Alcoholism and Relapse: Risks, Signs, and Prevention
Many people who struggle with alcohol or drug addiction may relapse at some point during recovery. It’s important to be aware of potential risks, and triggers that could prompt a relapse. Read more about having a relapse prevention plan in place and what to do if an alcohol relapse occurs.
What is a Relapse?
Relapse is a return to substance use after a period of abstinence.1
The recovery process is a time of reflection, personal development, and commitment. Recovery from alcohol misuse involves creating new habits and addressing feelings and emotions that may have been ignored for a long time. As a result, it requires people to develop and implement new coping skills to deal with difficulties when they arise.
It is important to note the difference between lapse and relapse, two terms often referred to when discussing recovery. Here’s what each term means:4
- A lapse is a “slip” when a person may have one drink and then returns to sobriety.
- A relapse is the continued use of alcohol or drugs after the initial lapse.
A relapse is not always a sudden decision. The warning signs may occur for weeks or even months before a person ultimately makes the decision to use alcohol, again.4
What are the Stages of Relapse?
Addiction medicine physician Steven Melemis explains in his research that relapse tends to be a gradual process with three distinct stages.5
- Emotional Relapse. At this stage, it does not necessarily mean a person is thinking about using alcohol again, but they may be neglecting self-care and their coping strategies. For example, isolating, not reaching out for support, and bottling up emotions.
- Mental Relapse. During a mental relapse, a person may fantasize about drinking alcohol. This creates an internal struggle where they may minimize the consequences of using drugs or alcohol to justify using again.
- Physical Relapse. At this point, drinking alcohol/or drug use begins and soon escalates to an uncontrollable level.
How Common is Alcohol Relapse?
Recovery is considered an ongoing, lifelong process, and relapse is often a part of that process. The Journal of the American Medical Association reports that 40% to 60% of people, who seek treatment for substance abuse, will relapse within 1 year.
As mentioned earlier, warning signs may appear weeks or months before an actual relapse.4 One of the biggest indicators someone might be headed for a lapse or relapse is halting the new behaviors learned in early recovery, which can make you vulnerable to triggers.4
Alcohol Relapse Triggers
Triggers are essentially reminders of the various reasons that caused you to misuse alcohol in the first place. Living near a bar or a place where you used to drink, being in a relationship with someone who is still using alcohol or other substances are risk factors that may trigger a relapse .5
Common triggers include:
- Withdrawal symptoms.
- Chronic stress.
- Certain people or places.
- Peer Pressure
- Relationship problems.
- Financial stress.
- Uncomfortable emotions, such as loneliness, anger, and anxiety.
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Alcohol Relapse Prevention Tips
There are ways you can implement your own relapse prevention plan. For example, having people you can call for support, a list of 12-step program meetings you can attend, and strategies that focus on self-care.
Strategies focused on self-care may include:5
- Healthy diet.
- Quality sleep.
- Breathing exercises.
- Take up a hobby like painting, yoga, running, or another creative endeavor.
- Be honest with your support group about your struggles
- Avoiding triggers (certain people and places).
What do to When a Relapse Occurs
A relapse does not mean you have failed in recovery. Treatment of addiction involves changing deeply entrenched behaviors. Chronic use of alcohol or drugs can cause brain structure and function to alter, and it takes time for the brain to heal itself.8 Having feelings of regret, shame, or guilt after a relapse is not uncommon, but the sooner you intervene the easier it may be to get back on track.
If you have already completed a treatment program, reach out to your therapist, psychiatrist, or medical doctor to get their advice on the next steps. You should also talk to the people in your support system (family, friends, and sponsors) to help determine the best course of action.8 Don’t be discouraged if it has taken you a while to get help again, take this as an opportunity to adjust your treatment plan and find a rehab facility that is individualized to your needs.
Furthermore, it’s important to remember you are not alone, about half of people who seek treatment for substance abuse experience a relapse. 8 Re-entering a treatment program can help you to again stop using alcohol and reduce the risk of future relapses.8,9
- Larimer, M., Marlatt, A., & Palmer, R. (1999). Relapse Prevention. National Institute of Alcohol Abuse and Alcoholism, niaa.nih.gov. Vo. 23, No. 2. p. 151.
- National Alliance on Mental Illness. (May 2020). Substance use disorders.
- American Psychological Association. (July 2017). What is cognitive-behavioral therapy?
- S. Department of Veteran Affairs. (September 27, 2020). Reducing relapse risk.
- Melemis, S. (September 3, 2015). Relapse prevention and the five rules of recovery. National Center for Biotechnology Information.
- Menon, J. and Kandasamy, A. (February 2018). Relapse Prevention. Indian Journal of Psychiatry and National Center for Biotechnology Information.
- National Institute on Drug Abuse. (July 2020). Treatment and recovery.
- National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction Treatment and Recovery.
- Mohammadpoorasl, A., Fakhari, A., Akbari, H., Karimi, F., Arshadi Bostanabad, M., Rostami, F., & Hajizadeh, M. (2012). Addiction relapse and its predictors: A prospective study. Journal of Addiction Research & Therapy, 3(1), 1–3.