To someone in recovery from substance use disorder (SUD), relapse can seem like the ultimate boogeyman. Some people even avoid getting treatment because they’re afraid they’ll relapse after getting sober. In reality, the role of relapse is much more complex. At Avery Lane, we believe that relapse can be a normal and helpful step on the road to long-term wellness.
What Is a Relapse?
A relapse is a return to using drugs or alcohol after a period of sobriety. For example, you may be sober for a year, then go out for the night with friends and find yourself having a drink. Many mental health professionals would consider this a relapse, though definitions can get a little hazy. How you choose to define relapse is up to you, but it’s crucial to recognize that for the majority of people with SUD, even one drink or one hit can cause a slip back into addiction.
It may be a one-time thing; you might have one drink or even one sip, and immediately regret it. Unfortunately, that isn’t usually the case for people with SUD. The typical relapse will be a shift back into a pattern of using reminiscent of their time before treatment. This is due to the highly addictive nature of substances, not because of a weakness in the person.
Your brain can remember the chemical makeup of a substance for a long time, even a lifetime. You may not have consumed it in months or years, but your brain will recognize it. A huge rush of dopamine is released as a conditioned response, and addiction takes hold again.
The 3 Stages of Relapse
Relapse can be broken down into three stages: emotional relapse, mental relapse, and physical relapse. Catching the signs of a relapse in the first two stages makes it easier to prevent moving on to the last stage.
During the first stage, emotional relapse, you aren’t even thinking about using. Thinking about using brings you no pleasure or enticement. However, your subconscious emotions may begin to influence your behavior, which can lead you down the path toward mental and physical relapse. Because this stage is so covert, even to the person experiencing it, it can be hard to catch. Some signs of emotional relapse include:
- Poor self-care
- Focusing on the issues of others instead of your own
- Repressing emotions
- Poor eating and sleeping habits
- Skipping 12-Step meetings
- Not sharing at meetings
You may be aware on some level that you are on a path to relapse, but you may consciously deny it. It’s important to release any pride or judgment you hold over yourself. Being honest with others can only happen if you’re honest with yourself first. This is the best stage to get help; you have the highest chance of avoiding physical relapse if you reach out at this point.
The second stage is mental relapse. This is when the desire to use again becomes conscious. You may resist the urges and talk yourself down from using, but you are aware of the cravings. Over time, the internal conflict will begin to wear you down and the need for escape will increase.
Signs of the second stage of relapse include:
- Thinking about using
- Minimizing the damage of using on yourself and others
- Thinking about people and places associated with using
- Glamorizing or romanticizing past use
- Thinking about how to use in a safer or more controlled way
- Lying to loved ones
- Bargaining (thinking of scenarios where it might be okay to use)
- Looking for opportunities to use
- Thinking about switching to a new substance
Bargaining is very common in this stage and is also one of the most dangerous signs. For example, you might give yourself permission to use when you’re on vacation or a trip. This can seem more appealing and controlled than just using whenever you want. The illusion of being in control can stop you from getting help when you really need it. Inevitably, if you change the rule to “I can use on vacation,” you’ll find yourself bending the rules even further for what counts as “vacation.”
Having cravings is normal, especially in early recovery. It’s not something to be ashamed of. You should discuss these thoughts with your therapist and people in your support system. Keeping thoughts like that secret can make their effect even more potent. At the same time, having thoughts of using is a sign that you need to be receiving treatment of some kind. Remember, if you’re thinking about using, you’re not in control – addiction is.
The third and final stage is physical relapse. This is when you actually use again. Most of the time, physical relapses happen as relapses of opportunity. That means that you find yourself unexpectedly in a situation where you have access the substances, and you give into the temptation. You also feel that you are not likely to get caught, which gives you a false sense of security. A relapse occurs whether other people witness it or not, and the consequences will still follow.
Getting to the stage of physical relapse does not mean that you’re beyond the point of return. The three-stage framework is simply a tool to help you recognize if you’re in danger of relapsing. Contrary to what you might think, the role of relapse in a recovery journey can be a normal and even helpful step toward long-term wellness.
Understanding the Role of Relapse
The role of relapse in addiction recovery is a complex and often misunderstood aspect of the journey toward sobriety. Recognizing the role of relapse involves acknowledging its potential impact on individuals striving to overcome addiction. The role of relapse extends beyond a mere setback; it is a pivotal moment that can illuminate underlying triggers and unaddressed issues.
Understanding the role of relapse demands a compassionate approach. Rather than viewing it as a failure, therapists and support systems play a crucial role in guiding you through the aftermath of relapse, helping you dissect the circumstances and emotions that led to it. By exploring the role of relapse, you can gain valuable insights into your own vulnerabilities, paving the way for enhanced coping mechanisms.
In addiction recovery, the role of relapse serves as a teacher, offering valuable lessons about resilience and the ongoing nature of the healing process. The acknowledgment of the role of relapse in treatment models fosters a more realistic and empathetic perspective, emphasizing that setbacks are an integral part of the recovery journey. Through this nuanced understanding of the role of relapse, you can develop a more robust foundation for sustained recovery, learning and growing from each experience to build a healthier, more resilient future.
The Role of Relapse: FAQs
Does relapsing mean that treatment has failed?
No, relapse does not mean that the treatment you received failed or that you failed. It simply means that your current strategy and routine are not meeting your needs as a person with SUD. Relapse indicates that a change is required for your needs to be properly met. Just like your stomach growls to tell you that the body is hungry, a relapse is your body’s way of telling you that it needs additional support.
What are some warning signs of a relapse?
Looking out for warning signs is a great way to get ahead of a relapse. If you or someone you love is experiencing any of the following symptoms post-treatment, it’s important to reach out for help as soon as possible:
- Feeling lonely, depressed, or stressed
- Isolating yourself from your support system, such as family and friends
- Not attending support groups or meetings that you previously attended
- Craving substances more often
- Thinking you’ve been sober long enough to start using again
- Neglecting responsibilities or self-care
- Triggers affect you more often or more severely
Does relapsing mean that I’m starting over at square one?
Not at all. A relapse can just be a step on the journey to long-term wellness. You still have all of the tools and skills that you built during treatment, along with your support network. If you find yourself feeling down after a slip-up or thinking that you’ve erased all of your progress, think instead about where you were before treatment. You are not in that place anymore. A relapse cannot change how far you’ve come on your recovery journey.
Does getting sober mean I can never use again?
Whether or not you use again is a personal choice that only you can make. Some people with alcohol use disorder (AUD) are able to return to drinking in casual or social settings after years of sobriety without any addictive behaviors or thoughts. For other people, even having one drink after decades of being sober can cause them to spiral into full-blown addiction. No matter the case, this is a decision that should only be made after many years of stability and wellness. If you’re at the beginning of your recovery journey, your focus should be on the present.
It’s important to remember that because of the chronic nature of the disease of addiction, there’s a good chance that you will always have an addiction to some extent. There is no “cure,” so to speak. The point of SUD treatment is not to cure you of your addiction or even to make sure you stay sober forever. It’s to help you cultivate a life of happiness and health.
What causes a relapse?
There are a number of things that can lead to relapse. One of the biggest factors is encountering “triggers.” Triggers are places, people, or experiences that cause emotional or mental distress. Encountering a trigger can cause you to crave substances as a way to cope with the stress. For people with SUD, triggers are often things associated with substance use. An example would be that for someone with AUD, seeing an old drinking buddy may be triggering, not because that person is bad, but because they are associated with a time of active addiction.
Other triggers may not be associated with substance use. A trigger can also be something that causes feelings of anxiety, anger, guilt, or sadness. People with SUD are often used to using substances to cope with negative feelings, so experiencing unpleasant emotions could drive someone to relapse.
Another factor is the accessibility of substances. If drugs and alcohol are easily available, a person with SUD is more likely to relapse. This is especially true if the substances are visible in a frequently used area, like their home. For that reason, making your home a substance-free space during and after treatment is very important.
Continuing the Journey After a Relapse
After experiencing a relapse in addiction recovery, it’s crucial to respond with compassion, self-reflection, and a commitment to re-establishing a path toward sobriety. The first step is acknowledging the relapse without self-judgment. Reach out to your support network, whether it’s friends, family, or a therapist, to share your experience. This communication helps build a foundation for accountability and understanding.
Next, assess the circumstances leading to the relapse. Identify triggers, stressors, or unresolved issues that contributed to the setback. Use this self-reflection to refine coping strategies and develop a more robust plan for the future.
Recommit to your recovery goals, taking small, manageable steps. Engage in activities that promote mental and emotional well-being and consider adjusting your treatment plan if needed. Seeking professional guidance is essential during this time, as therapists and support groups can provide valuable insights and encouragement. Remember, a relapse doesn’t erase progress; it’s a temporary detour on the path to lasting recovery.
Learning to prevent a relapse is the reason why most people seek out treatment. Many people with SUD have already tried to quit on their own, but ended up relapsing. They go to treatment seeking tools to maintain sobriety in the long run. Those tools are most often found through cognitive-behavioral therapy (CBT) and practicing skills for trigger situations.
CBT is a therapy approach we offer at Avery Lane that focuses on changing negative thought patterns and retraining the brain to choose more neutral ways of thinking. This is effective for addiction recovery because the biggest risk to your sobriety is often your own self-image and the way that you talk to yourself. Some common talking points that come up in CBT for people with SUD include:
- I’m not fun or interesting when I’m sober
- I’m not strong enough to handle life without drugs/alcohol
- I don’t have any friends outside of the people I use with; I’ll lose them if I quit
- I’m too lazy to get through treatment
- Going to rehab would mean abandoning my family
- I’m too damaged; treatment won’t work on me
This type of negative self-talk can be extremely damaging to your self-esteem and make you feel like you aren’t worthy of getting help. CBT helps to reframe these thoughts in more neutral ways that are grounded in reality instead of emotion. For example, instead of telling yourself, “I’m not strong enough to handle life sober,” CBT can help you change your thought pattern to: “Once I have the tools and support I need, I can handle life sober, and it’s okay if I need extra help.” It may seem like a silly thing to focus on, but your thoughts shape the way you feel and the way you act.
There are a lot of misconceptions about what relapse prevention means and what it looks like in practice. The biggest misconception is the belief that people in recovery need to learn to “just say no” to substances and that they need to have the willpower to put the drink down right before they take a sip. In reality, the moment before relapsing is the most difficult place to stop, so relapse prevention must start long before that.
Identifying your triggers so that they can be avoided is a big part of relapse prevention. Sometimes, you don’t know that something is a trigger until you encounter it, which is why reconsidering the role of relapse in your recovery journey is important. Once you know what your triggers are, you and your therapist can make a plan for avoiding them. However, not all triggers can be avoided all of the time. There’s a good chance that you’ll encounter some out in the world. That’s why it’s crucial to practice triggering situations in therapy. Being prepared for triggers means you know what to do when you experience them. Most of the time, that means removing yourself from the situation.
If you or someone you love is experiencing cravings or other signs of relapse, reaching out for help is the most important step. Remember, admitting that you have cravings or that you’ve relapsed is not the same as admitting you’ve failed. It’s just a step on your journey. In order to prevent addiction from taking over your life again, it’s crucial that you seek professional support. Avery Lane is here for you whether you’ve been sober for years or you’re starting over at day one. We help women of all ages and backgrounds in every stage of recovery, and we want to help you too. The first step is always asking for help. Give us a call at (800) 270-2406.