Relapse is a very common occurrence for those recovering from addiction. In fact, relapse rates for drug and alcohol addiction are estimated to be between 40-60%. This means that nearly half of all people in recovery will relapse at some point. Relapse is often referred to as a “part of the process” of recovery, but that doesn’t make it any less dangerous or devastating when it happens. When someone relapses after a period of sobriety, they are at very high risk for overdose due to reduced tolerance levels. Relapse also often leads to feelings of shame, guilt, and failure which can compromise recovery efforts. Identifying and understanding the most common causes of relapse is therefore critical in order to help prevent and reduce the risk of relapse.
What is Relapse?
Relapse refers to the process of returning to substance use after a period of abstinence. This could mean:
– Using alcohol or drugs again after a period of sobriety
– Returning to previous levels of problematic use
– Suffering a “lapse” or “slip” which leads to full blown relapse
Relapse is not an event, but a process. It usually starts weeks or months before the actual return to substance use. This can involve emotional, psychological, or behavioral changes and warning signs. Catching these early warning signs is key to relapse prevention.
Relapse Warning Signs
– Cravings for alcohol or drugs
– Glamorizing past drug or alcohol use
– Isolating from friends and family
– Neglecting self-care and recovery practices
– Skipping meetings, therapy, or appointments
– Changing behaviors, friends, hangouts
– Suffering a personal loss or crisis
– Experiencing work, financial, or family stress
The Dangers of Relapse
Relapse is extremely dangerous and can have severe consequences including:
– Drug overdose or alcohol poisoning due to reduced tolerance levels
– Legal issues such as DUI’s or drug possession charges
– Job loss, financial problems, or academic issues
– Deterioration of relationships and support systems
– Deep feelings of shame, guilt, failure, and despair
– A belief that sobriety is not possible long-term
The Most Common Causes of Relapse
While relapse can be triggered by many different factors, there are a few primary causes that tend to lead to relapse again and again:
1. Stress
Stress is arguably the number one cause of relapse across all types of addiction. When we experience high levels of emotional, psychological, or physical stress, it taxes our coping resources. Our usual coping mechanisms may not be enough, causing us to crave alcohol or drugs in order to deal with all the tension and chaos.
Stress can come in many different forms including:
– Work or career stress
– Financial stress
– Major life changes or transitions
– Family issues or relationship problems
– Social stress or isolation
– Stressful world events or politics
– Inner emotional turmoil or trauma
Learning healthy stress management techniques is imperative for relapse prevention. This can include exercise, meditation, therapy, improving time management, and asking for help and support.
2. Social Pressure
Humans are social creatures by nature. When we remove alcohol or drugs from our lifestyle, it can mean disrupting our social routines and relationships. This social pressure and loneliness can cause major temptation to relapse.
Common social relapse triggers include:
– Spending time with friends who still drink or use drugs
– Special occasions or holidays where alcohol is present
– Work happy hours or social events centered on drinking
– Fear of social awkwardness or missing out by not drinking
– Boredom and desire to have fun or party
Rebuilding a sober social support system is crucial in recovery. This can involve:
– Making new sober friends through support groups or activities
– Planning sober social events and trips
– Bringing a sober friend to events with alcohol
– Asking friends/family not to drink around you
– Finding enjoyable sober hobbies and activities
3. Physical Withdrawal
For those recovering from alcohol, opioids, benzodiazepines, and other substances, physical withdrawal can be an extremely powerful trigger for relapse. Withdrawal symptoms can include:
– Body aches and pains
– Nausea and vomiting
– Insomnia or sleep issues
– Anxiety and agitation
– Increased blood pressure and heart rate
– Hands trembling
– Sweating and fever
Post-acute withdrawal (PAWS) can also cause cravings and relapse risk for weeks or months after acute detox. Medication assisted treatment, medical supervision, therapy, exercise, proper nutrition, and support can help manage withdrawal.
4. Untreated Mental Health Issues
Research shows that up to 65% of those with addiction also suffer from another mental health disorder. Some of the most common dual diagnosis combinations include:
– Alcoholism + depression
– Addiction + bipolar disorder
– Addiction + PTSD
– Addiction + anxiety disorders
Attempting recovery while ignoring underlying mental health issues can sabotage rehab efforts and result in self-medication through drugs or alcohol. Seeking integrated treatment for both addiction and mental health can improve outcomes.
5. Romanticizing Past Drug Use
Those in recovery may find themselves reminiscing about the pleasurable effects of their drug(s) of choice. They recall and romanticize the euphoria, relaxation, confidence, and escape they once experienced. This denial minimizes memories of the negative consequences.
Fantasizing about using can quickly lead one to rationalize a relapse. Challenging thoughts about use through counseling, journaling, and sober social support can help counter cravings and temptation.
6. Access & Availability
If drugs or alcohol are readily available to us, the temptation to relapse skyrockets. This could mean drugs stored in the home or alcohol in the refrigerator. Even keeping phone numbers of old dealers or drug buddies can provide quick access if relapse thoughts arise.
Avoiding bars, parties, neighborhoods, and other triggers can also help reduce availability. Asking family members not to use or drink around you decreases access. Boredom and clearance from daily responsibilities also increase opportunity to relapse.
7. Complacency in Recovery
In early recovery, vigilance against relapse is usually high. Over time, this vigilance can fade. We may start to feel we have addiction “beat” and become complacent. Meetings and support systems are dropped or neglected. Healthy routines like exercise, meditation, and journaling fall by the wayside.
When complacency sets in, relapse risk rises. Staying actively engaged in recovery helps maintain motivation and vigilance. Adding new tools like yoga, volunteer work, or sober meetups can also inject energy into lifelong recovery.
How to Prevent Relapse
While there are many relapse triggers to be aware of, the good news is relapse is preventable through proactive strategies:
Seek Professional Help
Getting assistance through rehab, therapy, medication management, and support groups can provide the tools and accountably needed for recovery. Don’t try to go it alone.
Identify High-Risk Situations
Each person has unique triggers for relapse. Figuring these out and planning ahead can help avoid or manage these scenarios.
Have a “Relapse Emergency Kit”
A kit might include: recovery literature, healthy snacks, inspirational notes, phone numbers of supports, calming activities, and items that engage our senses.
Practice Self-Care
Relapse often happens when we stop making recovery a priority. Daily self-care habits build a foundation.
Stay Busy and Active
Boredom and too much free time breeds relapse. Having a routine, job, hobbies, responsibilities, and social life keeps us engaged.
Avoiding Alcohol and Drug Triggers
This might mean changing your hangouts, social circle, route home from work to avoid passing the old liquor store, deleting dealer numbers, or going to non-alcoholic restaurants.
Catch It Early
At the first sign of relapse thought patterns, take action! Call your sponsor, go to a meeting, schedule an appointment with your counselor. The longer we wait, the weaker resistance becomes.
| Relapse Trigger | Prevention Strategy |
|---|---|
| Stress | Meditation, exercise, time management, asking for help |
| Social Pressure | Sober social events, bringing a sober friend, avoiding risky situations |
| Physical Withdrawal | Medical detox, medication management, nutrition |
| Mental Health Issues | Integrated treatment for mental health and addiction |
| Romanticizing Past Use | Counseling, support group meetings, journaling |
| Access and Availability | Avoiding triggers and high-risk places, asking family not to use around you |
| Complacency | Staying actively engaged in recovery, trying new tools like yoga or volunteering |
What To Do After A Relapse
If relapse does occur, here are steps to take:
– Seek medical care if needed for overdose or alcohol poisoning
– Be gentle with yourself; relapse is common but DOES NOT mean treatment has failed
– Examine the relapse to identify your triggers and high-risk scenarios
– Reach out to your addiction counselor, sponsor, or supports
– Attend recovery meetings and be transparent about the relapse
– Consider intensifying your recovery plan and treatment
– Learn from the experience to strengthen your sobriety moving forward
The Danger of Relapse Cycles
One of the biggest dangers after a relapse is getting caught in the “relapse and recovery cycle.” This is where someone relapses, feels guilt and attempts sobriety, relapses again, and repeats this over and over. Each failed attempt can reinforce the idea we can’t get sober and diminish self-esteem.
Breaking this cycle often requires professional treatment, connection with others in recovery, and examining unresolved core issues leading to relapse. With hard work and the right supports, the relapse cycle can be broken for good.
Conclusion
While there is no single cause of relapse, the most common triggers include stress, social pressures, withdrawal, untreated mental health issues, romanticizing drug use, access and availability, and complacency. Being aware of personal relapse warning signs and having practical prevention strategies in place are key to maintaining sobriety long-term. Relapse is common, but definitely not inevitable with the right tools. For those who do experience relapse, hope should not be lost. Each day is a new opportunity to start again and apply what has been learned in recovery. Lifelong growth and vigilance can help ensure relapse triggers remain in the past, not the present.