Have you ever witnessed someone showing signs of the disease that got better in the past? Maybe the symptoms came back after a gap of time. This particular condition is known as relapse.
This means that the symptoms of a condition that got better for a while again started showing up in a person’s life.
In this post, we will talk more about alcohol relapse and how it can be looked after if it happens all over again.
What is Relapse?
Relapse is a worsening of a medical or psychiatric condition after a time gap of significant improvement. It means coming back from an illness or past condition after a certain time lapse.
In simple terms, relapse is returning back to a condition or disorder after it was on a path of recovery. In case of addiction, relapse occurs when the person picks up alcohol or substance abuse after a particular time gap.
They showed signs of improvement during this period but again somehow fell back to the same behavior pattern.
Relapse can occur with many chronic diseases such as cancer, drug addiction, Alcohol dependence syndrome, etc.
Relapse occurs when the addicted person does not maintain their goal of recovery and as a result they get back to addiction once again with the same or less intense ways.
According to American Society of Addiction Medicine (ASAM), “Relapse is defined as the recurrence of behavioral or other substantive indicators of active disease after a period of remission.”
This means that if a person was recovering from addiction and was maintaining sobriety for quite some time now suddenly shows addictive behavior or falls back into excessive drinking, it means he/she is suffering a relapse.
Relapse and recovery goes hand in hand. Studies have revealed that about 85% of addicts suffer from relapse symptoms while in the journey of recovery.
In relapse, the symptoms of the illness or condition resumes after abstinence for quite some time. Recovering from alcohol or drug dependence is lime consuming.
Thus, relapse is common and occurs when the addict falls back into drinking due to several personal or sociological factors. When a person falls into alcohol relapse, it means they have stopped following their goal of no-use policy.
Relapse is concerning because it hinders progress in treatment and also increases the risk of drug overdose.
What defines a relapse and what it is not?
We need to understand that slip ups and relapse are not the same. An important distinction defines these two conditions clearly. A relapse is a buck-up, sustained return to moderate or heavy drinking.
In relapse, the addicts get back to regular alcohol use that was present before the treatment started. The patient shows old symptoms of drug abuse and has no intention to commit to the treatment regime.
Contrary to this, slipups are short-lived abuse that are accidental and happen once in a while if the social trigger for drinking is present.
It reflects the inadequacy of the patient to control their drinking behavior in high-risk social circumstances; such as a game night, or family wedding, etc.
Slip relapses are not full-blown relapses and the person overcomes the problem easily. However relapse occurs when the person abandons the recovery plan and starts abusing the substance with renewed intensity.
Experts say that the likelihood of relapse is more during the first 90 days of recovery. This is because the mind and body of the addictive individual goes through various changes to accept sobriety.
The risk diminishes after 90 days. It should be noted that relapse doesn’t mean an ethical weakness. Rather it means the inability to resist drinking. There are intense cravings that are hard to resist. The person loses self-control and breaks the goals of recovery.
What does it mean when someone relapses – 10 key signs of relapse
If you are concerned about your loved one falling into a relapse, you can consider the following signs that give an idea what to look out for.
People suffering a relapse or recurrence to drinking or drug abuse often show some major signs. These signs are the cues that they are not following the treatment plan as given by the medical practitioner.
Some of the notable signs of relapse are discussed below:
1. Social isolation
Isolation refers to a condition when the person stops attending support group programs meant for their recovery. They may stop showing interest in Alcoholics Anonymous group.
Sometimes, they may avoid meeting family members, or not answering phone calls like earlier. These signs show that the person is missing out on something important in their life.
Usually, social isolation occurs during the stage of emotional relapse. The person feels lonely and support-less.
As such they decline invitations for recovery programs, or may cancel therapy schedules, feel down, and ruminate about their old habits of drug use.
2. Inadequate self care
During relapse, the person shows poor self-care. They may start ignoring their needs and wants. Self care involves activities that make a person feel healthy and good from within.
A person suffering from relapse can show declining self-care. They may not eat well, or show symptoms of low appetite. Sleep schedules may get irregular.
Missing appointments with the therapist or not showing interest to do daily chores are all warning signs of relapse. The person may slip out on daily hygiene or eating habits that suggests that they are not doing fine.
3. Mood swings
This is another notable sign of relapse. A general stress of expected sobriety, irritability can be seen during the relapse state. The person suffers from emotional outbursts such as anger, or sudden crying depicting signs of depression.
You may see that they are losing interest in recovery practices, have become excessively moody and frustrated for no obvious reason.
Addicts may also behave weird by showing excessive anxiety of not being able to resist drinking. They may start thinking about the worst scenarios of what others might think about their failure to achieve sobriety.
These negative thoughts trigger negative emotional outbursts that are difficult to tame unless treated through therapeutic ways.
4. Rumination about active addiction days
When the addictive person thinks too much about their old drinking behavior, they become nostalgic and suffer from sad feelings.
They daydream about past addictions that gave them pleasure and joy. In this way, they try to relive those moments of addiction that were satisfying and helped to remove feelings of guilt and suffering.
You can say that an addictive person becomes nostalgic about their past drinking habits.
5. Hanging out with friends or family who drink and merry a lot
The person may start meeting friends, going out with them for a party and enjoy their old addictions. This will act as a relapse trigger.
Sometimes, falling into old habits or meeting those who still abuse alcohol or drugs can increase the chances of suffering a relapse.
6. Having a minimalistic attitude
Another sign of relapse is when the person tries to minimize the consequences of falling into a relapse state. If your loved one is downplaying the after effect of a ‘single drink’ each time he/she is doing it, be aware of some major thing coming down the line.
Many addicts undermine the consequence of single drinking. They think that once or twice drinking is allowed during the recovery phase but they forget that these behaviors will cost them heavily sometime later.
Having a single drink can have adverse effects. In no time, the person starts consuming more of it even after realizing the price they’re going to pay for this.
Addiction is an ailment and thus no risks can be taken in this regard. If the person is sober for a while, and then they again consume the drug, it may cause drug overdose. This is because they do not know how much their body can tolerate now.
7. Person getting into cross addictions
Sometimes people suffering from signs of relapse get into cross addictions. This means they substitute the drug that they were consuming previously with a new addictive substance.
For example, if someone was using alcohol previously, they may start using heroin or marijuana. These people make themselves realize that other substances would not be harmful for them.
If you see your loved one using less addictive substances instead of the primary one that they are recovering from, be sure that they are already falling into the ‘relapse’ trap.
8. Constant cravings for substances
Addiction can change and alter the reward centers in the brain. Several research studies have shown that alcohol or any other drug abuse creates association between the reward centers of the brain and places, people, things, or situations related to past abuse.
Thus, if the person is exposed to the right trigger such as meeting an old pal after a long time who used to be a partner in crime can lead to relapse. In this case, the person ignores the recovery regime and follows his heart to drink again.
Just by encouraging some triggers can activate strong cravings to consume the alcohol or drug again. Cravings are one of the potent signs of mental relapse.
9. Ignoring signs of relapse
If the addictive individual constantly craves the drug and ignores the recovery plan, then it indicates relapse. Moreover, if relapse signs are not taken seriously and the person intends to consume the alcohol or drug, then full relapse can kick start any moment.
In these situations, the person chalks out a plan and assures themselves that they will drink once or twice and will never fall back into complete addiction.
False assurances are set that slip outs will be handled and they can manage if future cravings occur; but in reality this is not the case.
After one or two attempts, the person may consume a lot of alcohol or get into binge drinking with soaring alcohol levels in the blood. Thus, relapse can be dangerous leading to serious consequences such as overdose.
10. Physical relapse or a full blown relapse
This type of relapse takes place when the person overrides their old addiction completely without any control. Sometimes misfortunes such as job loss, financial crisis, death of a loved one can trigger addiction.
Sometimes, in spite of some best efforts, some people fall into relapse because of their poor confidence to fight adversities in life. They may think addiction is an easy escape from the pain and sufferings in life.
Quick checklist signs for relapse
So far, we have discussed some major signs of alcohol relapse and how it constraints the recovery plan. Besides these there are some quick signs that you should know.
You can identify whether you or your loved one is suffering from relapse or not. Awareness is the key in treatment that may help in restoring good mental health.
- Borrowing money from others due to financial crisis
- Getting into other compulsive actions such as hunting places to buy the substances
- Denial of taking drugs or abusing alcohol to family members
- Becoming defensive when asked about their relapse symptoms
- An impulsive action that goes out of the person’s nature may suggest that they are struggling to maintain sobriety.
- Overwhelming negative emotions such as annoyance and frustration.
- Missing office meetings, or not interested in doing daily chores can hint a relapse
- Person shows lack of concern about follow-ups and doctor’s appointment
- Trying to bond with old contacts
- They may put down their guards of remaining clean and sober and may indulge in drinking one or two times quite often.
Addiction relapse occurs because of the inability of the sufferer to maintain sobriety. As a result, occasional drinking may slowly turn heavy without the patient realizing it.
Relapse or recurrence of addiction symptoms is quite common during recovery. It is expected that a person suffering from alcohol or drug addiction might turn to substances one or more times before successfully quitting the problem.
In order to understand how relapse happen; we will discuss the various stages of relapse. Readers should note that relapse is not a sudden occurrence at all.
The addictive individual goes through various emotional and physical changes before a full blown relapse takes place.
The various stages of relapse are as follows:
1. Stage 1 – Emotional relapse
Emotional relapse is the first stage that things are not right somewhere in the person’s life. A person trying to quit addiction will not think about using drugs actively at this stage. But there will be some emotional issues that will be cumbersome for them.
Certain emotions and behavior may act as internal triggers that might provoke them to consume drug or alcohol again.
Emotional relapse has subtle signs that need to be recognized early so that the person can be helped out easily. They are as follows:
- Bottling up emotions and not sharing their inner thoughts with family members or friends
- Not attending group meetings and activities meant for drug quitting
- Isolation from peers and family
- Poor eating habits
- Irregular sleep
- Mood alterations
- Becoming intolerant and showing more anger and annoyance than usual
- Becoming defensive
- Lying and keeping things hidden from family members
- Poor self-care
2. Stage 2 – Mental Relapse
If the addiction sufferer chooses not to give importance to the subtle signs of emotional relapse, then they may fall into the second stage quite easily.
During mental relapse, the signs become more intense and the person shows cravings for the substance that they were using.
In this stage, the patient undergoes a mental turmoil where one part of them says that addiction is okay and the other part says it’s not. A mental dilemma operates within the person.
When the person is all consumed by thoughts of addiction in this stage, their resistance to relapse decreases and they wish to escape from the turmoil.
In mental relapse, the thoughts of actually using the drug or alcohol starts again and the person’s control over these thoughts go on diminishing till they fall into physical relapse.
The various signs of mental relapse are:
- Cravings for the substance
- Remembering old connections or places where they use to drink and enjoy
- Frequent hang outs with people who drink and consume substances
- The patient minimizes the consequences of past usage
- They may glamorize their past drinking habits and feel good about it
- Thinking about various schemes to controlled drinking
- Imagining and fantasizing drinking
- Planning to relapse in a all new way
3. Stage 3 – Physical relapse
This is the last stage that leads to a full-blown relapse. If the addictive individual doesn’t take care of the signs of emotional and mental relapse, they actually fall into physical relapse.
In this stage, the resistance to control the urge completely breaks down and the person becomes a victim to addiction again.
In this stage, the person resumes drinking or consuming the drug that they were previously addicted to. Sometimes drug overdose can occur leading to severe health issues.
This is a crucial juncture where the addiction sufferer or his/her family members should consult a doctor before things get really worse in a short time.
What is relapse prevention in psychology?
Relapse prevention refers to a systematic therapy intervention that uses CBT techniques to help addicts recover from their addiction.
The goal of this approach is to identify the triggers and address the risky situations that may lead to relapse. When the patient knows the high risk situations, they can alter their mind states and behavior patterns so that relapse can be prevented.
The relapse prevention plan uses several strategies that can stop the person from abusing alcohol or drugs so that the person can maintain sobriety for a long time.
The relapse prevention is a written or verbal plan that can be used by the patient suffering from addiction. It includes the behavior and situational variables that the person needs to avoid while undergoing recovery treatments.
The research studies done in 2018 show that the goal of relapse prevention is to identify the high-risk behaviors leading to relapse. The two specific goals are as follows:
- Reducing and preventing the chances of initial relapse. The person is taught to abstain from drugs or alcohol so as to minimize its health hazards.
- The plan provides coping skills that the person may follow if at all relapse occurs, so that further health hazards and overdose issues can be prevented.
Tips for making relapse prevention plan
If you find your loved one showing symptoms of relapse, you may consult a therapist who will help you in crafting a worthy relapse prevention plan.
Prevention planning for relapse include the following:
- To avoid people or places who remind you of your drinking behavior. They are the immediate triggers who might instigate you into further relapse.
- Remove thoughts and feelings associated with pleasure of consuming drugs or substances.
- Avoid emotional distress and minimize stress levels in daily life. Otherwise relapse may occur pretty easily.
- Prepare a weekly or daily routine that can make you focus on productive activities. This diverts your focus on other creative endeavors and you will forget your addiction behavior.
- Develop good social connections so that you can get help from others in times of boredom, or trying to pacify your impulsive actions.
Why does relapse happen? 8 causes to note
People suffering from alcohol or drug abuse often struggle to maintain sobriety. Thus, relapse is a common thing and there are certain risk factors that can contribute to relapse.
Experiencing a relapse can have the following causes. The likely relapse triggers are as follows:
Many addicts start abusing alcohol or drugs during the first week of following a recovery plan. This mainly occurs to stop or avoid the withdrawal symptoms.
Actually some of these withdrawal symptoms are too harsh to deal with. Some of these symptoms are nausea and vomiting, hot and cold flashes, mental irritation, muscle pain, and insomnia.
The pain and suffering makes the person get back to their old drinking habits.
2. Life stressors
Many people suffering from substance use can readily turn into relapse in times of stress. They may find alcohol or drugs an easy refuge during times of emotional turmoil. It’s an easy escape from facing the harsh realities of life.
For these individuals, alcohol is a way of coping with stress. Several stressful incidents of life such as job loss, divorce, death of a loved one may trigger relapse. Research indicates that stress increases the likelihood of relapse.
There is an increased wanting for alcohol or addictive activity during times of emotional upheavals. Addiction behavior worsens during stressful circumstances and relapse can happen any moment if the substance becomes the primary source of coping for the person.
3. People or places related with addiction
The people and places that were a part of your addiction behavior are potential threats for relapse. It could be an old friend who taught you how to drink, or the visit to the pub in the neighborhood can bring back old memories associated with drinking.
During emotional relapse, any one of these can make the person fall back into drinking. When you remember your old habits, you may find it hard to resist the urge of abusing drugs or alcohol. In such a situation, relapse is common. It can break your recovery plan quite easily.
4. Negative emotions can become threats
If the addictive individual is suffering from a trauma or facing any challenging emotion, they may restart substance abuse again after a period of sobriety. This happens because these individuals have become a victim of their negative emotions.
As they cannot handle emotions in a better way, they consider drug and alcohol abuse a quick shortcut that gives temporary relief from pain and suffering.
Research findings have shown that when people are in a bad mood, relapse occurs much earlier than when they are under the influence of positive emotions.
5. Sensing the object of addiction around you
A person suffering from alcohol addiction can start abusing drinks again if they sense stimulus associated with their old habit near them.
Seeing someone smoking, or sitting in a restaurant where others are enjoying drinks can bring back pleasurable memories from the past and lead to a relapse.
Being in a familiar place can urge the person to want drugs or abuse alcohol. These signs are common when the person is trying to quit and recover completely. At this stage, if the self-control of the person breaks off, they may again start their old addiction any moment.
6. Celebrations and functions
This is also a likely trigger for addiction and relapse. If the sufferer visits a party such as a wedding, or home-warming, and sees many people enjoying drinks, they may lose control and take up a glass again.
People who suffer from addiction cannot stop in a single drink. These people have weak self-control and as such they may continue boozing for longer than normal. In this way, they break the recovery plan and relapse sets in.
7. Over confidence and a sense of pride
People trying to recover from alcohol or drug addiction suffer from a pink cloud. This condition refers to a state of heightened self-confidence where they think that they are in control of their urges and they will never restart addiction no matter what happens in their life.
These individuals possess pride and excessive false faith in themselves. They forget that relapse is an emotional and physical weakness. Thus, it can happen to any addict who wants to turn to sobriety forever.
Being in a wrong place with a bad company around can trigger relapse. The person may lose control and feels strong urges that are irresistible.
Thus, it is always good to stay away from people, places, or situations that can bring back old pleasurable memories of abuse and instigate someone to start abusing the substance again.
8. Boredom and social isolation
Moments of boredom can lead to relapse during the early recovery phase. At this stage, the sufferer feels lonely and isolated. They think they are struggling alone and there is nobody by their side. Thus, they may fill their day by doing something related to addiction.
Things like finding old friends who introduced them to drinking, or walking down the street and seeing others getting inside a pub, etc. these feelings can trigger relapse by breaking the resistance as set by the recovery treatment plan.
So, it is advisable that whenever an addict is struggling to pass through the initial stages of recovery, they should not be left all by themselves.
The family members of the patient should keep an eye on their whereabouts. At the same time, they should be given some good company to bust boredom.
What to do when a person you know relapses?
If you know someone close to you has already started showing signs of relapse, you can help them in certain ways. Some tips are discussed below:
- Never blame or shame the person who has suffered a relapse. Remember that they are already feeling ashamed and guilty for breaking their recovery regime. If you fault-find and make it a big deal, the condition of the person will surely worsen,
- Don’t judge your loved one. Tell them that they need to be more cautious next time and will have to stick to recovery treatments.
- Help them recover from guilt by being kind and compassionate.
- Addiction support to a loved one involves love, care, and unconditional acceptance.
- Help them avoid future relapses by identifying those common triggers that led to the initial relapse. It could be a sudden friend’s meet-up that the person was exposed to. The trigger needs to be eliminated completely to help the addict overcome the urges to consume the substance again.
- Offer empathy as much as you can. This means you will have to support the sufferer with care and concern without making them feel guilty for what had happened.
- You can offer kind and encouraging words to the patient so that they can get back their lost confidence.
- Help them come out from a feeling of being failed in their recovery endeavors. You can make them realize their small success stories about sobriety and assure that they will do well in future. Help them overcome their fear of failing again.
What is drug overdose risk during relapse?
The recovery journey from alcohol dependence or any other form of drug abuse is not an easy thing. Patients fall back into relapse quite often and feel guilty of being a failure.
This means that emotional turmoil and anxiety to stay sober always haunts these individuals in their daily life.
Drug overdose is an associated risk of relapse. Sometimes, the situation can worsen leading to even fatal consequences.
Now, let’s understand what an overdose is. Alcohol or substance overdose refers to toxic intake of this drug to such a heavy level that it leads to several health issues instantly. Overdose state calls for immediate medical help.
The patient may fall back into drinking again and get out of control of excessive drinking in one go. This situation is critical and the patient needs immediate medical aid, without which the outcome will be really bad.
Overdose occurs due to low tolerance levels. Once the person was away from addiction for some time, And if they relapse, overdose issues become more common.
This is because the person may consume more than what they used to or the same amount can cost them heavily, because of intolerance.
They will not be able to tolerate the same amount that was normal for them before. The various recovery treatments have lowered the tolerance level, causing serious sickness and hospitalization also.
How common are relapses?
Any person suffering from addiction and trying to quit abuse are prone to relapse. Research findings reveal that relapse is a common thing during addiction recovery. It also says that a person may fall back into several relapses before completely quitting the drug.
Many individuals suffer from extreme unhappiness and guilt about relapse. They feel that they have failed in their recovery endeavors and now nothing can be done. In reality, the picture is somewhat different.
These individuals need to realize that relapse is common and is a hallmark of the addiction recovery process. World Health Organization reports revealed that relapse rates are higher for patients suffering from Alcohol Dependence Syndrome (ADS) or any other forms of substance abuse disorder.
About 140 million alcoholics are there worldwide. Out of this, relapse rates are high with 65-80% patients falling back to addiction all over again after a lapse of sobriety.
Treatment of relapse / what to do after a relapse
Relapse is not a failure but it’s a brand new opportunity to get back on your feet with better control and hold. It means you still have so much to look forward to in your treatment program.
People in the recovery stage fall to relapse due to constant urges and their inability to avoid withdrawal symptoms.
Anxiety and guilt are common symptoms after a relapse. The patient needs to realize that relapse is just a type of setback. They can recover fully with confidence and pride if they go on walking along the path of recovery.
A person can do the following things after a relapse to avail better treatment benefits from their recovery plan. The road to recovery is tough but not impossible at all. Little patience and tenacity may go a long way in complete quitting.
The addiction treatment facilities usually involve the following steps.
1. Stop drinking right away
When a person suffers a relapse, they may continue drinking, and think that they have already suffered a relapse and it’s no use stopping now. But this attitude is harmful and leads to many countless future relapses.
If you find your loved one already into a relapse state, make sure to encourage them to stop drinking right away. This helps in prevention of addiction in the long run.
2. Stick to recovery action plan
The treatment for addiction relapse is best done if you can follow what your doctor has said. Doing enough self-care is equally important. The addictive person needs to eat and sleep well, do regular exercises, and follow certain hobbies to keep themselves mentally fresh and energized.
They should take medications regularly and follow the guidelines for recovery given by the doctor strictly. Even if relapse happens, they should accept it as a challenge and continue progressing with the treatment procedures.
3. Look for support always
Addiction recovery is not as easy as it may sound. Whenever the person feels demotivated and loses confidence to move ahead with the recovery plan, they should seek support from trusted friends and caring family members.
Support from alcoholics anonymous groups are also a good option. These groups share individual success stories and the patient gets cues on various options to keep away from drugs or alcohol.
Moreover, these groups are formed by similar sufferers who can share each other’s coping techniques with one another. Support from well-wishers can help in preventing future relapses before the ultimate quit takes place.
4. Identify the triggers
The successful recovery from addiction is possible when the person knows his/her triggers and how to control them strictly. Triggers are the stimuli that can cause drug cravings.
Thus, becoming aware of the various triggers can help the patient avoid such people, or situations that can remind them of their past addictions. They will be able to control their cravings in a better way.
Moreover, knowing the triggers also helps in reducing temptations. The person feels empowered and can continue with their recovery efforts with renewed energy and confidence.
5. Visit a therapist to create an actionable recovery plan to prevent future relapses
If you or your loved one has recently suffered a relapse, do not wait and seek immediate medical help. The earlier you kick start your treatment regime, the better it becomes.
With the help of the doctor, you’ll be able to follow a recovery plan easily. They will guide you to develop strategies for trigger identification and how to stop craving if at all the symptoms of emotional relapse occur.
Clinical support and sober resource groups can help in recovery to a great deal with many unexpected achievements in your stride.
Cognitive behavior therapy works well with managing symptoms such as constant thoughts about abusing the substance. This should be undertaken in addiction centers for better recovery.
Summing Up from ‘ThePleasantMind’
Relapse allows you to come back with more confidence and you are more in control of your life. The hallmark of recovery would be to stay aware of your triggers and maintain a hopeful and positive outlook towards complete quitting.
Remember that you are powerful enough not to allow substances to take over your life’s well-being. Relapse gives you another opportunity to start afresh and make your life happy and satisfied.
You will break the cycle of addiction by staying sober, calm and hopeful for better changes to take place anytime, any moment.
A Psychologist with a master's degree in Psychology, a former school psychologist, and a teacher by profession Chandrani loves to live life simply and happily. She is an avid reader and a keen observer. Writing has always been a passion for her, since her school days. It helps to de-stress and keeps her mentally agile. Pursuing a career in writing was a chance occurrence when she started to pen down her thoughts and experiences for a few childcare and parenting websites. Her lovable niche includes mental health, parenting, childcare, and self-improvement. She is here to share her thoughts and experiences and enrich the lives of few if not many.