Despite the images typically portrayed on television and in the movies, the majority of people struggling with substance use issues are able to achieve a successful recovery.
According to a survey by the Substance Abuse and Mental Health Services Administration, around 70% of those who have had a substance use issue are in recovery or consider themselves recovered.
That number is encouraging, but it doesn’t necessarily mean that none of those 20.9 million people have ever relapsed. Relapsing is part of addiction recovery, just as it is part of living with any chronic illness. It doesn’t mean the individual has failed. Instead, it indicates that it’s time to reevaluate treatment and make adjustments.
How Common Are Relapses?
It is sometimes called a lapse, a slip, or a recurrence, but by any name, a relapse is an instance of substance use after a period of abstinence. Relapse is common, but that doesn’t mean it’s not serious.
The risk of a fatal overdose is high during relapse because the individual’s body no longer has the same tolerance for drugs or alcohol that it once had. Ingesting the same amount of a substance that was “safe” six months ago could now be deadly.
It’s estimated that approximately 40 to 60 percent of people who have undergone treatment for an addiction disorder will relapse. That number is comparable to the number of people living with diabetes or hypertension who experience relapse. Relapse can be more or less common depending on the substance.
For example, the relapse rate for those addicted to opioids is around 91%. Opioids like heroin, fentanyl, and prescription pain medications are known to be highly addictive.
One study concluded that people recovering from alcohol use disorder have a 70% chance of relapsing within the first six months after completing a treatment program. However, the longer they maintain recovery, the less likely they are to misuse alcohol again.
Preventing relapse is one goal of long-term recovery, but it’s not the only goal. Experiencing a relapse doesn’t mean you should give up or that you can’t enjoy a healthy, functional life. What a person does after a recurrence is the key to lasting recovery.
Reasons for Relapse
There are many reasons or triggers that can lead a person to relapse. The overarching answer to the question of “why” is that addiction is a chronic disease that can be treated but not cured.
A person might relapse when things are going well because feeling happy, hopeful, and healthy is unfamiliar and uncomfortable.
When things are going badly, returning to drug or alcohol misuse is a place of comfort. They may use a bad experience as a reason to give into the cravings they’re already struggling to overcome.
In general, five main triggers can lead to relapse. They are:
- Stress
- Encountering people or places connected to addictive behaviors
- Negative feelings or experiences
- Enticing sights or smells
- Celebrations or holidays
Relapse triggers vary by individual. What tempts one person to relapse may not tempt another. Most treatment programs help their clients develop a personalized relapse prevention program, and identifying personal triggers is an important part of that process.
3 Stages of Relapse
Relapse doesn’t happen in a vacuum. There are three recognized steps to recurrence — emotional relapse, mental relapse, and physical relapse. Recognizing that you are in the first or second stage will help prevent actual physical relapse from happening.
1. Emotional Relapse
Emotional relapse occurs when a person stops taking care of their physical or mental health. If you find you’re eating a lot of junk food, staying up late, or isolating yourself from friends and family, you may be experiencing an emotional relapse.
Not going to recovery support meetings or not participating in those meetings honestly is a major red flag.
2. Mental Relapse
If you ignore the signs of an emotional relapse, a mental relapse will most likely occur next. Mental relapse refers to dwelling on the thought of misusing substances.
You may romanticize past behavior or start hanging out with the people you used drugs or alcohol with in the past. Bargaining, such as telling yourself, “It will be okay this once,” is also a common sign of mental relapse.
3. Physical Relapse
Physical relapse means you have physically ingested a substance — you’ve taken that first drink or swallowed those pills.
Help is still available even if you’ve had a physical relapse. If you have a sponsor, call them. Connect with a trusted friend or family member who understands what you’re going through. You may consider going to an outpatient or residential treatment program to help strengthen your recovery.
5 Myths About Relapse
Avoiding these myths about relapse may help you stay in recovery.
Myth 1: One Beer Is Okay
To be successful in recovery, it’s necessary to avoid all substances that can alter your mind. A person who is struggling with opioid addiction may be tempted to think a single beer is no big deal.
A beer with a friend or an occasional roll may not send a person directly to using heroin, but any substance that affects your judgment could lead you to make poor choices.
Myth 2: If You’re Truly Committed to Recovery, You Won’t Relapse
This is one of the most dangerous myths because it perpetuates the stigma that people with addiction disorders are weak-willed or somehow morally flawed. Anyone can relapse, even people who have been in recovery for decades.
Life changes, and circumstances change. The loss of a job or the death of a loved one can send even the most dedicated person into a downward emotional spiral that leads to relapse.
Myth 3: Relapse Is Expected; You Can’t Prevent It
Believing you can’t prevent relapse is like giving yourself permission to abuse drugs or alcohol. While it is common — as with all chronic illnesses — relapse can be prevented. You can prevent relapse by using the skills you learned in treatment, seeking support from your sober network, and being honest about what you’re going through.
Myth 4: If You Relapse, You Have to “Hit Bottom” Again
Many people in recovery did experience life at its lowest point before they sought help. Some were near death.
For others, being at the bottom meant they had given up and no longer cared if they lived another day or overdosed that night.
However, the concept of having to “hit bottom” before you can recover is outdated. A relapse signifies there’s a need for change in your recovery management. There is no reason to believe you must spin completely out of control before seeking help.
Myth 5: Relapse Is a Surprise
Relapse is a process that rarely comes out of nowhere. A person who is taking care of their physical and mental health, attending and participating in support meetings, and focusing on their recovery is highly unlikely to wake up one day and decide to misuse drugs or alcohol again.
How to Help Someone Who Relapses Without Enabling Them
If your friend or loved one has relapsed, don’t give up on them, but don’t enable their behavior either. Enabling means making things easier for them. You might pay their rent because you don’t want them to be evicted or lie to their employer because you don’t want them to be fired.
These types of actions may seem helpful at the moment, but what you’re really doing is allowing them to sink deeper into substance misuse while someone else cleans up the mess.
To help without enabling, consider these tips:
- Set boundaries and keep them, such as they can’t come to your home if they are under the influence
- Don’t protect them from the natural consequences of their actions
- Let them know you care and that you can see they are struggling with their recovery
- Offer to drive them to therapy or help arrange admittance to a treatment program
- Stage an intervention if needed
- Educate yourself about relapsing
- Avoid judgment or blame
You can’t control another person’s actions, but you can offer support in healthy ways. Let the person know you are available to help if they want to regain their recovery.
Maintaining boundaries with a person you know is suffering is difficult, but when dealing with addiction disorders, taking care of yourself is more important than taking care of others.
Moving Forward From Relapse
People relapse for a variety of reasons, but it’s important to remember that it is common. Despite the misconceptions about it, relapse does not indicate failure or weakness. It is simply a signal that it’s time to make adjustments, seek help, and continue the recovery process.
