- 10 Signs of Relapse
- Emotional Relapse
- #1 Isolation
- #2 Decline in Self-Care
- #3 Depression, Anxiety, and Mood Changes
- Mental Relapse
- #4 Romanticizing Your Active Addiction
- #5 Hanging Out With Friends Who Use
- #6 Minimizing the Consequences of Relapsing
- #7 Developing Cross Addictions
- #8 Cravings
- #9 Making a Plan to Relapse
- Physical Relapse
- #10 Slip or Full-Blown Relapse
- What to Do if You’ve Relapsed
- We Can Help
- Relapse Prevention Plan and Early Warning Signs
- Early Relapse Prevention
- Techniques for Dealing with Mental Urges
- 8 warning signs that you may be heading toward a relapse
- 1. Stopping all recovery related activities
- 2. Glamorizing the old using days
- 3. Acting your old way: selfish and moody
- 4. “Maybe one won’t hurt!”
- 5. Connecting with old friends again
- 6. Slowly removing elements of balance and focus on sobriety
- 7. You want to reward yourself
- 8. You are extremely defensive when anyone brings up the changes in your behaviour and attitude
- 7 Warning Signs You Are Heading for a Relapse
- 1. You Stop Doing What You Need to Do to Stay Abstinent
- 2. You Start Romanticizing the Days When You Were Abusing Substances
- 3. You Start Acting the Way You Did When Using: Selfish and Moody
- 4. You start thinking that maybe just one drink or one pill wouldn’t hurt
- 5. You begin seeking out old friends from your substance-abusing days
- 6. You slowly but surely remove all those elements from your life that keep you anchored and balanced
- 7. You are extremely defensive when anyone brings up the changes in your behavior and attitude
10 Signs of Relapse
Relapse is often a normal part of addiction recovery. According to research, around 40-60% of people in recovery will relapse at some point.
Addiction is a chronic, relapsing disease, and just other chronic diseases, relapse is always a risk. Relapse is tough on both the individual who relapses and their loved ones.
However, it’s important to know that addiction relapse doesn’t mean that treatment didn’t work, or sobriety will never be achievable.
If you’re concerned that you or a loved one is at risk of returning to alcohol or drug abuse, there are several addiction relapse warning signs you should be aware of.
Researchers have identified three predictable stages of relapse: emotional relapse, mental relapse, and physical relapse. There are different signs of relapse within each stage.
Paying attention to these relapse warning signs can help you prevent a drug relapse before it happens.
An emotional relapse is usually the first stage of relapse. At this point, you aren’t thinking about using drugs or alcohol again, but stress, triggers, or difficult situations are bringing up emotions and negative thoughts that fueled substance abuse in the past.
Despite these feelings, you aren’t using the healthy coping skills you know can help. You may brush off these early relapse warning signs and feel overconfident about your ability to manage intense emotions and thoughts without turning to drugs and alcohol.
Signs of emotional relapse include:
Isolation and loneliness are known relapse risk factors. There are many ways people isolate in recovery. Perhaps you’ve stopped attending recovery meetings Alcoholics Anonymous, Narcotics Anonymous, and SMART Recovery.
Maybe you’ve quit participating in the alumni program at the substance abuse treatment center you attended.
Avoiding friends and family, cancelling therapy appointments, or skirting social activities are signs of isolation as well.
Isolation can be an important sign of relapse for loved ones. If the individual in recovery is declining invitations, not answering phone calls and texts, or not participating in usual social activities, check in with them to make sure they’re okay.
#2 Decline in Self-Care
Most addiction treatment programs teach the importance of self-care as critical components of relapse prevention.
If you’ve stopped doing the things you know help you feel good so you’re better able to resist drugs and alcohol, pay attention.
Self-care can be anything from exercising, eating right, and getting enough sleep to attending individual therapy or keeping up with medication-assisted treatment for heroin addiction or opioid addiction.
A decline in self-care is another warning sign of relapse loved ones can look out for. You may not know if the individual in recovery is keeping up with therapy, appointments, or exercise, but you can look for more obvious indicators. If you notice basic self-care slipping, hygiene, eating habits, or physical upkeep, this could be a sign your loved one is relapsing.
#3 Depression, Anxiety, and Mood Changes
Studies show that people with depression and anxiety are at higher risk for addiction relapse. Mental health can impact relapse in a couple of ways.
If you’re not following through with practices known to manage depression or anxiety symptoms therapy and medication, you’re putting yourself at risk for relapse.
People in recovery with co-occurring disorders need to treat mental health symptoms so they aren’t tempted to self-medicate them with drugs and alcohol.
On the other hand, relapse can be triggered by a general feeling of irritability, discontent, or low mood that is common especially in early recovery. This can result from experiences :
- Poor self-care
- General worry about sobriety
- Loss of motivation for recovery practices
- Boredom and isolation
Emotional relapse can fuel mental relapse. Without addressing difficult emotions, thoughts, and situations in healthy ways, your mind may wander toward memories of substance abuse as an escape.
At first, you may try convincing yourself that you wouldn’t actually use drugs and alcohol again, but as mental relapse progresses, you may fantasize about getting relief from drugs and alcohol — how it would feel, and how you would do it.
You might even start developing a plan for relapse.
Here are some warnings signs of mental relapse:
#4 Romanticizing Your Active Addiction
A significant relapse warning sign is becoming nostalgic for your old lifestyle. When you’re in a bad place emotionally, it’s tempting to forget about the pain, loss, heartache, and misery that came with substance abuse. You may daydream about past substance use that you found fun or relieving and disregard all the memories of bad experiences.
#5 Hanging Out With Friends Who Use
You may start engaging in behaviors that you know are relapse triggers. This can include talking to or seeing old friends who still abuse drugs and alcohol. Hanging out in places where you used substances or where you’re ly to run into your old friends is also a red flag.
#6 Minimizing the Consequences of Relapsing
During a mental relapse, you may start downplaying the danger of “just one drink” or “just one hit.
” If you’ve been through substance abuse treatment, you know that addiction is a disease and when you’re in recovery, there’s no such thing as moderation when it comes to using drugs and alcohol. Having one drink or one hit is playing with fire.
Furthermore, if you’ve been sober for awhile, taking drugs heroin or opioids can put you at high risk for overdose because you have no way of knowing how much of the drug your body can handle now.
#7 Developing Cross Addictions
More research on cross addictions is needed, but it occurs when you replace one addiction with another. For example, perhaps you were addicted to heroin, but you start abusing alcohol or marijuana because you’ve convinced yourself it’s not as bad. Maybe you start coping with life through another destructive behavior, such as an eating disorder or compulsive gambling.
Cross addiction is another sign of relapse that loved ones can look out for. If you notice the individual in recovery engaging in compulsive behaviors or using “less serious” substances, it is a definite indication that they need help.
Addiction changes your brain’s reward center. Research shows that repeated drug and alcohol abuse creates strong associations between the brain’s reward center and places, people, and situations tied to past substance abuse.
Just encountering these things can bring on powerful urges and cravings. If you’re at the point where you don’t try to avoid relapse triggers or are intentionally seeking them out, you can expect some cravings and urges.
This is pretty much throwing down the gauntlet between you and recovery, and it’s time to get help.
#9 Making a Plan to Relapse
When you’re teetering between mental relapse and physical relapse, you’re avoiding relapse warning signs and your intent is to use drugs and alcohol. You may be telling yourself things , “I can handle this. It will just be this once.
I won’t return to active addiction.” You’re mapping out the details of alcohol and drug relapse, such as when, how, and with whom it will take place. You can still change your course.
Now is the time to call your sponsor, tell a loved one, or check yourself into a treatment center.
A physical relapse is when you’re drinking or using drugs again.
#10 Slip or Full-Blown Relapse
Some addiction experts talk about a return to substance use as a slip or relapse. A slip may seem to come nowhere. It can be triggered by an unforeseen event a death, job loss, or unexpected trigger. A slip is usually a one-time event where you immediately feel regret and want to get back to sobriety. A relapse is a longer-term slip
into drug or alcohol abuse. During a relapse, you fall into your old lifestyle and may not have a desire to get sober for some time.
What to Do if You’ve Relapsed
If you’ve relapsed, don’t throw in the towel on your sobriety. Addiction relapse is a signal that you still have work to do. You’ll learn from this and move forward in sobriety — stronger, and with a better handle on what you need for long-term recovery.
Depending on the severity of relapse, perhaps you can get back on track with outpatient treatment or by increasing the frequency of individual therapy, support groups, and other critical relapse prevention resources.
Returning to a drug or alcohol addiction treatment center may be the best decision in some cases.
If you’re the loved one of an individual who’s relapsed, it’s important not to blame or shame them.
This will only put them on the defense and make them feel worse, which could encourage a further spiral into substance abuse.
The individual who’s relapsed is ly already putting an immense amount of shame and blame on themselves. Read about relapse, and why it happens, as well as what to do when a loved one relapses.
We Can Help
Relapse is not a failure, it’s an opportunity. If you or a loved one has started abusing drugs or alcohol again, we can help. Footprints to Recovery drug rehab centers specialize in evidence-based addiction treatment that addresses underlying issues, which can lead to substance abuse and relapse :
We’ll work with you to identify the reasons why you used drugs and alcohol again and create a comprehensive relapse prevention plan. Our recovery centers offer a full continuum of care that includes:
Loved ones get help too through family therapy and addiction education. You’ll learn about the signs of relapse and healthier ways to support each other and better communicate.
We understand what you’re going through. Call us for a free, confidential consultation and learn how we can help.
Relapse Prevention Plan and Early Warning Signs
- Withdrawal symptoms (anxiety, nausea, physical weakness)
- Post-acute withdrawal symptoms (anxiety, irritability, mood swings, poor sleep)
- Poor self-care (stress management, eating, sleeping)
- People (old using friends)
- Places (where you used or where you used to buy drugs)
- Things (that were part of your using, or that remind you of using)
- Uncomfortable emotions (H.A.L.T.: hungry, angry, lonely, tired)
- Relationships and sex (can be stressful if anything goes wrong)
- Isolation (gives you too much time to be with your own thoughts)
- Pride and overconfidence (thinking you don’t have a drug or alcohol problem, or that it is behind you)
Relapse is a process, it's not an event. In order to understand relapse prevention, you have to understand the stages of relapse. Relapse starts weeks or even months before the event of physical relapse. In this page you will learn the early warning signs of relapse and specific relapse prevention techniques for each stage of relapse. There are three stages of relapse.(1)
- Emotional relapse
- Mental relapse
- Physical relapse
Early Relapse Prevention
Relapse prevention at this stage means recognizing that you're in emotional relapse and changing your behavior. Recognize that you're isolating and remind yourself to ask for help. Recognize that you're anxious and practice relaxation techniques. Recognize that your sleep and eating habits are slipping and practice self-care.
If you don't change your behavior at this stage and you live too long in the stage of emotional relapse you'll become exhausted, and when you're exhausted you will want to escape, which will move you into mental relapse.
Practice self-care. The most important thing you can do to prevent relapse at this stage is take better care of yourself. Think about why you use. You use drugs or alcohol to escape, relax, or reward yourself. Therefore you relapse when you don't take care of yourself and create situations that are mentally and emotionally draining that make you want to escape.
For example, if you don't take care of yourself and eat poorly or have poor sleep habits, you'll feel exhausted and want to escape.
If you don't let go of your resentments and fears through some form of relaxation, they will build to the point where you'll feel uncomfortable in your own skin. If you don't ask for help, you'll feel isolated.
If any of those situations continues for too long, you will begin to think about using. But if you practice self-care, you can avoid those feelings from growing and avoid relapse.
Techniques for Dealing with Mental Urges
Play the tape through. When you think about using, the fantasy is that you'll be able to control your use this time. You'll just have one drink. But play the tape through. One drink usually leads to more drinks.
You'll wake up the next day feeling disappointed in yourself. You may not be able to stop the next day, and you'll get caught in the same vicious cycle.
When you play that tape through to its logical conclusion, using doesn't seem so appealing.
A common mental urge is that you can get away with using, because no one will know if you relapse. Perhaps your spouse is away for the weekend, or you're away on a trip.
That's when your addiction will try to convince you that you don't have a big problem, and that you're really doing your recovery to please your spouse or your work. Play the tape through.
Remind yourself of the negative consequences you've already suffered, and the potential consequences that lie around the corner if you relapse again. If you could control your use, you would have done it by now.
Tell someone that you're having urges to use. Call a friend, a support, or someone in recovery. Share with them what you're going through. The magic of sharing is that the minute you start to talk about what you're thinking and feeling, your urges begin to disappear. They don't seem quite as big and you don't feel as alone.
Distract yourself. When you think about using, do something to occupy yourself. Call a friend. Go to a meeting. Get up and go for a walk. If you just sit there with your urge and don't do anything, you're giving your mental relapse room to grow.
Wait for 30 minutes. Most urges usually last for less than 15 to 30 minutes. When you're in an urge, it feels an eternity. But if you can keep yourself busy and do the things you're supposed to do, it'll quickly be gone.
Do your recovery one day at a time. Don't think about whether you can stay abstinent forever. That's a paralyzing thought. It's overwhelming even for people who've been in recovery for a long time.
One day at a time, means you should match your goals to your emotional strength. When you feel strong and you're motivated to not use, then tell yourself that you won't use for the next week or the next month.
But when you're struggling and having lots of urges, and those times will happen often, tell yourself that you won't use for today or for the next 30 minutes.
Do your recovery in bite-sized chunks and don't sabotage yourself by thinking too far ahead.
Make relaxation part of your recovery. Relaxation is an important part of relapse prevention, because when you're tense you tend to do what’s familiar and wrong, instead of what's new and right. When you're tense you tend to repeat the same mistakes you made before. When you're relaxed you are more open to change.
1) The stages of relapse were first described by Terence Gorski. Gorski, T., & Miller, M., Staying Sober: A Guide for Relapse Prevention: Independence Press, 1986.
8 warning signs that you may be heading toward a relapse
Most people who struggle with substance use will have one or more relapses during their ongoing attempts to recover. Here are 8 signs to watch for.
Relapse is a cardinal feature of addiction, and one of the most painful. Most people who struggle with substance use will have one or more relapses – the return to drug or alcohol use after a period of abstinence – during their ongoing attempts to recover.
Unsurprisingly, this can be extremely frustrating for patients and for families, as they have already experienced great pain.
There are usually significant behaviours (mental relapse) that can signal high risks for relapse. It is important for anyone in recovery to understand these warning signs and triggers.
What leads to relapse? Multiple – and often interactive – factors can increase the lihood of relapse. These are some of the commonly cited precursors and triggers:
- drug and alcohol-related “reminder” cues (sights, sounds, smells, using thoughts or dreams) tightly linked to use of the preferred substance can trigger craving and seeking
- negative mood states or stressors
- positive mood states or celebrations
- Associating with old friends or partners still using substances
- Environmental i.e. driving by the liquor store or bar on the way home from work
The motivation to seek a drug, once triggered, can feel overwhelming and sometimes leads to very poor decision making: the user will pursue the drug, despite potentially disastrous future negative consequences (and many past negative consequences.)
1. Stopping all recovery related activities
The most common one for some is stopping going to peer-support meetings. They will make excuses: they’re too tired or it’s to far or I hate that meeting or there is someone there that is annoying. They may even lie and say they are going when they are not. Meetings are a lifeline for some people in recovery as it keeps them accountable.
The recovering person might stop therapy appointments because they are not ready to go that deep yet. Some will stop Sober Coaching appointments because they are not able to fulfil the commitment.
Another one is “recovery burnout.” Some people go full on recovery and then get sick of it, so much they resent the whole process. It is ok to take a break as long as you are staying healthy in other areas and seeking out some kind of support. Perhaps you need to re-evaluate your recovery plan to balance things out.
2. Glamorizing the old using days
This might take the form of remembering the good times when you were drinking or experimenting with drugs. Most recovering people had a time during which they had few consequences with substance use. They may even have had fun.
At some point though they became dependent on the substances and consequences piled up. Rituals i.e. the seeking, purchasing, setting up and using substances are often glamorized and can be triggering.
“Playing the tape” back to the dark days is a great tool and can often be a stark reminder to put things into perspective on why you are clean and sober today.
3. Acting your old way: selfish and moody
Sometimes this is called a “dry drunk.” You act you did when drinking, even without the drink. Those in recovery attempt to change their attitudes. They learn that they have a tendency to personalize things and overreact.
They discover that they have a low tolerance for frustration, and can get rather ornery if they don’t get what they want, when they want it. They are the focus of everything. If someone doesn’t smile at them, they take it personally.
If someone else gets a promotion, it says something bad about their work.
If you have been working on this behaviours then start to see it reappear, this is a warning sign.
4. “Maybe one won’t hurt!”
If you find you are talking yourself into “just one,” this is one of the most obvious signs of an impending relapse. Those in recovery know full well the consequences of substance use, so the first step in using again is to somehow convince themselves that it wasn’t that bad, or that they have “changed” and won’t have the same issues this time around.
The rule of thumb is that those who relapse pick up right where they left off. It might take a few days or weeks, but you will rapidly be in the same place you were when you last quit drinking or using drugs.
5. Connecting with old friends again
You might excuse this as just trying to find out how old friends are doing, but if you start seeking out old drinking or using buddies or people who shared your interest in using drugs, you are heading into dangerous territory.
6. Slowly removing elements of balance and focus on sobriety
Maybe you stop journaling, stop calling healthy friends, and quit going to the gym that always helped you clear your head. You probably already stopped doing the things that are important for sobriety, but now you are removing things that keep you calm and centred. You might say you are getting lazy, and your life is ly getting more chaotic and stressful.
You might also notice you are slipping back into old deceptive patterns; you might start lying to loved ones to keep them from challenging you.You are not taking care of your emotional, spiritual, and physical health.
7. You want to reward yourself
This is an interesting one. You have achieved six months of sobriety and tell yourself you can do it! So you celebrate by using and it spirals. You get a promotion at work or nailed a killer presentation – so you celebrate. Be aware if this motive appears.
8. You are extremely defensive when anyone brings up the changes in your behaviour and attitude
This feeling will be familiar: it’s the same feeling you had when you first were encouraged to get clean and sober and wanted everyone to mind their own business. It’s very uncomfortable when others begin to notice our movement back toward a way of living that made us and most people around us miserable.
Why? Because you are now in the place of moving with purpose back toward drinking and using, and the addictive personality in you is determined to get that drink or drug.
For some, this can be the ultimate point of no return: you either wake up and change direction, or end up taking that inevitable first drink or drug.
There is always a way back from this movement toward a drink. The important thing is to recognize it’s happening and be honest about your attitudes and behaviours.
Many a time those in recovery have heard stories where someone says, “I don’t understand; I just suddenly heard myself ordering a drink.
” In truth, if that person looked back over the past few weeks and months, they would see this was the natural result of a progression toward relapse.
The sooner you catch yourself slipping back into old behaviours, the better chance you have of not slipping.
Sources: Anna Rose Childress, Ph.D., Promises Treatment Center
7 Warning Signs You Are Heading for a Relapse
The sad truth is that many people who try to recover from addiction to alcohol or drugs do not stay in recovery. Although relapse may be common, rarely does it occur without warning. There are usually significant behaviors that can signal that the recovering person is at high risk for relapse. It is critical for anyone in recovery to understand these warning signs.
First, it is important to understand the triggers. Triggers are things that tend to lead addicts back to their drug of choice. A trigger can be a person, a place, certain types of events, or unresolved psychiatric issues, such as depression or anxiety. When a person undergoes addiction treatment, their therapist will help them understand those things that could trigger them to relapse.
The most common triggers are old friends who still abuse substances and significant stressors, such as job or relationship problems. For alcoholics, a trigger might be a bar they used to drink at. Some people in recovery will try to revisit their old haunts without the conscious intention of drinking or using drugs; they will claim they just miss their old friends.
This is rarely a good idea in recovery.
1. You Stop Doing What You Need to Do to Stay Abstinent
The most common thing is for the recovering addict or alcoholic to stop going to 12-step meetings. They will make excuses: they don’t the fact people pray or everyone talks too much about their past substance abuse.
Most people who stay in recovery maintain some sort of connection to the 12-step programs, even if it’s only a weekly meeting. This allows them to continually be reminded of who they are and what is at stake. The recovering addict might stop therapy because they find it too uncomfortable.
They might go against the advice of their doctor in treating a psychiatric disorder such as clinical depression or bipolar disorder.
2. You Start Romanticizing the Days When You Were Abusing Substances
This might take the form of remembering only the good times when you were drinking or experimenting with drugs. Most addicts had a time during which they had few consequences for substance abuse. They may even have had fun.
However, those times were long gone by the time you got clean. At some point, they became dependent on the drug and consequences piled up.
If you find yourself smiling about the “good times,” and conveniently forgetting the misery of your later drug or alcohol use, this is a strong warning sign.
3. You Start Acting the Way You Did When Using: Selfish and Moody
Sometimes this is called a “dry drunk.” You act you did when drinking, even without the drink. In recovery, addicts attempt to change their attitudes. They learn that they have a tendency to personalize things and overreact.
Discover that they have a low tolerance for frustration, and can get rather ornery if they don’t get what they want when they want it. They are the focus of everything. If someone doesn’t smile at them, they take it personally. Or if someone else gets a promotion, it says something bad about their work.
If you have been working on this behavior then start to see it reappear, this is a warning sign.
4. You start thinking that maybe just one drink or one pill wouldn’t hurt
It you find you are talking yourself into “just one,” this is one of the most obvious signs of an impending relapse.
Those in recovery know full well the consequences of substance use, so the first step in using again is to somehow convince themselves that it wasn’t that bad, or that they have “changed” and won’t have the same issues this time around.
The rule of thumb is that those who relapse pick up right where they left off. It might take a few days or weeks, but you will rapidly be in the same place you were when you last quit drinking or using drugs.
5. You begin seeking out old friends from your substance-abusing days
You might excuse this as just trying to find out how old friends are doing, but if you start seeking out old drinking buddies or people who shared your interest in using drugs, you are heading into dangerous territory.
6. You slowly but surely remove all those elements from your life that keep you anchored and balanced
Maybe you stop keeping your journal, stop calling healthy friends, and quit that daily walk that always helped you clear your head. You probably already stopped doing the things that are important for sobriety, but now you are removing things that keep you calm and centered.
You might say you are getting lazy, and your life is ly getting more chaotic and stressful. Maybe you notice you are slipping back into old deceptive patterns; you might start lying to loved ones to keep them from challenging you.
You are not taking care of your emotional, spiritual, and physical health.
7. You are extremely defensive when anyone brings up the changes in your behavior and attitude
This feeling will be familiar: it’s the same feeling you had when you first were encouraged to get sober and wanted everyone to mind their own business. It is denial crossed with an unhealthy self-righteous attitude.
It’s very uncomfortable when others begin to notice our movement back toward a way of living that made us and most people around us miserable. Why? Because you are now in the place of moving with purpose back toward drinking and using, and the addict in you is determined to get that drink or drug.
For some, this can be the ultimate point of no return: you either wake up and change direction, or end up taking that inevitable first drink or drug. There is always a way back from this movement toward a drink. The important thing is to recognize it’s happening and be honest about your attitudes and behaviors.
Many a time those in recovery have heard stories where someone says, “I don’t understand; I just suddenly heard myself ordering a drink.” In truth, if that person looked back over the past few weeks and months, they would see this was the natural result of a progression toward relapse.
The sooner you catch yourself slipping back into old behaviors, the better chance you have of not slipping. Start your recovery today by calling to speak confidentially with a Promises Recovery Advisor at 1.713.528.3709.