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Relapse: Signs, Causes and Effects

Navigating the road to sobriety is filled with hurdles, and one of the most significant challenges is the risk of relapse. However, understanding its frequency, triggers, and underlying mechanisms can empower you to manage it more effectively. Addiction is a persistent condition marked by an uncontrolled urge to use substances, even when they bring about negative outcomes. Experiencing a lapse or relapse isn’t a mark of weakness or failure; rather, it signals a need for new coping strategies. With the right support network, a fulfilling life post-addiction is entirely achievable. Staying engaged and employing robust relapse prevention methods can significantly enhance your life quality and pave the way for sustained sobriety.

It’s crucial to recognize that a relapse doesn’t indicate a failed treatment. Like managing other chronic conditions, addiction recovery is a long-term endeavor that may include occasional setbacks. Being aware of what prompts a relapse is key to avoiding it. Whether it’s emotional turmoil, specific settings, or social influences, pinpointing these triggers allows you and your healthcare team to fine-tune your treatment strategy.

Relapse often unfolds gradually and can be halted if detected early. Continuous support and treatment are vital for spotting early warning signs and taking proactive steps. The likelihood of relapse in substance use disorders is comparable to that in other chronic health issues like high blood pressure and asthma. This parallel highlights the importance of flexible, ongoing treatment plans that can be adjusted as circumstances change.

What Is A Relapse?

What is Relapse?

Relapse is a stage in the addiction cycle characterized by the resumption of substance use or behavior, such as gambling, after a period of abstinence or controlled use. It’s a common event, particularly for those new to the recovery journey, and should not be seen as a failure. Instead, it serves as an indicator that the existing treatment plan may require modification. A relapse typically involves a return to previous levels of substance use or behavior, often triggered by stressors or emotional events, and signifies difficulties in managing the addiction.

In contrast, a lapse is a brief or temporary return to substance use or behavior, which doesn’t necessarily escalate back to previous levels. For instance, consuming alcohol once after weeks of abstinence due to a stressful event would be considered a lapse. The key difference between a lapse and a relapse is the duration and intensity of the behavior. A lapse is momentary and often serves as a wake-up call to refocus on recovery efforts, while a relapse indicates a more significant setback that requires immediate attention and possibly a revision of the treatment plan.

Both lapses and relapses are common occurrences in the path to recovery and should be approached as opportunities for learning and growth rather than as signs of weakness or failure. The crucial action in either case is to seek help and adjust one’s approach to treatment and coping strategies

What is Sobriety?

Sobriety is more than just the absence of alcohol or drugs in your system; it’s a lifestyle choice aimed at holistic well-being. Sobriety refers to the state of not being under the influence of alcohol or drugs. It’s a clear and conscious condition where an individual does not consume or is not affected by any intoxicating substances. Sobriety is often seen as a daily choice, a continuous commitment to avoiding the substances that once controlled one’s life. While some define sobriety as complete abstinence from substance use, others focus on the ongoing process of recovery, which includes developing coping mechanisms and habits that support long-term health and wellness. The ultimate goal may be total abstinence, but it’s crucial to understand that setbacks, or relapses, are often part of the journey. You can’t relapse without getting sober in the first place.

Why Do People Relapse?

There are many different reasons why someone can relapse. The main drivers of relapse are emotional triggers, environmental factors and complacency.

Emotional Triggers: “Emotions are the gateway to relapse,” (verywell Health). Emotional triggers such as stress, anxiety, or depression can make individuals more susceptible to relapse.

Environmental Factors: Being in an environment that encourages substance use or being around people who use substances can be a significant trigger. “Your environment can either support your recovery or undermine it,” Dr. Michael Olla.

Complacency: After a period of sobriety, some people become complacent, thinking they are “cured.” This mindset can lead to risky behaviors that trigger a relapse. When someone with a substance use disorder stops their treatment routine, relapse becomes more likely.

What Are The Early Warning Signs And Symptoms Of Relapse?

Relapse is a common concern in the journey to recovery from drug addiction. Recognizing the early warning signs and symptoms of a drug relapse is crucial for timely intervention. Emotional changes, behavioral indicators, cognitive signs, and physical symptoms all serve as red flags that should not be ignored. By understanding these signs, individuals and healthcare providers can take proactive steps to prevent a relapse, ensuring a more successful recovery journey.

Emotional Changes: One of the first signs of a potential relapse is a shift in emotional state. Individuals may experience heightened levels of stress, anxiety, or depression. These emotional changes often serve as triggers, pushing the person closer to using drugs again as a coping mechanism. Emotional instability can manifest in various ways, such as irritability, mood swings, or withdrawal from social activities and loved ones.

Behavioral Indicators: Behavioral changes are another significant warning sign. These can include neglecting responsibilities, a decline in performance at work or school, and a lack of interest in activities that were once enjoyable. Additionally, changes in sleep patterns, such as insomnia or excessive sleep, can also be indicative of an impending relapse. In some cases, individuals may start to associate with friends or environments where drug use is normalized, further increasing the risk of relapse.

Cognitive Signs: Cognitive symptoms often precede a relapse and can be subtle yet dangerous. These include rationalizing or minimizing the consequences of drug use, fantasizing about using drugs again or experiencing cravings. The individual may start to think that they can control their usage this time around, underestimating the power of addiction. This cognitive distortion can quickly lead to a relapse if not addressed promptly.

Physical Symptoms: Physical signs are usually the last to appear and often indicate that a relapse is imminent. These can include restlessness, changes in appetite, or even physical discomfort like headaches or stomach issues. In extreme cases, individuals may start to exhibit drug-seeking behaviors, such as visiting places where they used to obtain drugs or even attempting to acquire drugs.

How Do People Relapse?

Gradual Slipping: Relapse often doesn’t happen overnight. “It’s usually a gradual process that starts with emotional relapse, followed by mental relapse, and finally, physical relapse,” explains psychiatrist Dr. Michael Olla.

Rationalization: People may rationalize substance use as a one-time event or as a reward for prolonged sobriety. This rationalization is often a slippery slope to full-blown relapse.

Lack of Coping Mechanisms: Without effective coping strategies, individuals are more likely to resort to substance use when faced with triggers. Coping mechanisms are your first line of defense against relapse.

How Often Does Relapse Happen?

According to various studies, the relapse rate for substance use disorders is estimated to be between 40% and 60% according to JAMA. This rate is comparable to relapse rates for other chronic diseases like diabetes and hypertension.

The frequency of relapse can vary widely among individuals, depending on various factors such as the length of sobriety, the presence of a support system, and adherence to a treatment plan.

Does Relapse Mean Treatment Has Failed?

The Chronic Nature of Addiction: Addiction is a chronic condition, much like diabetes or hypertension. This means that relapse—defined as a return to substance use after a period of abstinence—can be a part of the recovery journey. Newer treatments are increasingly focusing on relapse prevention, acknowledging that relapse can be a stepping stone, not a stumbling block, in recovery.

Relapse Rates Across Chronic Illnesses: According to a study published in JAMA, the relapse rates for substance use disorders range between 40-60%. Interestingly, these rates are comparable to those for other chronic medical conditions like hypertension (50-70%) and asthma (50-70%). “The similarity in relapse rates underscores the need to treat substance use disorders as we would any other chronic illness,” notes Dr. Mark Gold.

Treatment Modification: Relapse is not an indicator of failed treatment but a signal that the treatment plan may need reevaluation or modification. When someone in recovery experiences a relapse, it’s a cue to consult their healthcare provider for a revised or alternative treatment approach.

What Does Relapse Indicate?

A relapse doesn’t mean that the treatment has been ineffective; rather, it highlights the complexities involved in changing long-standing habits.

If a relapse occurs, it serves as a sign that the individual should consult their healthcare provider to either resume the existing treatment, modify it, or explore new treatment options. “Relapse is not the end but a checkpoint for treatment reassessment,” (Harvard Health)

According to Verywell Mind, A relapse begins long before the physical act. It involves emotional, mental, and physical phases, and recognizing these warning signs is essential for prevention

When Should You Try and Get Sober?

Recognizing the need for sobriety typically comes when an individual or those around them identify a pattern of substance abuse that is negatively impacting life. This realization may manifest through personal reflection or intervention from friends, family, or professionals.

Where to Get Sober?

Achieving sobriety can occur in various settings depending on the individual’s needs and the severity of the addiction. Options may include:

  • Inpatient Rehabilitation Centers: Providing a controlled environment with medical supervision.
  • Outpatient Programs: Allowing for more flexibility while providing necessary support and counseling.
  • Support Groups: Such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), which offer community support.
  • Individual Therapy: Working one-on-one with a counselor or therapist specializing in addiction.

How to Get Sober and Avoid Relapse?

The path to sobriety involves several key steps, including:

  1. Admission and Acknowledgment: Accepting that there is a problem with substance abuse.
  2. Seeking Professional Help: Finding a program or professional that suits the individual’s needs.
  3. Commitment to the Process: Sobriety requires ongoing dedication and effort.
  4. Building a Support System: Engaging with friends, family, or support groups that understand and aid in the journey.

Sobriety is not just a status but a continuous journey that requires consistent effort, support, and self-awareness. It’s a vital step toward recovery from addiction, leading to a life of clarity and purpose.

frequently asked questions (FAQs) about relapse

How Common is Relapse?

Studies indicate that relapse rates for addiction can be comparable to other chronic diseases like diabetes or hypertension, ranging between 40% and 60%. This underscores the need for ongoing treatment and monitoring, even after the initial phase of recovery is complete.

What are the Common Triggers for Relapse?

The most common triggers for relapse are emotional, environmental, and physical. Emotional relapses involve stress, anxiety, and other emotional states that can act as triggers for relapse. Emotional turmoil often tempts individuals to seek relief through substance use. Environmental triggers refer to being in places or with people associated with past substance use can ignite cravings and trigger a relapse. Physical triggers are certain physical sensations, like pain or even the taste and smell of a substance, which can also act as powerful relapse triggers.


Are There Medications That Can Help Prevent Relapse?

Yes, there are multiple medications that help to prevent relapse from substance use disorder that work for alcohol and drug addiction. Some of those medications include:


Used primarily for alcohol and opioid addiction, Naltrexone can reduce cravings and the effects of these substances.

Antabuse (Disulfiram)

This medication discourages alcohol consumption by causing unpleasant side effects when alcohol is ingested.


Commonly used for opioid addiction, Buprenorphine can lessen the severity of withdrawal symptoms and reduce cravings.

What are Effective Strategies for Relapse Prevention?

There are multiple strategies for relapse prevention including gratitude practices, self-empowerment, as well as spirituality. Some of the proven strategies for staying sober include:

Cognitive Behavioral Therapy (CBT)

This evidence-based approach teaches individuals how to identify and manage triggers, offering practical skills to cope with challenging situations.

Support Networks

Having a strong support network, which could include friends, family, and support groups, is crucial for accountability and emotional support.

Mindfulness and Stress Management

Techniques such as mindfulness, meditation, and deep-breathing exercises can help individuals become aware of their thoughts and feelings and make more conscious choices.

How Should a Relapse be Handled?

Immediate Safety

The first priority is to ensure immediate safety. This might involve medical intervention, especially in cases of overdose or severe withdrawal symptoms.

Reassess Treatment Plan

A relapse often indicates that adjustments need to be made to the current treatment plan. This could involve altering medication, engaging in more intensive therapy, or trying a new treatment approach.

Avoid the Abstinence Violation Effect

This psychological phenomenon can make individuals feel like they’ve failed entirely, tempting them to continue using. It’s crucial to understand that relapse is a setback, not a failure, and it’s possible to return to recovery.


How Often Does Relapse Happen?

The frequency of relapse varies from person to person and is influenced by numerous factors, including the length of time in recovery, the presence of support systems, and adherence to treatment plans. However, it’s worth noting that relapse rates for substance use disorders are comparable to those of other chronic illnesses, reinforcing the need for ongoing, adaptable treatment. There are stages to relapse, it doesn’t happen in a vacuum overnight.

What Is Relapse In The Spectrum of Addiction?

Relapse is a critical stage in the addiction cycle, which also includes experimentation, abuse, tolerance and dependence, addiction, and recovery. Understanding relapse within this context can provide valuable insights into the complexities of addiction and the ongoing challenges of maintaining a drug-free lifestyle.


This is the initial stage where individuals first try a substance like Adderall out of curiosity or peer pressure. At this point, use is sporadic and not yet a pattern.


In the drug and alcohol abuse stage, individuals start using the substance more frequently and in larger doses, often to achieve a desired effect such as increased focus or euphoria. This is where the risks of negative consequences, both physical and emotional, begin to escalate.

Tolerance and Dependence

Over time, the body becomes accustomed to the presence of the substance, requiring higher doses to achieve the same effects (tolerance). Simultaneously, individuals may find it difficult to function normally without the substance, leading to physical or psychological dependence.


At this point, substance use becomes a compulsive behavior despite the negative consequences. Individuals may neglect responsibilities, relationships, and even their own health in pursuit of the substance.


This is the stage where individuals seek help to quit using the substance. It often involves detoxification, therapy, and long-term treatment plans, which may include medications and lifestyle changes.


Relapse is the return to substance use after a period of abstinence. It’s a common part of the recovery journey and should not be seen as a failure but rather as an indication that the treatment plan needs reevaluation and possibly adjustment. Relapse can occur at any point but is especially common during the initial withdrawal phases, where symptoms like cravings, mood swings, and physical discomfort are at their peak.

Understanding relapse as a stage in the addiction cycle highlights its role as a potential, albeit unfortunate, part of the journey rather than an endpoint. It serves as a signal for introspection and reassessment, offering an opportunity to modify the treatment plan and incorporate new coping strategies. This can involve revisiting earlier stages of the addiction cycle to identify triggers or vulnerabilities that may have contributed to the relapse. By doing so, individuals can better prepare for future challenges and reduce the risk of another relapse, ultimately aiding in the long-term process of recovery and stabilization.


  1. NIDA. 2023, March 9. Treatment and Recovery. Retrieved from on 2023, September 7
  2. Center for Behavioral Health Statistics and Quality. Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2017.
  3. Volkow ND, Chang L, Wang GJ, Fowler JS, Franceschi D, Sedler M, Gatley SJ, Miller E, Hitzemann R, Ding YS, Logan J. Loss of dopamine transporters in methamphetamine abusers recovers with protracted abstinence. J Neurosci 21(23):9414-9418, 2001.

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