Drug Relapse: Signs, Triggers & Prevention

Learn the warning signs of a drug or alcohol relapse and how to create a relapse prevention plan to avoid experiencing a setback.

Recovering from a drug or alcohol addiction can be extremely challenging. When a person begins their recovery, they may face numerous challenges, including the possibility of experiencing a setback. A drug relapse is an instance of substance misuse after previously stopping use.

Learning about the recovery process, and the potential for setbacks, can help people set realistic expectations for addiction treatment and long-term healing.

What Is a Drug Relapse?

Many people ask, “What is a drug relapse”? There is no standard definition because people experience setbacks in different ways. Each person’s recovery is unique, and not everyone will experience a relapse after treatment ends. Setbacks are a reality of recovery for many people because addiction is a lifelong condition that does not have a permanent cure.

A relapse can mean:

• A person uses drugs or alcohol after abstaining from them for some time
• A person experiences a slip-up, or uses drugs or alcohol once, and then returns to sobriety
• Someone resumes drug or alcohol use after treatment and then returns to rehab
• Someone experiences a full relapse and slips into old patterns and habits

A relapse does not mean: 

• That someone is a failure
• That rehabilitation did not work or that it can’t work
• That all the progress someone made in recovery is undone

Recovery is possible for everyone, regardless of whether they’ve faced a setback. Setbacks are common and many people can get back on track with sobriety after experiencing a setback. A healthy way to frame a relapse is that instead of viewing it as a failure, view it as a learning opportunity that teaches how to manage life in sobriety.

Stages of Relapse

Setbacks can be unplanned and the result of an impulse. However, there are three stages of relapse: emotional, mental and physical. A relapse typically happens in three stages.

The 3 Stages of Relapse:

1. Emotional Relapse

Most emotional relapses involve someone re-experiencing emotions that they used to feel when they were actively using drugs or alcohol. During an emotional relapse, a person may not be thinking about using drugs, but they might be heading toward familiar patterns of addiction. A person who is experiencing an emotional relapse might be in denial, grow irritable, isolate themselves and avoid friends, family and support group members.

2. Mental Relapse

During the mental relapse stage, a person actively thinks about using drugs or alcohol again, and they may attempt to rationalize returning to drug use. Internal conflicts and bargaining are frequent during this stage as people feel strong urges to use drugs or alcohol, but know that doing so hinders recovery.

3. Physical Relapse

The final stage is a physical relapse, involving drug or alcohol use. A physical relapse can last for minutes or months for some people and may indicate the need to return to treatment. However, a physical relapse does not always indicate that someone will face addiction again or need rehab.

Signs of a Drug Relapse

There are many different physical and behavioral relapse warning signs. Becoming familiar with the signs of relapse can deter someone from using substances again.

Some common signs of drug addiction relapse include:

• Drug cravings
• Sudden mood changes
• Depressed, anxious or destructive thoughts
• Denial of events or behaviors
• Secretive behavior
• Increased irritability
• Avoiding family members or friends
• Making impulsive decisions
• Returning to previous habits, routines or social groups

Developing effective coping strategies to handle cravings can help people avoid setbacks.

Common Relapse Triggers

Various relapse triggers can cause people to succumb to old patterns or give in to their drug cravings. Drug addiction relapse triggers can be stress-inducing people, places or behaviors that can cause someone to misuse drugs or alcohol.

Most common drug and alcohol related relapse triggers

• Bars or clubs
• Friends or family members who also misuse drugs or alcohol
• Stressful environments, like hospitals
• Interpersonal relationship issues
• Places where substance misuse often occurs
• Feeling bored
• Parties where drug and alcohol use occurs
• Stressful life situations

Many people get triggered by high-stress situations, but others find celebrations and other positive experiences to be major triggers. A person should reflect on their thoughts, feelings and behaviors to learn what triggers them specifically.

Whether relapse triggers are verbal, physical, behavioral or environmental in nature, the presence of triggers does not mean that someone will relapse into drug use. With healthy coping mechanisms and a firm resolve, triggers can be faced and avoided.

Relapse Statistics

Drug relapse statistics reveal the reality of addiction recovery. Close to half of people who experience drug or alcohol addiction also experience relapses in recovery. According to the National Institute on Drug Abuse’s “Principles of Drug Addiction Treatment: A Research-Based Guide,” between 40 and 60 percent of people who struggle with drug addiction experience setbacks.

Although addiction relapse statistics may seem grim, not everyone who experiences addiction struggles with relapses, and many people progress in recovery despite setbacks.

What Drug Has the Highest Relapse Rate?

Anyone with an addiction to drugs or alcohol is susceptible to experiencing a relapse. However, some drug addictions may be harder to treat than others. Additionally, relapse rates by drug type vary. Because setbacks are shared among all types of drug addictions, it can be difficult to tell what drug has the highest relapse rate.

Some drugs are more addictive than others and have different rates of relapse. Nicotine excluded, some of the most addictive drugs that contribute to the highest relapse rates include substances like:

• Alcohol: Some studies show that of people who are treated for alcoholism, less than 20 percent remain sober for a year.
• Opioids: Heroin, oxycodone and hydrocodone are some of the most highly addictive opioids. According to international studies (not including data from China), the first-year relapse rate among people who abuse heroin is typically 80 to 95 percent. A study from 2010 concluded that of people treated for opiate addiction, more than 90 percent reported relapsing after treatment.

We surveyed 2,136 American adults who either wanted to stop drinking alcohol or had already tried to (successfully or not).

For the study, relapse was defined as a return to old alcohol abuse behaviors. Of those surveyed, only 29.4% reported not relapsing at all. The largest group (32.3%) relapsed back to alcohol use within the first year after stopping. With perseverance, your chances of relapsing decrease the longer you stay sober: 21.4% relapsed in their second year in recovery, but only 9.6% relapsed in years three through five, and only 7.2% did so after their fifth year in recovery.

Other drugs that have a high potential for abuse and high relapse rates include stimulants (specifically cocaine and methamphetamine) and benzodiazepines (specifically Xanax and Valium). For people in recovery, knowing which substances have higher setback rates can be helpful in drug relapse prevention.

Preventing a Drug Relapse

The first six months of recovery is the period when a relapse is most likely to occur. However, forming an alcohol relapse plan or a drug relapse prevention plan can be beneficial for people in recovery.

A strong relapse prevention plan can include:

• Following an aftercare treatment plan
• Participating in a 12-step program
• Identifying and avoiding triggers
• Building a strong support system
• Forming new coping mechanisms to deal with stress and difficult emotions
• Making lifestyle changes that are conducive to recovery

A strong relapse prevention plan can include:

• Changing your social network to avoid being around people who aren’t in recovery
• Avoiding specific settings such as bars or nightclubs
• Consistently attending outpatient programs
• Attending sober social activities to prevent boredom
• Attending individual therapy sessions

However, despite knowing how to prevent drug addiction relapses, setbacks can still occur. In the event of a relapse, you shouldn’t panic or assume you’ve failed at recovery. Instead, you can:

• Examine what led to the relapse: Learning from a relapse can help prevent future setbacks.
• Decide that the relapse was an isolated situation: In this case, you can recommit to recovery and move past a relapse by seeking support in a 12-step program and from peers in recovery.
• Consider re-enrolling in treatment: If the relapse lasted for a significant amount of time, or if you feel that you cannot continue to maintain sobriety without help, going back into a treatment program can be beneficial.
• Invest in professional mental health counseling: Cognitive behavioral therapy can be especially useful after a relapse. This therapy may be used in conjunction with substance abuse counseling to help change your thinking and behavior patterns to recommit to sobriety.

Helping a Loved One Avoid Relapse

Friends and family members of someone in recovery can form an invaluable support network. If you have a friend or family member in recovery, you should be aware of the potential for setbacks and the many ways in which they can occur. This knowledge can help you identify when someone has resumed drug or alcohol use and how to get proper medical help.

For people who want to know how to help someone avoid relapse, a good plan of action includes:

• Showing love, support and understanding rather than expressing disappointment and anger
• Avoiding being accusatory about someone’s relapse
• Avoid labeling the person as flawed or at fault for their relapse
• Staying hopeful and optimistic

In the case that someone experiences a relapse, their friends and family can:

• Reassure them that they are not a failure
• Remind them that setbacks are common and recovery is an ongoing process
• Help them seek treatment again, if necessary

The possibility for relapse is a reality of recovery. However, relapses are opportunities to create a stronger foundation for the future. If you’ve experienced a setback and want to go back to treatment, call The Recovery Village today to talk through treatment options with a representative.

Editor – Renee Deveney

As a contributor for Advanced Recovery Systems, Renee Deveney is passionate about helping people struggling with substance use disorder. With a family history of addiction, Renee is committed to opening up a proactive dialogue about substance use and mental health. Read more

Medically Reviewed By – Eric Patterson, LPC

Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more