What Is a Relapse in Addiction Recovery?

Relapse is the recurrence of any disease that’s gone into remission. Given that both substance use disorder and alcohol use disorder are classified as complex, chronic illnesses, the return to using drugs or alcohol after any prolonged period of abstinence is known as a relapse.

In addiction recovery, relapse is always a major risk. This is especially true during the first several years of recovery when the brain and body are still healing. During this time, people are still actively developing new coping skills.

For recovering addicts, there is no such thing as just one quick drink or single drug use. The fight to remain entirely substance-free is always an ongoing one. What many recoverees and their families may find surprising is that not every relapse culminates in an actual usage event. 

Contrary to popular thought, relapse doesn’t happen overnight. Instead, people usually go through several phases of relapsing, and some never physically return to substance use at all. Being able to identify the initial stages of a developing relapse is key for getting the right help and interventions early on. 

The Definition of a Relapse in Addiction

For most health issues, a relapse is identified by the return of physical symptoms. Conversely, relapse in addiction is defined by gradual changes in a person’s emotions, thinking, and behaviors. You don’t have to actually use drugs or alcohol to relapse. Instead, you might start romanticizing substances or substance use, distancing yourself from others, and gradually moving away from various types of post-treatment support.

Relapse ultimately occurs whenever addicts stop making recovery their first priority and begin exposing themselves to unnecessary risks for relapse. A person who’s relapsing will likely stop attending sober meetings and lose contact with their sober sponsors or accountability partners. Stressful situations and negative emotions are among some of the most common triggers for relapse. People are more likely to enter the early stages of relapse when:

• Dealing with stressful, work-related issues
• Experiencing financial distress
• Exposed to toxic or volatile relationships
• Exposed to others who drink or use drugs for stress relief

Certain environmental factors can also increase the likelihood of relapse. Going to bars or other high-risk situations with friends can tempt people to return to their former life habits. In some instances, even simply passing by these establishments, smelling familiar smells, or seeing familiar faces can incite feelings of longing and nostalgia.

In these situations, recovering addicts may negotiate with themselves to establish a seemingly “safe” plan for substance use. Rather than imagining a return to full-blown addiction, many people think that they can use substances in a controlled and limited way. They may even cite some of the strategies and coping techniques that they learned in rehab to further justify their return to substance use.

What Contributes to a Relapse?

During professional addiction treatment, recovering addicts spend a considerable amount of time devising their own post-treatment support plans. Rehab counselors work with clients to help them find the right resources and opportunities for avoiding:

• Joblessness
• Homelessness
• Financial stress
• Serious legal issues

and other common relapse triggers. When recovering addicts are able to establish comfortable and stable lives, they’re less likely to be confronted with overwhelming stress or other emotions that create the desire to use. 

However, stress isn’t the only driver for relapse. Choosing the wrong friendships and environments can leave a person vulnerable to relapse as well. This is why many recovering addicts choose to enter sober living facilities after exiting rehab.

A sober living home is an excellent bridge between formal, inpatient treatment and the return to the outside world. These environments aren’t rife with triggers and temptations, and they offer the support that newly recovered addicts often need for keeping their lives on track.

Post-Acute Withdrawal Syndrome and Relapse

During detox, most people contend with a diverse range of uncomfortable, physical withdrawal symptoms. However, once these early symptoms abate, they are invariably followed by post-acute withdrawal syndrome (PAWS) that are entirely psychological. PAWS include:

• Lack of motivation
• Malaise
• Insomnia
• Depression

and anxiety among other things. PAWS are most intense during the first one to two months of recovery, but they can occur at random for one to two years or even longer. Dealing with PAWS and lacking the right interventions often leads to relapse. The first stage of relapse is emotional relapse. Thus, people who are lonely, anxious, depressed, having a hard time sleeping, or dealing with prolonged bouts of restlessness are likely at the very start of relapse.

Types of Relapses

There are many different types of relapse and they are best defined by their underlying causes. Among the four most common are:

• Avoidance Relapse
• Perfectionism Relapses
• Overwhelmed/Excess Stress Relapse
• Social Pressure Relapse

Social pressure relapses are often the easiest to avoid. By steering clear of friends and family members who are actively using drugs or alcohol, and by avoiding environments in which substances are present, you can sidestep the most common social triggers. This is something that many recovering addicts are able to accomplish by:

• Spending time in sober living homes
• Extending their inpatient treatment stay
• Only engaging with individuals who are willing to prioritize their recoveries

Post-treatment support services can be helpful for preventing overwhelming stress. In outpatient treatment, relapse prevention programs, and sober living facilities, patients are exposed to resources such as transportation assistance, financial assistance, housing assistance, and legal assistance. Knowing when to reach out for help and maintaining close contact with sober sponsors can be beneficial to this end as well. These are all excellent strategies for preventing relapses caused by excess stress.

Perfectionism relapse occurs when shortcomings or perceived failures in other life areas cause people to throw the proverbial towel in on their recoveries. For instance, after addiction treatment, you might be struggling to control angry outbursts, stop smoking cigarettes, or achieve specific career goals. Taking an all-or-nothing approach to rebuilding your life after addiction treatment is dangerous. It’s generally best for people in recovery to celebrate their sobriety one day at a time and to limit pressure on themselves to perform or over-perform in other areas.

Stages of a Relapse

Relapse typically occurs in three distinct stages:

• Emotional
• Mental
• Physical

During an emotional relapse, most people are hardly aware that they’re relapsing at all. They might be suffering from extreme feelings of malaise and discontentment, or dealing with anxiety or depression. During an emotional relapse, it’s not uncommon for people to begin distancing themselves from others and spending more time in isolation. People in the first stage of relapse often stop attending sober meetings and actively using other forms of post-treatment support.

Mental relapse occurs when people start negotiating with themselves concerning substance abuse. At this stage, people romanticize substances and convince themselves that drinking or drug use can be controlled in sustainable ways. They may even begin to fantasize about buying drugs or alcohol and using them. Physical relapse is the final stage of relapse, and it entails one or more actual use events. When interventions aren’t received during emotional or mental relapse, physical relapse becomes increasingly likely.

Relapse at any stage is often a sign that more treatment is needed. Relapse can also mean that you may need other treatment types. A single relapse event doesn’t mean that recovery from drug addiction has come to an end. In fact, relapse is so common among recovering addicts that it’s often considered an expected part of the recovery process. Working with rehab counselors is a great way to identify the underlying cause of your relapse, and to start implementing the right preventative measures and mitigation strategies.

If you’ve recently relapsed or if you’ve been fantasizing about returning to drug or alcohol use, we can help. At Mississippi Drug and Alcohol Treatment Center, we offer a comprehensive range of treatment programs for meeting the needs of patients at every stage of the recovery process. Call us today to find out more about our inpatient and outpatient programs, and our options in aftercare support.