Addiction is a treatable condition. Research-backed treatment methods can help people stop using drugs and alcohol. This is known as recovery. But successful recovery from substance use disorders often involves setbacks, which are commonly called relapses.
The National Institute on Drug Abuse estimates that relapse rates from substance use disorders are 40-60%. Please continue reading to learn more about the three stages of relapse and how you can recognize and prevent setbacks in your journey of recovery.
What Does It Mean to Relapse?
Relapse means to become worse again after an improvement. In reference to substance use, relapse means a return to drug or alcohol use after previously managing to reduce or stop it completely.
It’s important to understand that relapse does not mean addiction treatment has failed. Episodes of relapse (returning to drug or alcohol use) after stopping are part of the recovery process.
Causes of Relapse
Withdrawal symptoms can lead to relapse. These are a collection of uncomfortable symptoms that a person experiences when they reduce or stop using drugs or alcohol. They occur while the body adjusts to the absence of the substance and are typically short lived. However, in some cases addiction withdrawal symptoms can last for several weeks or months and cause a person to relapse.
Research has also shown that cues linked to alcohol or drug use, including things, people, places, and moods are triggers for relapse. Common triggers for relapse include:
- Emotional stressors or major life transitions
- Easy access to drugs or alcohol
- Revisiting places or meeting people connected to substance abuse
- Social isolation or boredom
There are effective strategies and therapies that can counteract these triggers and help people stay in recovery.
Early Warning Signs of Relapse
The warning signs of relapse are unique to every individual in recovery. However, the following early warning signs can tell you that a relapse has occurred or is about to occur:
- Overconfidence about overcoming addiction or talks of quitting treatment against medical advice.
- Significant changes in attitude or emotions such as anxiety, sadness, hopelessness, or pessimism.
- Mood swings such as irritability, anger, frustration, and other negative emotions.
- Changes in behavior, such as consistently missing therapy appointments, acting out of character, or alterations in eating or sleeping habits.
- Withdrawal from friends and family, self-imposed isolation, or avoiding or neglecting social connections.
- Spending time with people who were previously drinking buddies or fellow drug users.
- Lying about things like going to therapy, finances, and generally being dishonest with loved ones.
- Neglecting personal hygiene.
What Are the Three Stages of Relapse?
Relapse is not an event or something that happens suddenly. It is a slow process that happens in three stages: emotional, mental, and physical.
Emotional relapse refers to experiencing negative emotions that can lead to relapse. This includes mood swings, changes in eating and sleeping habits, and social isolation.
Mental relapse is the stage when a person starts to actively think about using drugs and alcohol. Warning signs of this stage of relapse include strong cravings, spending time with people linked to drug use, and fantasizing about or romanticizing drug or alcohol use.
Physical relapse refers to the actual use of drugs or alcohol, i.e., a full-blown slip or setback. Warning signs of this stage of relapse include appearing disheveled or intoxicated and lying to loved ones.
Stage 1: Emotional Relapse
Emotional relapse occurs when a trigger causes a person in recovery to become less emotionally stable. The trigger can be any stressor such as an argument with a loved one or the loss of a job. It causes a person to start slipping up on the coping techniques learned during psychotherapy for their substance use disorder.
Some of the warning signs and symptoms of emotional relapse are:
- Mood swings.
- Clamping up, keeping emotions to oneself, being defensive.
- Eating and sleeping too much or too little.
- Social withdrawal and avoiding hobbies and enjoyable activities.
- Neglecting self-care.
- Avoiding therapy sessions or meetings.
Stage 2: Mental Relapse
Mental relapse is the stage of relapse when a person starts having active thoughts of using drugs or alcohol because of the emotions experienced during the emotional relapse. For example, they may start fantasizing about using drugs, making plans to meet old drinking buddies, or wondering where and how they can obtain drugs or alcohol.
Some of the warning signs and symptoms of mental relapse are:
- Strong cravings.
- Thinking about the people and places associated with drug or alcohol use
- Making plans to meet old friends associated with substance use.
- Romanticizing drinking or drug use.
- Looking for opportunities to use drugs or alcohol.
- Convincing themselves that they can stop whenever they want.
- Bargaining with themselves or giving themselves permission to drink or use drugs in certain situations.
Stage 3: Physical Relapse
Physical relapse is the third and final stage of relapse when a person actually starts using drugs or drinking alcohol again.
Some of the warning signs and symptoms of physical relapse are:
- Lying to loved ones about whereabouts, missing money, attending therapy appointments, etc.
- Appearing intoxicated or hungover.
- Experiencing withdrawal symptoms.
- Neglecting personal hygiene.
- Withdrawing from loved ones.
Why Do the Stages of Relapse Matter?
Recognizing and getting help proactively when someone is experiencing emotional relapse can prevent them from going into a full-blown relapse. This is the earliest stage of relapse from where it is the easiest to turn around.
If a person has reached the stage of mental relapse, they are at a greater risk of a full-blown slip, i.e., returning to drug use or drinking. This is a critical stage where they are torn between staying sober and going back to substance abuse. By recognizing this stage, it is possible to seek help and prevent the next stage from occurring.
Is Relapse Always a Part of Recovery?
Addiction is a chronic disease, and its treatment requires deep-seated changes in behavior. Experts say relapse rates are 40-60% for substance use disorders. These rates are comparable to other chronic illnesses such as hypertension and asthma. If people stop treatment for these conditions, they are likely to relapse (have a return of symptoms or worsening of their condition).
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+18442884672 Similarly, when a person relapses to alcohol or drug use, it means they should talk to their healthcare team to resume, modify, or try a different approach to addiction treatment.
However, relapse can be very dangerous, even fatal, in some cases. If a person relapses and uses a large quantity of a powerful drug, even an amount they were previously accustomed to, it can result in a fatal overdose because their body is no longer adapted to this level of drug exposure. For this reason, it is crucial to seek professional help for a relapse.
How to Make a Plan to Prevent Relapse
If someone is in the first stage of relapse (emotional relapse), here’s what they can do to combat it:
- Recommit to the coping skills learned in therapy.
- Practice journaling to reflect and gain insight about their triggers and mental state.
- Engage with positive and supportive people.
- Schedule fun sober activities, such as art classes, dancing, or sports.
- Practice relaxation techniques like yoga, meditation, mindfulness, and deep breathing.
- Go to meetings and therapy sessions regularly.
If a person is in the second stage of relapse (mental relapse), the following strategies can help:
- Distract themselves when they have the urge to drink or use drugs.
- Make a list of the consequences of drinking or drug use.
- Mentally walk themselves through prior experiences with substances, such as feelings of shame and guilt.
- Make a list of the positives of sober living.
- Focus on their current state in recovery and what they have achieved.
- Reach out to their mentor.
- Confide in their counselor or therapist.
If someone has had a physical relapse and has started using drugs or drinking alcohol again after stopping, it’s important to contact their counselor or a member of their addiction treatment team as soon as possible.
A physical relapse does not mean failure. It simply means the person needs more help or a higher level of care. For example, if someone is in an outpatient rehabilitation program, they may want to consider attending an intensive outpatient program, a partial hospitalization program, or an inpatient (residential) drug or alcohol rehab program as recommended by their mental healthcare team.
Tips to Avoid Relapsing
1. Therapy
Psychotherapy modalities such as cognitive behavior therapy (CBT) have been proven effective in recognizing and handling the early warning signs of relapse. Therapy helps to develop coping skills and replaces negative thinking patterns with healthier ones. These skills are vital in controlling the thoughts and emotions that trigger relapse. If someone is experiencing any of the three stages of relapse, they should be honest with their therapist and ask about other types of treatment if they feel the current therapy isn’t helping.
2. Medications
Medication-assisted treatment (MAT) is very effective for certain substances such as opioid drugs and alcohol. If a person has experienced a relapse, they should talk to their health care providers about taking medications such as methadone, naltrexone, or disulfiram to reduce cravings. If someone is already on MAT, the healthcare team may recommend increasing the dose or switching to a different medication.
3. Monitoring
It’s important to cooperate with doctors and take urine drug tests as recommended. If a drug test identifies drug use, the person in recovery should talk to their healthcare professionals about making changes in the treatment plan. Urine drug tests are not a punishment but rather a way to ensure substance abuse treatment is working and the person is continuing to abstain from drug use.
4. Peer Support
Regularly attending AA or NA meetings and talking with other people in recovery can be very effective in preventing relapse. If a person is experiencing a crisis and is at a risk of relapse, they should talk to their mentor and go to meetings to lower the possibility of returning to drug or alcohol use.
Frequently Asked Questions (FAQs)
Can you recover from relapse at any stage?
Yes, you can recover from relapse at any stage. Relapse is common during recovery and can happen once or more than once. In fact, experts say relapse and recovery go hand in hand. There are effective relapse prevention strategies that can help to turn you back on the path to recovery.
How can I prevent relapse from occurring?
The most common relapse prevention strategies are therapy, medications, monitoring, and peer support. Another way to look at it is most relapses can be managed with five simple rules:
- Focus on creating a sober life.
- Don’t bend the rules.
- Be completely honest with yourself and others.
- Ask for help.
- Practice self-care.
What is relapse pattern?
A relapse pattern is formed by your thought processes and attitudes. Meaning, you begin to slip at a mental level. Others notice your thought processes through your behaviors and actions, which tells them you are heading toward drug use again. These sequences of events are called relapse patterns.
How long do relapses last?
Relapses can be a single episode or they can last for days, weeks, months, or even years. About 40-60% of people relapse within 30 days of leaving inpatient treatment and up to 85% relapse within the first year. Seeking treatment for a relapse is vital to lower the risk of health complications and a fatal drug overdose.
Key Takeaways
Recovery is an ongoing, even lifelong, process with many milestones. People in every stage of recovery from substance abuse can relapse. Relapse is not a failure but rather an opportunity to reassess and modify the addiction treatment plan.
Contrary to what many people think, relapse is not an event that happens suddenly or spontaneously without warning signs. It is a gradual process with three distinct stages – emotional relapse, mental relapse, and physical relapse – and warning signs. The goal of relapse prevention is to recognize the warning signs of relapse and seek help in the early stages when the chances of success are highest.
The main tools for relapse prevention are psychotherapy (cognitive behavioral therapy), medication-assisted treatment, monitoring with urine drug tests, and peer support from support groups like Alcoholics Anonymous and Narcotics Anonymous. A support system of friends and family also plays a critical role in relapse recognition and relapse prevention.
Get Help Now
Recognizing the early warning signs of relapse is an opportunity to get help before it’s too late. Mental health professionals with expertise in addiction treatment can help people in every stage of relapse. There are several effective strategies to get back on track toward recovery.
At Discover Recovery, our team of mental health professionals is highly experienced in helping people with challenging substance use disorders and multiple relapses. Whichever of the three stages of relapse you may be experiencing, we can help. Call us today to find out how we can develop a relapse prevention plan for you.
Related Resources and Articles
The National Institute on Drug Abuse and National Library of Medicine have several resources for further reading on recognizing relapse and preventing relapse. Here are some links to get you started:
