How to Prevent or Manage Relapse in Addiction Recovery

Addiction relapse is a common worry among people in recovery and their loved ones.

This page will cover what relapse is, the risk factors for relapse, how to help prevent a relapse, and what to do if you or your loved one experiences a relapse in recovery.

What Is Addiction Relapse?

Addiction relapse is when someone with addiction drinks or uses drugs again after a period of sobriety.¹

To better define what an addiction relapse is and what causes it, it helps to understand first a little bit more about substance use disorder, the clinical term for addiction.

Substance use disorder (SUD) is a chronic condition—characterized by compulsively seeking and using substances despite serious consequences—that requires lifelong management.^1,2 Treatment can help a person gain control over their behaviors; however, it does not cure someone of their addiction.¹

Relapse is a characteristic of other chronic, incurable medical conditions as well—not just addiction. In fact, the relapse rate of an SUD is comparable to that of other chronic medical illnesses, such as asthma or high blood pressure.¹

Drug and alcohol relapse is not a failure of someone’s strength or character; rather, it is an indication that their treatment plan needs to be resumed, reevaluated, or possibly changed.¹

How Does Addiction Relapse Happen?

When a person has a relapse, it is not that they just chose to start using again or lacked the willpower to stay sober.² Chronic substance use can cause changes in the brain, particularly in the areas of the brain that are associated with stress, reward, and self-control.²

People with addiction often experience intense, uncontrollable cravings for substances when they attempt to abstain.³ However, treatment can help patients develop effective coping methods and tools to avoid cues that trigger cravings in order to manage them, in hopes of enabling many people to avoid relapse and remain in recovery.¹ Relapse prevention is a key element of many addiction treatment programs, like the ones offered at Desert Hope in Las Vegas, Nevada.

Potential Signs of an Impending Relapse

A common theoretical model used in drug and alcohol relapse prevention treatment frames relapse in 3 stages. This theory of addiction relapse indicates that the actual physical act of drug or alcohol use occurs long after the relapse process actually starts.⁴ The stages of relapse are as follows:⁴

• Emotional. During the emotional stage, patients don’t intend to drink or use drugs; however, their behaviors are setting them up to stumble in the future. Because they don’t intend to relapse, they may be in denial about the risk of it happening, which keeps them from effectively preventing the relapse from progressing.
• Mental. The mental stage of relapse is characterized by a battle between someone’s wishes to stay sober and their cravings.
• Physical. This is when a person ultimately drinks or uses drugs again. Because of the nature of addiction, this person will likely be unable to control their substance use, necessitating correction and for treatment to resume.

According to this theory, there are signs at each stage of the relapse process. In the stage of emotional relapse, a person is likely to engage in:⁵

• Suppressing emotions.
• Isolating from others.
• Not attending support group meetings or going to meetings but not sharing.
• Focusing on other people’s issues or behaviors, and not themselves.
• Poor self-care, including unhealthy eating and sleeping habits.

The next stage of substance use relapse, according to this theory is mental, where people may show signs such as:⁵

• Having cravings to use substances.
• Thinking about the people, places, and things associated with substance use.
• Downplaying the consequences of past use.
• Bargaining, where people try to think of ways to use that seem justified, such as using on a vacation.
• Lying.
• Thinking of ways to control use.

In the last stage—physical relapse—the person may display physical and behavioral signs of substance use. The physical relapse is most likely to occur when patients have the opportunity and believe they can hide their use and escape detection from loved ones or treatment providers.⁵

What Causes a Relapse in Recovery?

The actual causes of drug and alcohol relapse are hard to determine, as there may not be a single direct cause. However, one can lower their risk of relapse by identifying and avoiding triggers their brain consciously or unconsciously associates with substance use.¹

Common Relapse Triggers to Look Out for

There are many triggers for relapse, such as:

• Memory cues, like certain people, places, or things, which can cause intense cravings. For example, someone may feel strong urges to relapse when passing by a place where they used to drink or use drugs.¹
• Being in close proximity to the substance (e.g., going to a party where others are using drugs) can be a trigger for many people.¹
• Studies have found stress to be associated with an increased risk of developing addiction, as well as experiencing cravings for substances and relapse.⁶
• Depression, which is a common co-occurring disorder found alongside addiction. Often, more severe depression is correlated with shorter periods of recovery among people with an SUD.⁶
• Withdrawal, especially during early recovery. Unpleasant withdrawal symptoms such as cravings, irritability, and sleep problems, can make it very hard to avoid drugs and alcohol.^1,6

Who Is Most at Risk for Addiction Relapse?

There are many factors that can put a person at greater risk of relapsing on drugs and alcohol. Some of these include:^6,7

• The severity of addiction and physiological dependence on a substance, with more extreme levels being associated with higher rates of relapse.⁶
• Stronger cravings during treatment are associated with higher rates of relapse.⁶
• Having a co-occurring disorder, such as depression.⁶
• Lack of coping skills.⁷
• Believing that substance use has positive benefits, such as decreasing anxiety.⁷
• Less social support.⁷
• Lack of motivation to change.⁷
• Having a comorbid medical condition.⁷
• For older people, in particular, having depression, grieving, or being socially isolated.⁷

How to Prevent Drug and Alcohol Relapse

Preventing relapse is a combination of several interventions. Some of these include:

• Working with a treatment provider to develop a written relapse prevention plan.⁷
• Going to a 12-Step meeting or another form of mutual support group. ⁷
• Staying in treatment for an adequate length of time to ensure the skills and strategies needed to remain in recovery have been properly developed.⁹ Additionally, living in a sober-living facility after formal treatment can provide the added benefit of a drug and alcohol-free living environment with a supportive sober network.
• Ongoing monitoring to encourage recovery and abstinence.
• Educating participants about the course of recovery and warning signs of relapse.⁷
• Encouraging people to develop a healthy lifestyle and self-care habits.⁷
• Using mindfulness meditation.⁷
• Treatment for co-occurring mental health disorders, such as depression, PTSD, or anxiety.⁷
• The use of medication in the treatment of certain types of SUDs, including opioid use disorders and alcohol use disorders, in combination with behavioral therapies.⁹
• Cognitive-behavioral therapy (CBT), which uses techniques to help people deal with cravings, cope with relapse cues, and build problem-solving skills. ⁸
• Contingency management (CM), which utilizes incentives to avoid relapse. The incentives chosen for CM are reinforcing to a person, such as vouchers for needed items, or small rewards.⁸
• Brief interventions (BI), which involve short, targeted conversations with people to help them understand that substance use is risky and encourage them to seek treatment or stop using.⁸

What to Do if Someone Relapses

Addiction relapse requires an urgent response. This is especially the case with substances like opioids, where the threat of overdose is heightened after periods of abstinence and subsequent loss of tolerance.⁷

The various types of relapse prevention techniques typically incorporate a relapse management strategy to follow in case a relapse occurs.⁸ If you have a loved one in recovery, it may be helpful to have a conversation and familiarize yourself with this plan so you can better support them if and when relapse happens.

As noted earlier, a relapse typically requires someone to resume or shift their addiction treatment.¹ If you or your loved one has relapsed, Desert Hope offers several levels of substance abuse treatment. The inpatient treatment in Las Vegas and various outpatient rehab options can help you or your loved one after a relapse.

Desert Hope admissions navigators are available 24/7 to assist with the rehab admissions process or answer any questions regarding what to expect in inpatient rehab. One of your big concerns might be how to pay for rehab and whether your health insurance covers the cost of rehab, which our staff can assist you with.

You can also confidentially or see if you qualify for financing by completing the questionnaire below.