18 Minutes

By THE BALANCE
Fact checked

Addicts are likely to relapse at least once during their recovery. Some people may even fall off the trail multiple times before finally becoming sober. In fact, despite FDA-approved treatments for nicotine, alcohol, and opioid addiction, more than two-thirds of those who start treatment will relapse. The first step toward prevention is to understand what might cause you to relapse and have a plan to deal with these triggers. A relapse is a worsening of a previously improved medical condition. A reversion to addiction occurs when a person who has previously struggled with addiction resumes their addictive behavior after a period of abstinence.

“Relapse” is defined by the American Society of Addiction Medicine (ASAM) as the return of behavioral or other substantive indicators of active disease after a period of remission. A relapse would be experienced by someone who had completely stopped drinking for some time, say six months, and then began drinking in an unhealthy manner. They might be considered to have had a “slip,” but not a full relapse, if they only had one drink. A relapse occurs when a person who is trying to control their behavior rather than quitting altogether loses control. For example, someone trying to control their drinking and relapsing could end up binge drinking. Going on a shopping spree can be a relapse for a shopaholic who is trying to stick to a budget.

A relapse is when someone returns to drinking or using other drugs, or gambling, after successfully controlling or quitting previously. In a relapse, the use of alcohol, other medications, or gambling returns to, or approaches, previous levels of service. A lapse, on the other hand, is a brief departure from a person’s alcohol and other drug goals followed by a return to those goals. A person who has set a goal of not drinking alcohol, for example, may have a glass of wine at a party before returning to their alcohol goal the next day.

A lapse differs from a relapse in that it occurs after a brief period of substance use and is followed by a clear return to the person’s recovery goals. Because chronic substance use can cause structural and functional brain changes that last well beyond the period when sobriety was first achieved, many people recovering from addiction face a consistently high risk of relapse.

For instance, Peter has been alcohol-free for two weeks. He went to a family gathering over the weekend and had a tense argument with a close family member. He returned home and drank five glasses of red wine, and for the next three weeks, he consumed a bottle of red wine every night. This is the same amount of alcohol he used to consume daily. He hasn’t been able to control his behavior and is seeking assistance. Peter has had a relapse because he is having trouble controlling his alcohol consumption and has returned to binge drinking.

Addiction recovery takes time, and lapses and relapses are inevitable. A lapse or relapse is not an indication of ‘weakness,’ ‘failure,’ or inability to recover. Instead, they are indicators that old coping mechanisms must be replaced with new ones. The most important thing to keep in mind is that lapses and relapses can both be avoided. The road to recovery isn’t always easy. Change takes time, and people who are working towards recovery may run into difficulties that cause them to revert temporarily (a lapse) or for longer periods (a relapse). If you have a lapse or a relapse, remember that you can overcome them and achieve your goals.

The following is a list of common addiction relapse triggers. 

1. Withdrawal

Many people relapse within the first week of quitting drugs to avoid withdrawal symptoms or later because of post-acute withdrawal symptoms that can last up to 18 months. When people who are addicted to alcohol or drugs stop using their substance of choice, they will experience a variety of withdrawal symptoms. Withdrawal symptoms will vary depending on the type of substance used, the amount consumed, the frequency with which it was consumed, the duration of use, and other factors. Nausea, hot and cold sweats, restlessness, vomiting, diarrhea, insomnia, and muscle aches are some of the most common physiological withdrawal symptoms. Withdrawal from substances like alcohol and benzodiazepines (Xanax, Ativan, Klonopin, Etizolam, and others) can be fatal and/or result in seizures. As a result, it is strongly advised that people who want to quit using drugs or alcohol go to a medical detox center, where they can safely and comfortably detox from the substances they were using under medical supervision and with the help of medically assisted treatments like Suboxone or Valium. 

2. Mental Health

Alcoholism and drug addiction are problems in and of themselves, but there is also an underlying problem. It’s like putting a band-aid on a severed limb without addressing the underlying issues and simply stopping the substance use. Anxiety, depression, mania, personality disorders, or post-traumatic stress disorder are frequently unaddressed or hidden mental health issues. Therapists, psychiatrists, and other addiction specialists will work with the patient to address underlying mental health issues if they receive proper alcohol and drug addiction treatment. Mental health issues, like alcohol and drug addiction, often necessitate long-term treatment to maintain recovery. If mental health issues aren’t addressed, or if a person doesn’t know how to cope, they can lead to an alcohol or drug relapse. People who are addicted to alcohol or drugs aren’t used to dealing with psychological issues like depression or anxiety without using alcohol or drugs as a coping mechanism. Individuals with a mental health diagnosis can live a fulfilling life with the help of a mental health professional and, in some cases, prescribed psychotropic medications. 

3. People 

Individuals who suffer from an alcohol or drug addiction frequently associate with others who share their addiction—being in the same environment as people who are using substances while in recovery can lead to a relapse. Setting healthy boundaries with friends, family, or coworkers who do not respect your sobriety enough to stay sober while they are around you is an important part of the recovery process. You want to get to the point in your recovery where you can enjoy social gatherings where other people are drinking alcohol without feeling compelled to relapse, but this takes time and effort. Unless they have a solid foundation in their recovery, people who use alcohol or drugs should not be intentionally surrounded by them. When surrounded by people who use alcohol or drugs, it’s also a good idea to have a plan in place and, if possible, bring a sober support and accountability partner with you.

4. Places 

There are many places that people in recovery from alcohol or drug addiction should avoid, including bars, liquor stores, wineries, strip clubs, casinos, and parties. The location will be determined by the person. Any location that you may have associated with your alcohol or drug use should be avoided at all costs. The effects of addiction on the human brain are so extensive that even minor events can trigger someone in recovery, even if they are not aware of it. Individuals in recovery should be aware of this, and if they are triggered in an “unexpected” situation, they should take stock of their surroundings and ask themselves why they are feeling triggered. If an addicted person was frequently abusing alcohol or drugs in their own home or apartment, that location could be triggering in and of itself. They may not be able to simply avoid their own home for obvious reasons (although this is why Sober Homes are very helpful in early recovery). It may be beneficial in such cases to purchase new furniture or rearrange existing furniture to create a new space that they can associate with their newfound sobriety rather than their substance use.

5. Things

So, what exactly are things? Let’s start by remembering how addiction affects the brain, as mentioned above, and how even minor events can trigger a relapse, events that may not even occur to us. Glasses clinking, bottles popping, and cans opening, for example, may cause an alcoholic to think of alcohol. A cocaine addict or other drug addict may be reminded of their drug of choice by credit cards, straws, or a pill bottle or syringe. Anything you associate with your drinking or using should be kept in mind. We live in a world where such events are nearly impossible to avoid. With awareness and mindfulness, you can understand why you’re having cravings, why you’re feeling the way you’re feeling, and how to cope without using alcohol or drugs in any given situation. 

6. Lack of Self-Care 

Addiction recovery necessitates the practice of self-care. Self-care will improve your self-esteem and send a message to yourself that you are concerned about your well-being. Poor self-care, on the other hand, sends the message to yourself that you don’t care about your health and can lead to a relapse. Eating an unhealthy, low-nutrient, and/or high-sugar diet, for example, can lead to poor physiological and neurological health, which can lead to low mood and alcohol or drug cravings. Weight gain can make people depressed, and it can make them think that their substance use will help them lose the weight they’ve gained. Poor sleep hygiene can cause people to become irritable, stressed, anxious, and depressed, which can lead to a relapse. It is critical for people in recovery to eat well, exercise, meditate, sleep well, and engage in other self-care activities that support their mental health and addiction recovery. 

7. Intimacy and Relationships

If a person is not in an intimate relationship when they enter recovery, it is often recommended that they stay out of one for several months, if not a year, until their recovery is more stable. This is because newly sober people may attempt to fill the void with an intimate partner. There are numerous other reasons why dating in sobriety is discouraged. Dating and intimacy, for example, frequently involve alcohol, and a newly sober person may not know how to navigate the dating scene without it. Relationships (even long-term relationships that existed before recovery) can also trigger unpleasant and unwanted emotions that a newly sober person may not know how to deal with. Furthermore, because newly sober people may have never had sober sex, sexual experiences in recovery can be extremely triggering. Because of the potential for arguments, discomfort, or insecurity that relationships can bring, a newly sober person should proceed with caution in this area. 

8. Overconfidence and Pride

People who are new to sobriety may feel a pink cloud or believe that no matter what happens, they will never drink or use drugs again. Despite having such bad memories of their substance abuse, they are enjoying their recovery journey. Sure, it feels great to be confident in your recovery, but remember that anyone can relapse. It only takes a split second, being in the wrong place at the wrong time, or one bad thought to make a poor decision. Don’t put yourself in dangerous situations or seek them out to prove to yourself that you can stay sober at a party. Don’t get cocky or complacent or think you’ve been “cured.” Regardless of how confident you are in your sobriety, it is recommended that you follow treatment recommendations and engage in recovery-related behaviors and activities, as well as avoid people, places, and things that are incompatible with your sobriety.

9. Isolation and boredom 

Many people in early recovery could easily list boredom and isolation as the number one reason for relapse. Before recovery, they spent all of their free time getting their substance, using their substance, and recovering from their substance. As a result, people who are new to sobriety frequently find themselves with a lot of free time. When someone is bored or lonely, they are left alone, and as the saying goes, an addict alone is bad company. When bored or alone, one is left with their thoughts and emotions, which often refuse to be heard or felt. While it is important to avoid filling one’s days with activity after activity to escape reality and avoid one’s thoughts and emotions, being bored and isolated during early recovery is also unhealthy. Spend your free time participating in recovery-related activities such as exercising (joining a fitness or running club), cooking nutritious meals with loved ones, attending recovery-related therapy or support groups, or trying new activities and hobbies. 

10. Emotions That Make You Uncomfortable

When you were actively addicted, you used alcohol or drugs when you were tired. When you were angry, you drank or used drugs. You drank or used drugs when you were sad. You used alcohol or drugs when you were lonely. You drank or used drugs when you were stressed. Nobody wants to feel bad, but it’s a natural and necessary part of the human experience. Avoiding such emotions, or worse, using alcohol or drugs to cover them up and sweep them under the rug, is unhealthy. The more we accept unpleasant emotions and recognize that they are attempting to teach us something important about our current situation, the better equipped we will be to deal with and cope with them. Learning to be aware of emotions, accept emotions, feel emotions, and cope with emotions is an important part of the addiction recovery process.

Relapse rates for people who are recovering from a drug or alcohol addiction are unfortunately quite high. According to studies, 40-60% of people relapse within 30 days of leaving an inpatient drug and alcohol treatment facility, and up to 85% relapse within the first year. Individuals struggling with an alcohol or other substance addiction must recognize the high risk of relapse, be aware of their triggers, and learn to cope with their triggers and emotions healthily. Individuals can be better equipped and able to maintain their recovery by understanding common risks for relapse in addiction.

The longer a person can stay sober, the better their chances of long-term recovery are. As previously stated, up to 85% of people relapse within the first year of sobriety. The good news is that the longer one can maintain recovery, the better one chances of long-term sobriety become. Once a person has successfully maintained sobriety for a year, their chances of remaining sober increase exponentially. Do not believe you are cured just because you completed a 28-day inpatient treatment program.

Outpatient drug and alcohol treatment is highly recommended, as is having additional support such as a sober coach and/or sober companion. Participate in holistic recovery-related activities and surround yourself with people who care about your well-being.

According to recent drug relapse statistics, more than 85% of people relapse and return to drug use within a year of finishing treatment. According to studies, more than two-thirds of people in recovery relapse within weeks to months of starting treatment. 6. Why are the statistics on drug relapse so depressing? Most people will fail in their attempts to stay sober if they do not have a long-term drug relapse prevention plan in place, so having one in place is critical. Drug relapse prevention programs are designed to address the issue of relapse by teaching techniques for preventing or managing it.

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Relapse prevention models for drug addiction are based on the notion that high-risk situations make a person more vulnerable to relapse. People, places, or feelings that lead to drug-seeking behavior are examples of high-risk situations. Most people will fail in their attempts to stay sober if they do not have a long-term drug relapse prevention plan.        

This isn’t to say that a relapse isn’t something to be concerned about. Relapse prevention is an important part of good treatment programs, as it prepares patients for the possibility of relapse.G. Alan Marlatt, Ph.D., and Judith Gordon, Ph.D., developed relapse prevention therapy (RPT) over 40 years ago. This method aids people in recovery in anticipating the factors that might prompt them to revert to their addictive behavior — and preparing for them.

In RPT, there are three main areas of focus: 

  • Behavioral techniques/lifestyle changes: to assist people in developing habits that will help them recover and avoid relapses, such as regular sleep, exercise, and relaxation techniques.
  • Training in coping skills: to assist people in coping with cravings and urges, as well as potentially dangerous situations and emotions.
  • Interventions in cognitive therapy: to help people reframe their thoughts about relapse so that it becomes an opportunity to learn rather than a deep personal flaw.

It’s critical to stay focused on recovery right after a relapse. It’s critical to consider what caused the relapse to prevent it from happening again. Are there any positive or negative triggers that occurred just before the relapse, for example?

Stressful events can sometimes trigger a relapse, especially if the addictive substance or behavior was used to cope with the stress. However, happy occasions can set off a relapse, especially if others are drinking.

It’s critical to keep things in perspective. People can move on from their relapse with a stronger commitment to avoiding relapses in the future by avoiding or managing triggers before they happen.

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