Drug & Alcohol Relapse: Definition, Risk Factors and Treatment

Although drug and alcohol relapses can be a regular part of recovery, a relapse with certain drugs can have dangerous or fatal consequences.

Drug and alcohol relapses can occur when someone stops using alcohol or drugs, and cravings, triggers and withdrawal symptoms tempt them to use substances again. Understanding why relapses occur and knowing the warning signs or triggers can help prevent drug and alcohol relapse.

What Does It Mean to Relapse?

A relapse is returning to regular misuse of alcohol or drugs after a period of sobriety. It differs from a slip when someone uses a substance once and then returns to their recovery goals. A relapse is a complete departure from recovery goals, and the person often struggles to return to sobriety. Substance use tends to return to previous levels during a relapse or even worsens.

Types of Relapse: “Traditional” vs. “Freelapse.”

A relapse is when someone abstaining from drugs or alcohol returns to their previous level of use. A “freelapse” refers to when someone unknowingly or unwillingly consumes drugs or alcohol with no intention of continuing substance use. An example of a freelapse is when someone sober from alcohol is given a drink that has alcohol in it without their knowledge, and they drink it.

The Three Stages of Relapse

Recovery is an active process requiring daily commitment. While relapses may seem spontaneous, some stages lead to the event.

Emotional Relapse

Emotional relapse is the beginning phase of relapse when a person is not actively working on sobriety. A person experiencing emotional relapse may not be attending to or managing their emotions, which puts them at risk of mental and physical relapse. Examples of emotional relapse can include:

• Isolation
• Not attending or sharing at meetings
• Not reaching out to support systems
• Poor self-care

This stage of relapse can be tricky because someone is not thinking about using substances, but their emotional state is setting them up for a relapse.

Mental Relapse

Mental relapse is the second phase, which can occur when one’s emotions are not being regulated in a healthy way. It is when someone is considering using alcohol or drugs, and their ability to resist using decreases over time. Mental relapse signs include but are not limited to:

• Thinking about past drug use
• Hanging out with individuals who use
• Having cravings
• Planning situations in which it is acceptable to use
• Looking for situations to relapse

Physical Relapse

If a person fails to confront and deal with their mental and emotional relapse symptoms, their risk of a physical relapse increases. Physical relapse is intentionally using drugs or alcohol. If this occurs, it does not mean recovery has irreversibly failed. You can seek treatment before the relapse becomes unmanageable or even immediately after the point of physical relapse.

Signs of a Relapse

Common warning signs of a relapse exist. If you notice any of these behaviors in yourself or a loved one, it is important to seek treatment before things get out of control.

• Isolation and social withdrawal
• Expressing cravings
• Poor self-care
• Missing meetings or therapy sessions

• Sudden behavioral changes
• Bottling up emotions

Common Risk Factors For Relapsing

Triggers

A trigger initiates certain feelings that can lead to actions. With substance use disorder, a trigger for relapse can be running into someone who was associated with the use of drugs or alcohol. Being in an environment such as a party or location where substance use frequently occurred can also trigger someone to crave drugs or alcohol. Triggers can also be emotional, such as stressful situations, trauma responses or interpersonal relationship conflict.

Stress

Stress can be another reason someone relapses from their sobriety. We encounter stressful situations every day, but someone with a history of substance use who does not have the necessary coping skills to deal with stress may be more likely to relapse. Work stress is a common factor that contributes to relapse.

Interpersonal Issues

If someone is experiencing issues in their relationships with friends, family or romantic partners, this can lead to feelings of stress and anxiety. Negative emotions that go unmanaged may contribute to relapse in someone abstaining from drugs or alcohol. There may also be feelings of a lack of support in someone recovering if they are experiencing issues with their social support.

Peer Pressure

It can be difficult to fully disengage from people who use drugs or alcohol in various settings, which can become triggering for someone recovering. If this person is around people or situations with substances, it can become increasingly more difficult to stay in recovery if there is peer pressure to participate in drug or alcohol use.

Pain

Physical pain can be tricky to manage regarding relapse prevention. There are legitimate reasons why someone with a history of substance use may be prescribed pain medication by a doctor, such as post-surgery care or after an injury. A medical professional and a therapeutic team must closely monitor these situations to ensure that the prescribed use of something does not lead to improper use or cause a relapse.

Limited Social Support

If someone does not have a strong support system in their recovery, it can be difficult to maintain sobriety. Factors like stress or triggers can lead to a relapse if someone does not have support to help them cope.

Low Self-Esteem

Low self-esteem or poor self-perception can be a risk factor for relapse. Consistent negative emotions or a poor belief that they can maintain sobriety can make it more difficult to prevent a relapse in someone with a history of substance use.

Related: What is a Dry Drunk?

How To Handle a Relapse In the Short-Term

If you or someone you know experiences a relapse, thinking of what to do next can be overwhelming. The following things can be done to handle a relapse in the short term.

• Seek support: Reach out to social and emotional support teams to discuss what may have triggered a relapse.
• Attend support groups: Connecting with others who have experienced and conquered a relapse can help guide someone in their journey to recovery.
• Avoid triggers: Avoiding the situation that caused the relapse and may cause a future relapse is important in moving forward.
• Set boundaries: Someone who has experienced a relapse should set limits with themselves and others to maintain their mental, physical and emotional health after a relapse.
• Practice self-care: Proper self-care, such as good sleep habits, adequate nutrition and a healthy exercise routine, can help someone recover from a relapse.
• Reflect: Using the time after a relapse to think about why it occurred and how it can be prevented is a healthy coping mechanism after a relapse.
• Create a plan for staying sober: The best way to stay sober after a relapse is to have a plan in place to avoid another relapse. Working with medical professionals and a support system to create a barrier to substance use is important in relapse prevention.

Is Relapse a Part of Recovery?

According to the National Institute on Drug Abuse, relapse is normal and a part of recovery. It becomes less common the longer someone is sober. Despite its normalcy, a relapse with certain drugs can have devastating consequences. If a person relapses using the same amount of drugs they did before pre-recovery, they have an increased risk of overdose. In addition, a relapse can make a person in recovery feel shameful, leading to isolation and more intense drug use.

Find Sobriety Again With Professional Addiction Treatment

Relapse is not a sign of failure. In fact, it could be one step closer to a long-term recovery. If you or your loved one is battling addiction, consider seeking treatment at The Recovery Village at Baptist Health. We offer comprehensive treatment programs for alcohol misuse and drug addiction, including medical detox programs. Contact a Recovery Advocate today to learn more about our programs or to begin the admissions process.