Relapse After Addiction Recovery

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 doing his or her 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.

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.