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What is a ‘Relapse?’

A relapse occurs when someone with a previous addiction (usually to drugs or alcohol) starts using again. It can be a single event or repeated behavior. 

The modern approach to recovery considers relapse a part of the recovery process. Approximately 40 to 60 percent of people with substance use disorder (SUD) relapse at least once.1

This is because addiction is a chronic medical condition. A person is never “cured” of an addiction, even if they never use the substance(s) again. 

Relapse is always a risk, just as it is with other chronic diseases like asthma or high blood pressure. 

However, relapsing is not a sign of failure. It’s an opportunity to reassess your current treatment plan and continue to move forward in recovery.

A relapse is sometimes referred to as a lapse, slip, or slip-up. In most cases, a slip refers to a one-time return to alcohol or drug use. Whether or not a single use of a substance qualifies as a relapse varies from person to person.

For many, it’s a matter of intention. For example:

  • Someone with an alcohol use disorder (AUD) who plans to take a drink, and then immediately attends a 12-step meeting to get back on track, likely had a slip. 
  • Someone who made the decision to drink, and does nothing to get sober, has relapsed.

Regardless of how you define these terms, a slip increases the risk of a complete relapse. The best way to avoid a relapse is to attend an addiction treatment program. 

11 Reasons Why Someone May Relapse

Several factors put someone at risk of relapse:

  1. Isolation
  2. Focusing on other people’s issues
  3. Poor eating habits
  4. Poor sleeping habits
  5. Skipping AA and NA meetings
  6. Abandoning the 12-steps of recovery
  7. Choosing not to share and/or participate during AA or NA meetings
  8. Drinking alcohol (doing so also increases the risk of drug relapse)
  9. Stress
  10. Being in the presence of paraphernalia
  11. Spending time with other people struggling with drug or alcohol use

Why is Relapsing Dangerous? 

Despite being a common aspect of recovery, relapses are dangerous. This is because of the changes that occur in the body once you stop using substances. 

In other words, if you start using again and take a high dose of the drug, the risk of a fatal overdose increases. This is because tolerance decreases the longer a drug is out of your system.

There is also no way to determine your tolerance level after weeks, months, or years of non-use. Even ingesting small amounts of the substance can be dangerous. 

You’re Not Alone: Relapse Statistics 

  • According to the National Institute on Drug Abuse, approximately 40 to 60 percent of people with SUD relapse.1
  • People who entered treatment or received help for an addiction were more likely to achieve a 3-year period of sobriety.2
  • Relapse rates decrease over time. There’s no amount of time that reduces someone’s risk of relapse to zero. But someone 1 year out of rehab has a higher risk of relapse than someone who has been sober for 5 years.3

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Should You Go Back to Rehab?

Returning to rehab is an option after a relapse. At the very least, someone who slips or experiences a relapse should attend a 12-step meeting.

Whether or not you need to return to a long-term rehab program is based on the severity of your relapse. Ask yourself:

  • How long have you been using drugs or alcohol again after the initial slip?
  • How often and how much are you using?

If you slip and use drugs or alcohol for only a brief time – usually one day or less – and you realize you’ve taken a risk, rehab might not be necessary.

However, if you find yourself returning to a pattern of use for several days or weeks, relapse is likely necessary. In part, this is because you’re less likely to attend 12-step meetings and more likely to isolate once you return to a pattern of using.

If you believe your use of drugs or alcohol is only a slip, it’s still important to contact your sponsor, reach out to a counselor, attend a 12-step meeting, and avoid triggers.

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5 Signs You Should Go Back to Rehab 

Some of the signs you should return to rehab include:

1. You’re struggling to function.

If you feel as if your coping skills are lacking and you aren’t meeting your normal obligations, it might be time to reach out for help. This includes keeping up with hygiene, household chores, going to work, attending school, caring for family, and more.

2. You have a lack of motivation.

Motivation to remain sober is often high right after release. If you feel your motivation waning as time passes, it might be time to return to rehab. You don’t need to feel a high sense of motivation every single day, but if you’ve noticed a decline in motivation over time, rehab can help.

3. You’re using substances.

Even if you haven’t returned to your substance of choice, rehab might be a good idea if you turn to other substances to cope.

4. You find yourself considering whether or not a return to rehab is a good idea.

Essentially, if you have to ask, the answer is probably yes. Maybe you aren’t ready to admit a return to rehab is needed. But it’s important to seek help before you experience a complete relapse and no longer have the ability to reason through your decision.

5. You’ve slipped and your guilt or shame is overwhelming.

For many, an occasional slip isn’t a big deal. It’s just an indication that a 12-step meeting is needed. For others, even a small slip can bring on intense feelings of failure, including guilt and shame. Professional support and guidance for dealing with those feelings are an important part of avoiding a relapse.

Why Didn’t Rehab Work The First Time?

One of the first questions you might ask when you experience a relapse is ‘why didn’t rehab work?’

The truth is, it might have. Relapse is a normal part of recovery. 

And just because you relapse, doesn’t mean rehab wasn’t helpful. It just means you need to adjust your treatment plan or relapse prevention plan.

Rehab gives you the tools you need to reduce the risk of relapse. It also teaches you how to respond if and when a relapse occurs.

Some of the things you should consider if you relapse and believe an adjustment to your treatment plan is warranted include:

You didn’t participate in the program.

If you aren’t attending 12-step meetings or making recovery a part of your daily life, the plan is likely to fail. The same is true of therapy sessions and counseling.

Alcohol and drug addiction is a chronic illness and requires ongoing maintenance and care. 

You got out of a drug rehab program too quickly.

For some people, a week or even 30 days in an intensive program is not enough to prepare them for long-term recovery.

You enrolled in a program that wasn’t right for you. E

ven the most successful rehab programs aren’t right for everyone. The best treatment center graduates plenty of people who eventually relapse. If you relapse, you might want to consider different treatment options.

You didn’t get enough support.

Having a strong support system is an important part of a successful, long-term recovery.

If you believe your support system is lacking, consider speaking to a counselor about what you can do to improve support from those around you.

You didn’t get enough aftercare support.

It’s important to remember that cravings for drugs or alcohol continue long after the detox and withdrawal phases. Long-term aftercare support programs — including 12-step programs and group and individual therapy — are essential parts of long-term sobriety.

Before treatment, discuss with your specific treatment center what they offer in terms of aftercare.

Other Steps You Can Take Besides Rehab 

There are things you can do other than return to rehab in response to relapse. For example:

  • Contact your AA or NA sponsor
  • Speak to a counselor or therapist
  • Avoid locations where you’re likely to use
  • Get rid of all drug and alcohol paraphernalia
  • Avoid people that encourage you to use or continue to use drugs or alcohol
  • Attend a 12-step meeting
  • Accept that relapse might be a part of your recovery journey
  • Create a plan for what you’ll do if a relapse occurs

Resources

MORE
LESS
  1. Treatment and Recovery.” Drugabuse.gov, 2018.
  2.   Moos, Rudolf H., and Bernice S. Moos. “Rates and Predictors of Relapse after Natural and Treated Remission from Alcohol Use Disorders.” NCBI, 2006.
  3. Melemis, Steven M. “Relapse Prevention and the Five Rules of Recovery.” The Yale Journal of Biology and Medicine, 2015.
  4. Relapse Prevention Training.” Center for Practice Transformation.
  5. Recovery Is Possible: Treatment for Opioid Addiction.” Centers for Disease Control and Prevention.
  6. Eastwood, Brian, et al. “Effectiveness of Inpatient Withdrawal and Residential Rehabilitation Interventions for Alcohol Use Disorder: A National Observational, Cohort Study in England.” Journal of Substance Abuse Treatment, May 2018.
  7. Kelly, John F., et al. “Alcoholics Anonymous and Other 12‐Step Programs for Alcohol Use Disorder.

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