What is the Definition of Relapse?

A relapse occurs when an individual who is in recovery from drug or alcohol abuse returns to substance use. There is no agreed-upon length of time you must be sober before your drug use is considered a relapse, but it should be established that you’re in recovery from your addiction.

The way we talk about a relapse is important because it can affect the narrative you create for yourself and your recovery. A drug or alcohol relapse doesn’t mean that you failed, and it doesn’t mean that you cannot continue on the path to sobriety.¹ When professionals define relapse, they generally view it as a part of the recovery process.

Is a Relapse a Normal Part of the Recovery Process

Addiction is a chronic, relapsing condition characterized by compulsive substance abuse regardless of negative consequences. As such, relapsing is a very common part of the addiction recovery process—in fact, between 40% and 60% of people in recovery relapse at some point. These figures are comparable to relapse rates in individuals being treated for asthma or high blood pressure.¹

Not everyone who quits drinking or using drugs relapses, but many do—many times over. And it’s not a sign of failure on your part. All it means is that you’ve had a temporary slip-up and that you may need some extra support. If you’ve relapsed, that may be a sign that you need to re-enter treatment, work with your therapist or doctor to change your treatment plan, or seek a new recovery program.¹

Ultimately, the worst thing you can do is shame yourself for returning to drug or alcohol use. Learning to live a substance-free lifestyle takes a lot of practice, and it’s normal for it to take a while for you to replace your maladaptive habits with healthy behaviors. A relapse prevention plan can help you stay sober in the long run.

If you have relapsed or you worry that you will relapse, call 800-681-1058 (Who Answers?) to talk to a recovery support specialist about your treatment options. Making the decision to pick up that phone and get help can be difficult but it will make all the difference.

Common Triggers: What Causes a Relapse?

It’s important to know what the common relapse triggers are so that you can do your best to avoid or minimize them. Common triggers for relapse include:^1,2

• Being around people you used to do drugs with.
• Passing by or spending time at places you used to do drugs or drink.
• Drug paraphernalia.
• Seeing people do drugs.
• Stressful life events.
• Moods that previously caused you to seek out and do drugs.

If you are aware of what specific situations, people, and places trigger you, then you are better equipped to stay away from them to reduce your risk of relapse. This may mean having to end old friendships, especially with dealers.

Prevention

We already reviewed one major way to prevent relapse: avoiding stressful cues and relapse triggers. If you are diligent about this, you are far less likely to relapse than someone who is still spending a lot of time around drug-related cues. Here are a few more ways to prevent a drug relapse and stay sober:³

• Make sure you complete your addiction treatment program.
• Be honest with your therapist or counselor about your struggles.
• Ask for help, if necessary. You never have to do this alone.
• Practice self-care, whether that means meditating every morning, taking a bath at night, or going for a run.

You may not realize this, but relapse actually occurs gradually—it may begin weeks or even months prior to when you actually wind up using a drug or having a drink. Professional treatment can help you learn to identify the early warning signs of relapse and develop the coping mechanisms necessary to avoid returning to substance abuse.

Below are some common early signs of relapse:³

• Isolating yourself.
• Not going to meetings if you attend AA or NA.
• Bottling up your emotions.
• Focusing on other people’s problems.
• Attending AA or NA meetings but not sharing.
• Poor sleeping and eating.
• Drug or alcohol cravings.
• Thinking about people, places, and things associated with substance abuse.
• Glamorizing drug use.
• Minimizing previous consequences of your use.
• Lying.
• Bargaining.

Most relapses occur because you are faced with an opportunity to have a drink or use a drug and you feel that you won’t be caught. A major part of developing a relapse prevention plan is learning to identify these situations, rehearsing what you will do or say when they arise, and creating healthy strategies to exit the situation.³

Dangers of Relapse After a Period of Abstinence

Although relapsing should absolutely be a normalized part of the recovery journey, it still comes with some dangers—namely, the increased risk of overdose associated with certain substances, such as:

• Opioid painkillers
• Heroin
• Sedatives, like barbiturates or benzodiazepines
• Alcohol

There is an increased risk of overdose after a period of sobriety because your tolerance to the substance has decreased during abstinence. Tolerance develops when your body adapts to the presence of alcohol or drugs, which means that you need higher amounts or doses to feel the same desired effects. But once you stop using drugs, you may not realize that your tolerance goes down and you need less of the drug to get high. If you return to your typical dose from when you were using, you may accidentally overdose, which could be fatal.¹

Typical signs of an overdose may include:⁴

• Unconsciousness
• Shallow breathing
• Heart rate slows or stops
• Coma
• Unresponsiveness
• Pale, blue, or cold skin
• Vomiting or gurgling noises

If you or someone you love is in recovery from opioids, such as prescription painkillers or heroin, you may want to obtain naloxone (Narcan) and carry it with you. Naloxone is a life-saving medication that can reverse opioid overdoses. Every state is different, but in many states, you can buy it without a prescription from pharmacies, such as CVS, Rite Aid, or Walgreens.

What to Do If You Relapse

The first thing you should do after you relapse is seek out support, whether from an addiction professional or your NA or AA sponsor. You shouldn’t be alone during this time. The sooner you reach out to a trusted person, the better it’ll be for your recovery.

If you’ve relapsed from drug or alcohol use, you may want to re-enter an addiction treatment program where you can get back on track. There’s nothing wrong with going back to a recovery program—in fact, it means that you’re taking the right steps to make sure your relapse doesn’t escalate. If you liked your previous treatment program, you may want to return to that one, but if you didn’t love it, now might be the time to find one that better suits your needs.

You can always call 800-681-1058 (Who Answers?) to discuss your rehab options with a treatment support specialist. They will help you find the perfect addiction treatment program for you.

Sources

1. National Institute on Drug Abuse. (2020). Treatment and Recovery.
2. National Institute on Drug Abuse. (2020). What Triggers a Relapse? “Cues” Give Clues.
3. Melemis, S. M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale Journal of Biology and Medicine, 88(3), 325-332.
4. S. National Library of Medicine. (2020). Opioid Overdose.