While everyone hopes that a relapse prevention plan will stop a relapse from happening, it is not always foolproof. That being said, it is vital to understand relapse in addiction, the warning signs, and coping mechanisms.
What Does Relapse Mean?
In recovery, it is fairly common for an individual to relapse. A relapse in addiction is when an individual goes back to full usage of the drug or alcohol that they were attempting to abstain from. Luckily, relapse can be avoided or at least caught in its early stages if there is a proper relapse prevention plan in place.
How Common is Relapse?
Relapse can be a common part of recovery. Some studies indicate that about half of the individuals who attempt sobriety returned to heavy use. In addition, some studies have shown that 70% to 90% of individuals in recovery will experience some sort of mild or moderate drug relapse or alcohol relapse.1 It may take as much as five or six relapses in addiction to maintain change.2
Relapse as Part of Recovery
A relapse or even multiple relapses can be a part of the recovery process from a drug or alcohol dependence. As an individual in recovery, experiencing a slip, lapse, or even full relapse is not a sign of failure. It can be just one step on the road to recovery.
Relapse in addiction can be a crucial aspect of recovery because the individual learns to recognize their triggers. That person can practice using effective coping mechanisms to combat these triggers and reasons why they may partake in usage once more.
Slip vs. Relapse vs. Lapse
When discussing relapse, it’s important to understand the terms associated with relapse as well as their severity. Generally, three terms will be associated with the relapse process: slip, relapse, and lapse.
- Slip: A slip is a single unplanned use of alcohol or substances3
- Relapse: A relapse is a return to uncontrolled using. In this case, a relapse is a return to full use and abandonment of the treatment plan to maintain sobriety.
- Lapse: A lapse refers to the initial drink or drug use that could turn into a full relapse.4
The Dangers of Relapse
Unfortunately, some dangers coincide with relapse. Regardless of if the person has been sober for weeks, days, or years, an uncontained relapse can harm the treatment plan.
Withdrawal is the symptoms of alcohol or drug dependency experienced as the substance leaves the body. Typically, these symptoms are a rather unpleasant experience. The use of drugs or alcohol can rewire the brain, which is why recovery takes a long time. During this period, the brain has to completely rewire itself for the cravings to lessen. The cravings will likely get worse before they get better, and it can be difficult to manage these symptoms on one’s own.
An individual’s mental health is also an area that can be highly impacted by recovery and relapse in addiction. Any underlying symptoms of anxiety or depression will become present during times of recovery and may even influence relapse. Luckily, like the withdrawal symptoms, these symptoms will lessen over time as the individual learns to use coping mechanisms.
In addition to withdrawal symptoms and mental health, there is an increased overdose risk during times of relapse. The person who used to abuse the substance regularly built up a tolerance that they no longer have. When they use a substance at the same level that they had in the past, they may find that they no longer have that tolerance and an overdose is much more likely to occur.
Stages of Relapse
Relapse happens gradually. That being said, there are some distinct stages as well as signs that loved ones can learn to look for.
- Emotional Relapse: Emotional relapse refers to the potential emotions and behaviors that have influenced a past relapse. In this stage, the individual is not thinking about using, but they may be isolating themselves, avoiding meetings, not sharing during meetings, or may be focusing on other people instead of themselves.
- Mental Relapse: Mental relapse refers to the internal war that the individual faces. During this stage, the individual may start to think about using, begin to remember the people and places that were associated with past use, and may even begin to look for relapse opportunities.
- Physical Relapse: Physical relapse is when someone experiences a relapse and begins to use substances again. At this stage, a single use of the drug or one drink may lead to a quick and severe relapse if the individual does not have the proper coping mechanisms and has a difficult time controlling their usage.4
Causes of Relapse
Even in late-stage recovery, relapse is possible. Regardless of if you are a family member or an individual recovering from an addiction, you should watch and understand the signs of relapse. Furthermore, the exact cause of relapse will depend on the individual, so it is important to understand triggers and causes of relapse.
- Stress is the top cause of relapse and can be due to poor coping mechanisms, stressful life events, or a majorly stressful episode.5
- The individual is reconnected to the people or places that they associated with using.
- Individuals who want to forget they ever had an addiction stop attending meetings or attend fewer meetings.
- As the individual experiences improvements in their addiction, they focus less on self-care and take on more responsibilities to make up for a lost time. In a sense, they stopped doing the things that helped contribute to their recovery.
- The individual feels they are not learning anything at meetings and stop attending them or attend fewer meetings.
- The individual feels that even though they have been attending therapy for a long time, they should be beyond the basics of recovery and become embarrassed to discuss the cravings that they may be experiencing regularly.
Relapse Warning Signs
Oftentimes, the goals of treatment include helping the individual recognize early warning signs of relapse so they can find the help that they need. Additionally, individuals should learn to develop coping skills so that they can help combat pay potential causes of relapse. However, it’s important to understand the early warning signs of relapse so that coping mechanisms can be utilized effectively.6
- Bottling up emotions
- Avoiding meetings
- Attending meetings but not sharing
- Focusing on the problems of others and not one’s own
- Poor eating habits
- Sleep disturbances
- Poor self-care
- Craving drugs or alcohol
- Thinking about the people or places that were associated with past use
- Glamourizing past use
- Overlooking the consequences of past use
- Bargaining and lying
- Thinking of ways to better control using
- Looking for opportunities for relapse
What is a Relapse Prevention Plan?
Relapse is a process and not a single event. Relapse prevention plans are typically put in place to help an individual in the recovery process. The relapse prevention plan will incorporate each of the stages of relapse and include ways that the individual can use coping mechanisms instead of resorting to substance use. This, in turn, can help the individual maintain their sobriety and continue on the path to recovery.6
Relapse Prevention Models
There are generally two relapse prevention models discussed in the recent literature.
Gorski-Cenaps Relapse Prevention Model
The Gorski-Cenaps Relapse Prevention Model focuses on teaching individuals about the warning signs of relapse in hope that they can learn to recognize those signs in themselves. This model has a 9-step process that includes: stabilization, assessment, relapse education, identifying warning signs, managing warning signs, recovery planning, inventory training, family involvement, and follow-up.7
Marlatt’s Model of Relapse Prevention
Marlatt’s Model of Relapse Prevention is a relapse prevention plan that teaches individuals how to maintain changes in their behavior so that they can better cope with relapse. It discusses events that happen over time and breaks down the relapse process and treats relapse as an event and not a failure in treatment.8
Creating a Relapse Prevention Plan
When creating a relapse prevention plan, you should incorporate all the stages of relapse as well as identifying potential triggers that could incite a relapse. This planning is best done with someone who struggles with substance use as well as family members and close friends who will be supporting the individual as they recover.
- Assess History with Drugs and Alcohol: Firstly, the team should assess any history with drugs or alcohol and determine potential risk factors and triggers at each of the stages of relapse.
- Determine Relapse Signs: Once the history has been assessed, it’s important to determine an individual sign of relapse. Because this can differ from one person to the next, it’s important to have open and honest conversations to develop an effective plan.
- Establish the Actions to Take to Avoid Using: Once triggers and signs of relapse in addiction have been established, the team should work together to create a plan that will help the individual avoid using.
Important Components in Relapse Prevention
- Triggers: Triggers can be anything such as people, places, or situations that remind someone of their substance use. Recognizing one’s triggers helps one learn to avoid such triggers or use proper coping mechanisms.
- Cravings: Cravings refer to the strong feelings that typically encourage an individual to use a substance. These feelings can be severe, and without a proper relapse prevention plan, they can be challenging to manage.
- Damage Control: When an individual relapses, a proper relapse prevention plan can help with damage control and get the person back on track as soon as possible.
- Recovery Programs: Anyone can research recovery programs in their area or even ask friends and family to help them find a treatment center that aids in preventing relapse in addiction.
- Healthy Coping Mechanisms: When in recovery, developing healthy coping mechanisms allows the individual to better handle stressors and more towards a life of sobriety.
What to Do if I Relapse After Addiction Recovery
If you experience a relapse in addiction during recovery, seek medical support immediately. This support can be from a treatment center that you attended, but you may go to a medical center if it is an emergency. Additionally, make sure that you have supportive people in your life that can help you find the resources that you need to continue on your recovery plan. Finally, ensure you have a safe place to stay in if you feel as though you need to use substances again.