The thought of relapse can be scary for a person recovering from addiction, as well as for their loved ones.
But for many people, relapse is part of the recovery process.
In fact, the National Institute on Drug Abuse defines addiction as a chronic, relapsing disease and estimates that roughly 40–60% of people who’ve gone through treatment for substance abuse will experience some kind of relapse.1
It’s crucial to realize that relapse does not mean that treatment has failed! It simply means the treatment plan needs to be readjusted.
Remember, drugs and alcohol have actual physical effects on the brain as well as the body. Research that’s supported by the National Institute on Drug Abuse and many other organizations affirms this. Any chronic condition that’s being managed—diabetes, arthritis, multiple sclerosis—can “flare up” from time to time. Maybe the medication stops working, or maybe the disease progresses and more aggressive care is needed.
Relapse isn't the patient's fault.
You wouldn’t consider a person with asthma to be “too weak” or lacking the willpower it takes to breathe. Similarly, relapse in addiction just means it’s time to try a new course of treatment. It may be comforting to know that a study published by the Journal of the American Medical Association (JAMA) reports that relapse for addiction is similar to that of other chronic diseases like asthma and hypertension.2
Causes of Relapse
There are many reasons a person in recovery might start using drugs or alcohol again, but the actual use is usually related to a trigger. While detoxification begins the process of detoxifying your system from the effects of drugs and alcohol, it doesn’t reverse the changes in the brain that have been caused by drugs or alcohol.3 As a result, the recovering brain will always be more susceptible to a craving activating a compulsion to use. That’s why long-term treatment is important for long-term recovery.
There are both environmental and mental triggers that may cause a person to relapse. Physical triggers include places where someone used drugs or alcohol, the people with whom someone associated at the time of the usage, objects (like a pipe), or even a song or movie.4 Mental triggers may include being exposed to one of the stresses that caused a person to turn to drugs or alcohol, such as a grueling job or a bad relationship.5 They can also be related to traumas including physical or sexual abuse.6 Of course, every person in recovery is different, and personal triggers vary widely.
The good news is that being in recovery creates "protective triggers" as well. Just like relapse triggers, these protective triggers are learned behaviors that a person in recovery develops through repeated practice. For example, if a person in recovery is rewarded by a family member every day they’re sober—with proud praise, quality time, lunch dates, trinkets—it creates a positive trigger for recovery. When used as part of a treatment program, providing these kinds of positive rewards is called "contingency management" and has been shown to be effective at supporting ongoing recovery.7
The best way to create these “protective triggers” is to follow a treatment plan, and to reassess it regularly to help prevent relapse. Talking to a therapist, going to group meetings, and seeking the support of a sponsor are all behaviors that can help create healthy triggers that reduce the feelings of pleasure associated with using drugs or alcohol. When those cues to relapse pop up—like seeing an old drinking buddy, or hearing a song that reminds you of a traumatic event—you’ll have other tools to combat those urges.8,9,10
If you feel yourself slipping back into addiction, or you’re worried about someone you love, don’t be afraid to get help. Call your doctor to discuss "ramping up" your treatment plan temporarily, or join a peer support group and share your concerns. There’s no shame in needing to adjust your treatment plan, or in being proactive and taking early action to prevent relapse. Ask for the help you need to stay on track.
Dealing with Relapse
An estimated 60% of people recovering from addiction will deal with some kind of relapse, according to the National Institute on Drug Abuse (NIDA).11 And if it happens, additional treatment or plan adjustments may be needed. So what should you do in the event of a relapse?
As soon as possible, call your doctor to discuss the relapse and form a new recovery plan. Depending upon the severity and the duration of the relapse, a detoxification may be necessary. The doctor may recommend a new type of therapy or peer support group, or medication to help with recovery.
No matter what, remember: Do not lose hope.
Relapse does not mean you or your loved one has lost all the ground gained while in recovery. Someone who's relapsed is still in a better place than they were when they first sought treatment. Even after relapse, you still have the recovery techniques, tools, and information you'll need to get back on track. You can identify the specific trigger that caused you to resume your addictive behaviors and you can work with a therapist to treat any issues that might be contributing. You may also realize that you need more support, either from friends or family or from others in recovery.
Even if you have relapsed, that does not mean your recovery journey is over. Adjust your treatment plan, resume your recovery, and keep moving forward on the path toward a healthy and happy life.