When you go through the difficult recovery journey and come out on the other side clean and sober, you have a lot to feel good about. Yet you may also feel something many others who have walked in your shoes feel: fear of relapsing. After winning that hard-fought battle for sobriety, it can be devastating to consider that it might not last forever. However, it is actually relatively common to relapse at some point after you get clean. So common, in fact, that relapse is often considered one part of lifelong recovery.
This article will take an in-depth look into relapse after getting clean and what to do about it.
By the simplest definition, a relapse is when a person returns to using drugs or alcohol after a period of sobriety. Many people recovering from addiction face a consistently high risk of relapse because chronic substance use can result in certain structural and functional brain alterations that persist well beyond the period that sobriety was first obtained.1
What is most often considered a “traditional” relapse occurs when someone makes a conscious decision to drink or use drugs. For example, they may choose to smoke marijuana to relieve stress after a year of sobriety or have a glass of wine with friends because they feel like they can manage it without going overboard. A “freelapse”, on the other hand, is the colloquial term for an accidental relapse that happens when a person unintentionally uses drugs or alcohol. This could happen when they mistakenly drink alcohol thinking they were being given a non-alcoholic beverage at a party.
Sometimes, you unknowingly begin taking steps toward a relapse weeks or months before actually drinking or using drugs. Certain thoughts, feelings, and events may trigger cravings and urges for drugs and alcohol, and, if not properly dealt with, may increase your chances of relapsing.
A relapse often proceeds in a series of 3 stages:2
People who relapse often face risk factors in the days, weeks, or months leading up to the actual act of relapsing. These usually come in the form of difficult feelings or experiences that challenge their ability to cope with their addictions without their substance of choice. And, the greater the number of risk factors, the higher your risk for relapse.3
Some of the most common risk factors for relapse include:1,3–5
Many different philosophies about recovery and relapse exist, often with opposing tenets, which can leave you confused about which is correct. For some, relapse is viewed in a negative light and indicates weakness. But this view is considered harmful since it fosters feelings of guilt and shame that can hinder your ability to recover from a setback. For others, recovery is a personal growth process that usually involves a couple setbacks.2 Rather than viewing a relapse as shameful, this perspective looks at it as a learning experience.
Understanding how a relapse happens is an important prevention strategy because you learn to recognize the signs and course-correct before you start using again. According to the model developed by Marlatt and Gordon, a relapse begins with a high-risk situation that is followed by a poor coping response. When this happens, you experience decreased self-efficacy and are more prone to a lapse, or initial one-time use of drugs or alcohol.5 For some people, a lapse is followed by a sense of guilt and failure about using again. Then, they might believe that drugs and alcohol will feel good and alleviate these negative feelings, and this chain of events can lead to a full-blown relapse where a person returns to uncontrolled use.
Whether or not you relapse is closely tied to your sense of self-efficacy. If you feel confident that you can cope with triggers and cravings, you are less likely to relapse in the face of stress.6 Remaining aware of your triggers and learning coping strategies can help enhance your confidence in your ability to remain sober and are vital to preventing and coping with relapse.
Whether you have experienced a relapse in the past or not, knowing how to deal with one can help you prevent future setbacks and recover if one should happen. Remember, no relapse is too big to recover from. If you or a loved one have suffered a relapse, consider taking action as soon as you can by:
The sooner you take steps to intervene following a relapse, the easier it is to get back on track. However, it is never too late to recover from a relapse, so don’t be discouraged if you think you’ve gone too far back into your addiction. It is not uncommon to need professional help to stop using after a relapse; many people benefit from the added support of an addiction treatment program a second and even third time (or more, in some cases).
If you find you just can’t stop using your substance of choice after a relapse, it is a good idea to seek out professional help. If you have recently attended treatment and experienced a relapse, it does not mean that your treatment failed. Similar to other chronic illnesses, relapses during addiction may simply indicate that you need to enter treatment again or adjust the current course of your recovery plan.1 Renewed participation in a treatment program can help you to again stop using drugs or alcohol and reduce the risk of future relapses.4,7
Different types of treatment programs offer various levels of care to meet you where you are in your recovery process. If you have already completed a treatment program, you can reach out to your former (or current) treatment providers, such as your therapist, psychiatrist, or medical doctor to get their advice on the next step to take. It is also helpful to have the members of your support system—family, friends, and sponsors—on board with whatever the best course of action is for you to help with the practical matters of everyday life while you’re getting sober again.
When deciding whether to attend an inpatient or outpatient program following a relapse, discuss these factors with your treatment team and support system:
Less-intensive treatment may be an option if this is your first relapse and you are in good physical and mental health, are not at risk for severe withdrawal, and have a sober support system in place. Your treatment team can help you decide whether inpatient, outpatient, or other treatment options are more appropriate for you.
In addition to the treatment options mentioned above—detox (particularly for alcohol, opioids, benzodiazepines, barbiturates, and prescription sedatives), inpatient, and outpatient programs—there are a few other avenues to consider after a relapse.
Behavioral therapies are one type of treatment that can help prevent future relapses. They teach you to modify unhealthy and incorrect beliefs about drug use and provide you with skills to manage stress, cravings, and triggers. The most commonly used form of this is known as cognitive behavioral therapy (CBT), which focuses on understanding how your thoughts lead to feelings, which prompt behaviors, and how to change negative beliefs to positive ones.1
Other treatment options you might consider following a relapse include:
Maintaining a positive mindset is important following a relapse. It is normal to experience negative emotions, like guilt, shame, and disappointment, but it is helpful to remember that a relapse can be a learning experience. Taking the time to understand the events surrounding the relapse and making changes to reduce the chances of future lapses can help you get back on the track toward long-term sobriety.