Watching someone you love struggle with addiction is heartbreaking. Their ups and downs don’t only affect their lives; they also affect the lives of the people closest to them. The worry, anger, and confusion over what to do is, unfortunately, normal.
Once that person finally gets treatment and begins a new path, you may rightfully worry about the possibility of relapse.
But relapsing doesn’t mean that treatment didn’t work or the individual has failed. Alcohol addiction can’t be cured, only managed. If a relapse occurs, that means it is time to reevaluate treatment and make whatever changes are needed to support the person’s long-term health goals.
Understanding the Stages of Relapse
When people refer to an alcoholic as “relapsing,” they often mean the individual began drinking regularly again. The process of relapsing actually starts long before a person takes a drink of alcohol. The National Institutes of Health recognizes three distinct stages of relapse: emotional, mental, and physical.
Emotional Relapse
Emotional relapse begins on a subconscious level. An individual isn’t contemplating relapse, but they are taking subtle actions on an emotional level that sabotage their recovery efforts. Not dealing with the emotional issues that trigger relapse and not practicing self-care habits are common.
Ignoring self-care for a prolonged time can lead to physical and emotional discomfort and stress. As the tension builds, they begin to think about ways to relieve it.
Mental Relapse
While emotional relapse begins with a lack of self-care that can leave a person feeling vulnerable, mental relapse is when an individual actually starts to romanticize and reminisce about their past alcohol use. They may begin to think they could handle alcohol better if they tried it again. This kind of thinking leads to fantasizing about drinking. It’s common to look for or create relapse opportunities – such as picking a fight with a loved one.
Physical Relapse
Physical relapse is when a person starts drinking again. Some experts don’t consider a single drink or episode a full relapse but rather a “lapse.” For some, the word “relapse” is reserved for a complete return to the uncontrolled use of alcohol. Others in the world of recovery believe any use should be defined as a relapse.
Regardless of semantics, physical relapse is the most difficult stage to stop. There are successful interventions for both the emotional and mental relapse stages, but once a person has crossed the line to physical relapse, regaining sobriety becomes more difficult.
Warning Signs of Relapse
It is not always easy for a person to spot the warning signs of relapse in their loved one. People living with addiction are often masters at concealing their thoughts, feelings, and actions. Watch for these symptoms if you’re concerned about someone you care about:
- Isolating from loved ones and their sober support network of friends
- Skipping recovery meetings
- Poor self-care, not eating well, not getting enough sleep, or not taking prescribed medicines
- Focusing on other people’s problems instead of their own
- Expressing a craving for alcohol
- Telling stories about the “good old days” when they were drinking
- Getting in touch with friends they used to drink with or visiting old haunts
- Lying (about anything)
- Picking fights or creating drama where it’s not needed
- Any changes in behavior that are secretive
One of the reasons family members are encouraged to participate in counseling when their loved one receives treatment is to learn that they can’t control someone else’s drinking.
If your loved one is showing the warning signs of a relapse, there are steps you can take to help. However, you can’t stop them from drinking, and their decisions are not your fault.
Speak to your loved one about your concerns and follow these tips:
- Don’t blame or shame — speak from a place of love and concern
- Avoid any behaviors that enable or encourage co-dependency
- Remember that addiction is a disease that affects the brain and decision-making
- Practice active listening
- Prioritize your own mental and physical health
- Encourage your loved one to get help
- Don’t make ultimatums or “bottom lines” unless you are fully prepared to follow through
Lastly, attend peer-support meetings or speak with a therapist who is experienced with addiction issues.
Accepting that relapse is part of the process doesn’t mean you have to accept living with a person whose out-of-control behavior is negatively impacting your life. Regardless of the other person’s decisions, you have the right to live a healthy, stable life.
How to Create a Relapse Prevention Plan
In most cases, a person who has completed treatment for alcohol addiction will have created a relapse prevention plan with the help of their wellness team — a written plan that includes the contact numbers of your support team and actionable steps to stop or immediately recover from a relapse.
A prevention plan takes into consideration that relapse is common and helps individuals learn to recognize and avoid their personal triggers. It also provides clear, doable strategies for managing triggers and a course of action when relapse triggers occur. If your loved one already has a prevention plan, revisit it with them. Help them get back on track by following the pathway already laid out in their plan.
If they don’t have a plan or the suggestions no longer seem valid, helping them create a new plan is a good way to show love and support without enabling unhealthy behaviors.
Identify Triggers
What is triggering your loved one to desire alcohol? Some of the most common triggers include:
- Financial issues
- Stress
- Illness or physical pain
- Conflicts within primary relationships
- Feeling lonely, angry, or sad
Every person is different, and people can get triggered by a variety of issues. Identifying triggers, no matter how insignificant they seem, gives the person the opportunity to avoid them or deal with them in a productive manner.
Recognize the Warning Signs
It doesn’t matter how well you recognize the warning signs of a relapse. The person with the alcohol use disorder must learn to recognize them. Including a list of warning signs in the relapse prevention plan may help the individual identify a relapse in its early stages.
List Coping Strategies
Once triggers and warning signs have been identified, the next step is to do something about them. What helps your loved one manage their stress and keep a positive attitude about recovery? Activities like exercise, making art, or being in nature can be helpful.
Connect With a Support System
Part of the work of recovery is developing an aftercare support network outside of treatment. Now is the time for your loved one to call on sponsors, sober mentors, therapists, and support group members who are strong in their recovery.
If you’re not already seeing a therapist, consider making an appointment with a mental health professional who is experienced with addiction and get medical support if needed.
Lifestyle Changes
What needs to change to protect sobriety? Long-term recovery requires almost constant assessment and adaptation. It may be time to pursue some new hobbies, improve self-care habits, or set new goals.
Relapse Response
If, despite all the best efforts, physical relapse happens, a quick response may help prevent your loved one from sinking back into destructive habits. What comes next?
If the individual can stop drinking quickly and recommit to a stringent schedule of meetings and counseling, undergoing treatment may not be necessary. However, re-entering some form of treatment program is typically the best option.
Should My Loved One Get Treatment at an Inpatient Rehab Facility?
Your loved one may be hesitant to return to the intense schedule of inpatient treatment after a relapse, but 24-hour support and accountability are often the best options to reinforce recovery.
Because addiction is a chronic disease, returning to rehab can be viewed the same as returning to a doctor’s care when your high blood pressure medication is no longer working.
Going through treatment a second or third time (or more) isn’t a sign that the individual is failing. Instead, it is a sign that they take their recovery seriously and will do whatever it takes to live a sober life. Knowing what to expect from rehab may help an individual delve deeper into their recovery process.
Personalized treatment programs are designed to provide patients with the care they need the most. Revisiting an inpatient program can help with:
- Medical detox
- Medication management
- Resolving the emotional triggers that led to relapse
- Healing underlying trauma
- Focusing on recovery without distractions
- Reconnecting with a sober community
- Restoring confidence in the process
- Diagnosing and treating co-occurring disorders that may have been missed previously
Committing to an inpatient treatment program for 30 days or more may seem like a step backward, but making your sobriety a priority is a step in the right direction.
Relapse Is Not the End
When you see your loved one spiraling toward a relapse, it may seem like your world — and theirs — is ending. The serious nature of a relapse should never be minimized, but it doesn’t have to mean all hope is lost.
Getting help for relapse in the early stages is ideal. If physical relapse has already happened, returning to an inpatient treatment program may be the answer.
