How to Prevent Relapse
Relapse is a common part of the recovery process during which an individual returns to substance misuse. However, a relapse doesn't have to be permanent.
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Addiction is a chronic disease that can involve relapses, behaviors that involve returning to the use of drugs or alcohol after an individual has stopped for a brief period. A relapse can occur even if you have successfully completed an addiction treatment program. Relapse rates vary widely but some studies show that approximately half of people relapse within 3 months of completing inpatient addiction treatment.1 However, experiencing a relapse doesn’t mean that your treatment or recovery efforts have failed.2 There are steps you can take to understand your risk factors and reduce the likelihood of relapses. These measures are known broadly as relapse prevention. Understanding the causes of relapses, how to recognize the warning signs of a relapse, and how to reduce the likelihood of a relapse can help you live a long, healthy life in recovery.
What is a Relapse?
A relapse means returning to substance use after a period of not using.3, 4 The first time using after making an effort to stop is known as a lapse or a slip, while returning to previous levels of use is considered a relapse.3, 5 Relapse is not a term that is specifically used for addiction as relapse can occur with many chronic illnesses, such as diabetes, asthma, heart disease, or mental health disorders.2 A relapse doesn’t represent a failure of a person’s efforts to remain in recovery, but rather a resurgence of the disease.2
While it can be discouraging to relapse, it can also be a learning experience. A relapse means that you may need to change some aspects of your treatment plan in order to address the behaviors that are commonly associated with substance use disorders.2 It can highlight areas of your relapse prevention plan that are not working for you and that need to be changed to work more effectively for your individual recovery.2
Why do People Relapse?
People relapse for a wide variety of complex reasons, and these reasons can be different for each person. Early relapses from drugs like alcohol, opioids, or benzodiazepines could be a result of the uncomfortable withdrawal symptoms associated with prolonged use. Substance use can change brain chemistry and drug making it especially difficult to stop using despite the desire and efforts put towards reaching sobriety.2 Substance use primarily affects the areas of the brain involved in reward and pleasure, impulse control, and decision making.2, 4 It can take time for brain chemistry to return to normal after you stop using.2, 4 A relapse prevention plan for substance abuse can offer effective coping skills to help you stay sober.
Stages of Relapse
Rather than occurring as an isolated event, relapse slowly occurs in a series of gradual stages.1, 5 Coping skills for relapse prevention can vary depending on the stage of relapse.1 The stages of relapse include:1, 3
- Emotional relapse: This is the first stage of relapse. You remember how bad addiction or relapse was, don’t want to relapse, and aren’t actively thinking about using again. However, some people may be overconfident in their ability to stay sober and even deny the fact that they could be at risk of relapsing. This can lead to not engaging in recovery-oriented behaviors, such as focusing on others rather than yourself, not practicing self-care, and avoiding treatment or self-help meetings.
- Mental relapse: During this stage, you may be torn between wanting to use again and wanting to stay sober. Cravings, focusing on positive aspects of use, avoiding or minimizing how bad addiction or its consequences were, and considering how it could be possible to use without things getting out of hand are hallmarks of this stage.
- Physical relapse: This is the final stage, and involves actually picking up a substance. People in this stage are actively planning a relapse, and come up with excuses to use. They may put themselves in situations where it is easy to use, and convince themselves that the consequences of addiction weren’t so bad, or won’t happen this time. Old patterns of behavior may resurface, even before you begin to use.
Relapse Warning Signs and Triggers
A relapse warning sign is an indicator that you are at risk of relapse.3 These can vary between individuals and the stage of relapse you are in.1 Recognizing and understanding your warning signs can be especially helpful in preventing relapse.3
Triggers are another aspect that may help you foresee and prevent a relapse. Simply put, relapse triggers are people, places, and things that place you at increased risk for relapse.1 (Learning how to identify your unique triggers is the cornerstone of an effective relapse prevention plan and allows you to utilize coping strategies to stay sober. An effective relapse prevention plan may involve methods to recognize both early warning signs and relapse triggers in order to help reduce one’s risk.
Common Relapse Warning Signs
Relapse is a different process for each person. No two relapses are exactly the same, but there are some warning signs that are commonly seen before relapse. Identifying warning signs early can allow you to avoid relapse and refocus your energy towards recovery. Common warning signs include:1, 3
- Actively thinking about using again.
- Avoiding meetings or treatment or attending meetings and not openly sharing.
- Reverting to old behaviors when you were actively using.
- Coming up with schemes in which you can use without returning to addiction.
- Focusing on behaviors and problems of other people, rather than yourself.
- Isolating from friends, family, and/or your sober support network.
- Lack of attention to practicing self-care, such as eating properly and getting enough sleep.
- Lying to others or yourself.
- Minimizing the negative aspects of substance use.
- Not taking medication that is prescribed to help you stay sober.
- Overconfidence in thinking you aren’t going to ever relapse, and that you don’t need treatment or meetings.
- Romanticizing or glamorizing past use of alcohol or drugs.
- Spending time with people you have used with in the past.
- Strong urges to use.
- Visiting places where you can access drugs or alcohol easily, such as parties, bars, or where you used to get substances.
Common Relapse Triggers
Identifying your individual relapse triggers is an important step in preventing relapse. Understanding what your relapse triggers are will empower you to develop effective relapse trigger management strategies. Relapse triggers can be people, places, situations, emotions, or other cues that can make you more likely to relapse and cause you to experience strong urges to use. 2 (p17) Some common relapse triggers include:2 ,3, 4, 5, 6
- Being around a person or place that is associated with your use.
- Easy access to alcohol or drugs.
- Having something to celebrate.
- Increased stress levels.
- Mental health symptoms.
- Not practicing self-care.
- Peer pressure.
- Relationship issues.
- Seeing the substance of abuse, or something that looks similar.
Tips for Avoiding Relapse
While a relapse does not represent a failing of character, there are behaviors you can adopt to reduce your risk of relapse. Some common relapse prevention behaviors may include:1, 3, 5
- Avoid people, places, and things associated with addiction, or develop a plan if you can’t avoid them. This can include bringing a supportive person with you to situations, changing routines, and building a new social group.
- Consider attending self-help meetings if you don’t already, and become an active participant.
- Create a pros/cons list identifying negative consequences of relapse.
- Developing strategies to manage feelings that can make it easy to relapse, such as anxiety, boredom, depression, and loneliness.
- Get rid of alcohol, drugs, or paraphernalia that you may have.
- Identify your coping skills and practice them.
- If you have other mental health concerns, address them with a professional.
- Incorporate healthy behaviors into your routine, including exercise, meditation, or other stress relieving activities.
- Keep a list of people you can call if you are struggling.
- Learn skills to help you manage cravings.
- Prioritize self-care routines.
- Return to treatment, if you aren’t already receiving care.
- Speak honestly about what you are thinking and feeling. This can be done in treatment sessions, at self-help meetings, and with your support group.
- Try to stay in the moment, focusing on each day as it comes rather than your entire future.
Going Back to Rehab After a Relapse
Some individuals who relapse may find that they need to return to rehab for treatment. A return to rehab does not constitute a failure. Instead, attending treatment after a relapse is a way to reduce the risk of harm to your health, and is a great way to support a stronger, healthier recovery process. If you have relapsed and need to enter treatment, there are some steps you can take. If you have already attended a rehab, a good start would be to contact them and explain what happened. They may be able to recommend a program for you at a familiar facility, or refer you to facility alumni who can offer support.
If you haven’t been to treatment before or would prefer to start somewhere new, American Addiction Centers (AAC) operates a confidential detox and rehab hotline that is available 24/7. Our hotline is staffed by an admissions team who truly understands the struggles of addiction as many of our them are either in recovery or have supported someone close to them throughout their addiction. Available at or you can text us, our team will help you find the right treatment program for maintaining your recovery.