Addiction Addictive Behaviors What to Do After a Relapse By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on June 18, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Verywell / Laura Porter Table of Contents View All Table of Contents What Is a Relapse? How Common Are Relapses Is Relapse a Sign of Failure? The Stages of Relapse Responding to a Relapse What Is a Relapse? Put simply, a relapse is the worsening of a medical condition that had previously improved. A relapse to addiction is when the person with the past addiction starts engaging in their addictive behavior again after a period of not doing it, known as abstinence. The American Society of Addiction Medicine (ASAM) notes that "relapse" is defined as the recurrence of behavioral or other substantive indicators of active disease after a period of remission. For example, someone who had completely stopped drinking for a period of time, say six months, would be experiencing a relapse if they began drinking in an unhealthy manner. If they had just one drink, they might be considered as having a "slip," but not a full relapse. For people trying to control their behavior rather than trying to quit entirely, a relapse happens when the individual had gotten control over the behavior but is re-experiencing a period of uncontrolled behavior. For example, someone trying to control their drinking, who had been drinking according to relapse could result in a session of binge drinking. For a shopaholic who is trying to follow a spending plan, a relapse could be going on a shopping spree. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. How Common Are Relapses? Relapse is a hallmark of addiction. It is common, even expected, that people who are attempting to overcome addiction will go through one or even several relapses before successfully quitting. Relapse is even considered a stage in the stages-of-change model, which predicts that people will cycle through a process of avoiding, considering quitting, taking active steps to quit, and then relapsing. Sometimes people will cycle through the stages several times before quitting. Is Relapse a Sign of Failure? Despite the fact that relapse is a well-recognized aspect of recovery from an addiction, many people attempting to quit an addiction will feel they have failed if they relapse. They might abandon their efforts, feeling that quitting is too difficult for them. Even some treatment programs take a hard line on participants who relapse. Accepting that relapse is a normal part of the process of recovery is a more helpful way of looking at relapse. Individuals and treatment programs that take this view are more successful, and in the long run, those who accept and work to try again after a relapse are more likely to eventually overcome their addiction. The Stages of Relapse In order to understand how to prevent relapse, it is essential to first understand the relapse process itself. Relapse isn't a sudden event; it is a process that occurs over a period of time which can range from weeks to even months. The stages of relapse include: Emotional relapse: During this stage, people are not thinking about using a substance, but their behaviors and emotions might be placing them at a higher risk of future use. For example, they might be experiencing isolation, anxiety, poor self-care, and low social support.Mental relapse: During this stage, people are thinking about using the substance and perhaps even missing the people and places they associated with their substance use.Physical relapse: As the name suggests, this stage involves actually using the substance once again. How to Respond to a Relapse Positively This is not to say that a relapse should not be taken seriously. Good treatment programs plan ahead for the possibility by including relapse prevention as part of the process. Relapse prevention therapy (RPT) was developed over 40 years ago by G. Alan Marlatt, PhD, and Judith Gordon, PhD. This approach helps people in recovery anticipate the factors that might cause them to engage in their addictive behavior again—and to plan ahead for these situations. There are three primary areas of focus in RPT: Behavioral techniques/lifestyle changes: to help people establish habits that enhance recovery and prevent relapse, including regular sleep, exercise, and relaxation strategies.Coping skills training: to help people cope with cravings and urges as well as potential high-risk situations and emotions.Cognitive therapy interventions: to help people reframe how they think about relapse, so they can view it as an opportunity to learn rather than a deep personal flaw. It is important to remain focused on recovery immediately after a relapse. Thinking through what led to the relapse is an important step in avoiding it from happening again. For example, were there any triggers that happened just before the relapse, either positive or negative? Sometimes, stressful events can trigger a relapse, particularly if the addictive substance or behavior was used as a way of coping with stress. But happy events can also trigger a relapse, especially if others are celebrating with alcohol. It is important to put this in perspective. People can move on from the relapse with a stronger commitment to avoiding future relapses by avoiding or managing triggers before they occur. A Word From Verywell Remember, if you are trying to quit, you should plan for and try to avoid relapse. But if you do relapse, you should accept that it is a normal part of quitting and resolve to learn from the experience. One goal of treatment is to help people learn to recognize the signs of relapse during the early stages in order to increase the chances of a successful recovery. Mindfulness-Based Relapse Prevention 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Parks GA, Marlatt GA. Chapter 6: Relapse prevention therapy. In The Essentials Handbook of Treatment and Prevention of Alcohol Problems. Heather N, Stockwell T. (Eds.). Wiley; 2003. Guenzel N, McChargue D. Addiction relapse prevention. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Hendershot CS, Witkiewitz K, George WH, Marlatt GA. Relapse prevention for addictive behaviors. Subst Abuse Treat Prev Policy. 2011;6(1):17. doi:10.1186/1747-597X-6-17 Melemis SM. Relapse prevention and the five rules of recovery. Yale J Biol Med. 2015;88(3):325-332. Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation. Editorial Process Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit