What Is a Relapse?
The National Cancer Institute defines a relapse as “the return of a disease or the signs and symptoms of a disease after a period of improvement.” Relapse is common with a range of chronic diseases, such as diabetes and heart disease. It’s also incredibly common with substance use disorders (SUD).
When related to addiction, a relapse usually refers specifically to a person engaging in at least semi-consistent substance use after a period of drug abstinence while in recovery. In essence, a relapse means a person has re-entered a period in their recovery journey where they find it difficult to resist drugs or alcohol long enough to stay reliably sober.
The severity of a relapse can vary, with some people relapsing to a rate of drug use similar or worse than before they began recovery. Others relapse to a rate of drug use that is problematic but less than they were engaging in before beginning the recovery process.
Are Relapses a Normal Part of Recovery?
A relapse is a setback in the recovery process, and the goal is to avoid relapse.
If a relapse does occur, it should be taken seriously. Most often, connecting with an addiction treatment professional as soon as possible can help to regain control and stop further drug use.
With that said, relapses are also fairly common for people in recovery. For example, people struggling with alcohol use have a high rate of relapse, especially if a person doesn’t seek help for their alcohol abuse and instead recovered on their own.
It’s important not to get discouraged by information like this. Recovery is possible regardless of the severity of one’s addiction. Some people experience multiple relapses before achieving sustained recovery.
Signs of a Relapse
Many of the signs of drug abuse can also signal a person has relapsed. These are some of the signs:
- Changes to appearance, such as changes to pupil size, smell, and weight
- Changes to the people one associates with, their favorite hangouts, and hobbies
- Increased engagement in risky behaviors, such as having unprotected sex or committing crimes
- Amplified feelings of paranoia and suspicion
- Legal trouble, including legal trouble seemingly unrelated to drug use
- Neglecting important responsibilities, even to the detriment of one’s own life and the lives of their loved ones
- Unexplained changes to mood, personality, or attitude
Sometimes, a person’s relapse will be obvious. They may even be willing to talk about it, which is generally a healthier way of dealing with a relapse than hiding it.
It’s important that you avoid coming off as angry or judgmental when someone relapses. Instead, approach them with empathy and a desire to help. If you intend to talk to them about their drug use, make sure to research the realities of the drug you think they’re using and the best ways to combat addiction.
Relapse vs. Slip
While the line between a relapse and slip isn’t always well-defined, there is a significant difference between the two.
A slip, also known as a lapse, refers to when a person engages in any kind of harmful drug use after a period of sobriety. It is generally a one-time use of a substance. It may occur due to especially strong drug cravings or being in similar circumstances to those that initially drove the person to drug use.
With a slip, the person still feels mostly in control after their drug use. Then, they continue to avoid drugs after using once or after a brief period of drug use. While having a slip isn’t ideal, especially if a person engages in particularly heavy drug use, it doesn’t necessarily significantly impact recovery.
Relapsing is different, and it signals a person re-entering a period of drug use where they have lost control. While similar circumstances can lead to a relapse and a slip, a relapse isn’t necessarily temporary. It often requires that a person re-engage in many (although not necessarily all) of the steps they initially took to regain control over their drug use and stop using.
At the very least, a relapse usually requires a person to talk with a drug treatment professional and possibly go through withdrawal again if they want to stop using drugs.
What to Do if You Relapse
Relapsing can be incredibly stressful and disheartening. After working very hard to stop using drugs, a relapse can feel like some kind of moral failure and like your progress has been reset.
It’s important to understand that relapsing, while not ideal, isn’t shameful. Addiction is a chronic disease, and it isn’t easy to learn how to manage it.
A relapse also doesn’t mean all your progress in recovery is reset. The same techniques you learned talking to treatment professionals and in counseling sessions can still help you. The main goal in the short term is to regain control, so you can continue with your addiction treatment plan.
When you relapse, don’t treat it as an all-or-nothing scenario where there’s now no point in resisting any of your cravings. The shorter your return to substance use, the less those drugs can affect your health and expose you to any associated risks, such as overdose.
As soon as you can, talk to an addiction treatment professional about your relapse. Try to work with them to identify what may have caused it. They can help you implement further strategies to regain control over your drug use again and to continue on your path to recovery. Oftentimes, a relapse signifies that some aspect of the treatment plan should be tweaked.
How to Help Someone Who Has Relapsed
Practice care when trying to help someone who has relapsed. They’re likely in a vulnerable and emotional state, as a relapse can be extremely stressful, especially if they felt in control of their drug use for a significant period of time. Now, they might be afraid that they’re going to experience many of the consequences of drug use that led them to seek help in the first place.
Before talking to them, do some research on drug use, addiction, and recovery. Try to come to them informed about the topic and with some useful treatment resources you can share with them if they’re willing to listen.
If possible, talk to them in an environment where they’re comfortable. It’s usually best to talk to them individually, so they don’t feel like you’re engaging in some kind of attack or otherwise trying to ostracize them.
Oftentimes, people relapse as a result of stressors in their lives. In some cases, these may be very serious events, such as the loss of someone they cared about, relationship troubles that can’t necessarily be repaired, or financial problems.
How much you can help with these problems will depend on the scenario (and not all relapses have such identifiable causes), but any help you can provide will likely be appreciated. At the very least, offering ways to make getting addiction treatment easier, such as offering to transport them or babysit their kids, can potentially enable them to more easily access the help they need.
When to Seek Help for Relapse
If you have engaged in drug use after a period of recovery, it is best to at least talk to an addiction professional, even if you still feel in control. Regardless, the moment you can’t control your drug use, you should see a professional and treat the situation as a relapse.
The sooner you seek help, the faster you can address your relapse and the less this new period of drug abuse can impact your life. There’s no advantage to waiting.
Remember that a relapse isn’t shameful, but it’s still a significant obstacle in the recovery process that won’t generally go away on its own. You need help to move forward.
Treatment Options for Relapses
Many of the same strategies used to help people address drug addiction continue to help after a relapse. Counseling and drug-assisted treatments are two examples.
There are a number of relapse prevention strategies a person can work with their mental health professional on, including these:
- Dispelling myths and misconceptions about drug use, addiction, and relapse
- Identifying high-risk situations that make drug use more likely and finding coping strategies for them
- Developing lapse management strategies that give the person a plan whenever they engage in drug use
- Working to reframe how one thinks about drug use to avoid common pitfalls some people who struggle with addiction have
- Helping a person rebalance their lifestyle and engage in healthier behavior patterns that can replace drug use, such as exercise or meditation
There are many approaches that can help people deal with relapse. The key is to stop the relapse episode as soon as possible to get back on track in recovery.
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- Chronic Stress, Drug Use, and Vulnerability to Addiction. (August 2009). Annals of the New York Academy of Sciences.
- Relapse Prevention. (February 2018). Indian Journal of Psychiatry.
- Mindfulness-Based Intervention and Substance Abuse Relapse. (June 2014). JAMA.
- The Risk Factors That Lead to Addiction and Relapse Among Addicted Patients. (November 2016). Menoufia Nursing Journal.