may need to establish or re-adjust your boundaries with the people in your life. Examples of healthy boundaries include avoiding contact with abusive people or people that enable your drug/alcohol use.
- Practice self-care. Experiencing a relapse will likely take an emotional toll on a person. Engaging in healthy activities that can calm your emotions and reset your perspective can be beneficial. Consider options like going for a run, doing yoga, meditating, making a healthy meal, journaling, or taking a relaxing bath.
- Reflect on the relapse. You should also take some time to think about the relapse. Consider what took place before the relapse happened. Did something trigger you? What went wrong that you can adjust in the future?
- Avoid any further triggers. The relapse has already happened, but you want to get back on track. Therefore, you should start by avoiding anything you know might trigger you. Triggers might include people, places, and things that remind you of your substance abuse. Triggers can also be people or things that unearth negative emotions and encourage you to return to substance abuse.
- Create or adjust your relapse prevention plan. If you don’t already have one, now is an excellent time to create a relapse prevention plan. (If you already have a plan, it’s worth reviewing your plan to make any important adjustments.) A good relapse prevention plan will pinpoint your triggers and include a shortlist of healthy coping mechanisms. You may also want to write down names and contact info for your sponsor, local support groups, and/or other supportive individuals that helped you during the aftermath of this relapse.
Getting Back on the Road to Recovery
Recovery after relapse will be similar to your initial substance abuse treatment. You will likely need to start with the detox process, and opting for a medical detox will usually be your best option. Just like your initial recovery, you can select a treatment program (inpatient or outpatient rehab) suitable for your specific situation.
It’s normal to feel shame, guilt, frustration, or defeat after a relapse. Remember that recovery isn’t always linear and relapse does not mean that your initial treatment failed. Maintaining a positive mindset will help you remain sober and avoid relapsing in the future.
Do I Need to Go Back to Treatment after a relapse??
You should seek out addiction treatment if you cannot stop drinking or using drugs after your initial relapse. The sooner you seek help, the easier it will be for you to get back on track.
Treatment centers offer both inpatient rehab and outpatient treatment options, and you may not need the same level of care after a relapse. Even if you previously engaged in an inpatient program, you may be alright with selecting an outpatient treatment option to help you return to a sober lifestyle.
Long-Term Relapse Prevention
You can succeed in long-term relapse prevention through positive life changes that become healthy habits. Statistically speaking, the longer you remain sober, the lower your chances for relapse become.
Recovery is a lifelong journey. Besides the tips listed on this page, there are some additional strategies you or your loved one can employ while maintaining a drug and alcohol-free lifestyle.
Some valuable practices to incorporate in your life for long-term relapse prevention include:
- Understanding relapse. The first step in avoiding relapse is understanding more about it, including how it happens and why. The more you comprehend relapse, the more prepared you will be to prevent it.
- Engaging in (or increasing) individual therapy. If you aren’t already getting individual counseling, such as Cognitive Behavioral Therapy (CBT), now is an excellent time to start. Attending therapy will help you improve your coping strategies and learn to deal with negative emotions more healthily. If you’re already in therapy, you may want to increase how often you see your therapist after a relapse. Your therapist will help you cope with your recent relapse and any fallout that might have occurred.
- Increasing your commitment to a self-help program. Like with therapy, if you are already participating in a support group (such as a 12-step program) you should consider increasing your attendance after a relapse. Not only will the increase in attendance provide you with additional accountability and support, but the environment of a support group can also help you process your recent relapse. You may also consider attending relapse prevention classes or support groups. Learning more about avoiding relapse can equip you with more tools and strategies to handle triggers and temptations in the future.
- Practice regular self-care. Self-care includes basic hygiene and taking time to nourish and refresh yourself regularly. It may seem unimportant, but self-care is directly connected to your self-esteem and overall wellbeing. Taking care of your body and mind will positively influence your sobriety in the long run.
- Be honest. Deceit is often a significant aspect of substance abuse and being honest when you need support will allow others to help you when you are struggling with sobriety. Not only that but being honest with yourself throughout your recovery journey sets you up to avoid potential triggers and seek help before a relapse.
Are You in Need of Relapse Support?
If you or a loved one has experienced a relapse, you can speak with your doctor or similar healthcare provider for medical advice about what treatment option you might need to get back on track.
You can also look at the SAMHSA program locator to see what treatment options are available in your area.