What Is a Relapse After Recovery?

Relapse is defined as the recurrence of behaviors that indicate a condition or disease is active or worsening. A person who has relapsed with drugs or alcohol use may return to an active state of using the substance after a period of not using. As a result, they may have difficulty controlling their behavior.

Recovery is about more than not using drugs or alcohol. It's about creating a lifestyle that can help a person maintain their recovery goals. The goal of addiction treatment is recovery, and part of the recovery process includes talking about relapse, since it can occur in recovery.

Read more to learn about types and stages of relapse, as well as relapse prevention strategies.

Illustration of relapse prevention strategies such as exercise, sleep routine, relaxation techniques, therapy interventions, and planning

Verywell / Jiaqi Zhou

How Common Is Relapse?

No one is perfect, and managing addiction is challenging. For some, relapse is part of recovery.

According to a review of relapse prevention, lapse and relapse are not only possible, but common within and after the first year of seeking treatment. Treatment for addiction can help clients work through a relapse and begin taking active steps to change their behavior. 

Types of Relapse

Substance Abuse Relapse

Substance abuse relapse occurs when a person who has been away from using a substance for some time begins using again. A lapse is viewed as the initial or one-time use after not using, while a relapse is characterized by uncontrolled or continued use of substances.

A traditional relapse involves a person choosing to use again, while a "freelapse" occurs when a person unintentionally becomes intoxicated.

Examples of Freelapse

Examples of a person unintentionally becoming intoxicated include:

  • From anesthesia for a surgery or medical procedure
  • Accidentally inhaling fumes from an intoxicating substance
  • Accidentally eating or drinking something that contains an intoxicating substance

Mental Health Relapse

A mental health relapse occurs when a person begins experiencing symptoms of a mental health condition that worsen or lead to decreased functioning. For instance, a person who had experienced a period of remission from depression begins feeling hopeless, has a low mood, or has thoughts of death again may have relapsed.

Physical Illness Relapse

The resurgence of physical health symptoms after a period of well-being signifies a physical health relapse.

Why Addiction Relapse Happens: The Brain After Addiction

Addiction is considered a brain disease. Research shows that the use of drugs and alcohol can alter the brain.

With addiction, the brain's reward center is activated. The influence of dopamine, the "happy" chemical, can cause changes in the brain. Substance use can affect the brain by damaging systems responsible for cognitive control.

Stages of Relapse

Relapse is a gradual process. It can begin with an emotional relapse, followed by mental and then physical relapses. Awareness of thoughts, feelings, and behaviors can be indicators of where someone is and what they may need regarding recovery. 

Emotional Relapse

During this stage, a person may not be thinking about using drugs or alcohol, but their emotions may be placing them in jeopardy of relapse.

During an emotional relapse, a person can experience:

  • Feelings of denial
  • Isolation
  • Low motivation to take care of oneself
  • Not attending treatment

Focusing on self-care from a psychological, emotional, and physical perspective can improve a person's emotional state.

Mental Relapse

While thinking about relapsing is a normal part of recovery, it can become problematic when there is a preoccupation with using. An individual may think about or have the desire to use.

In addition to cravings, signs of a mental relapse include:

  • Finding opportunities to use
  • Thinking about positive experiences related to using
  • Being dishonest about thoughts and feelings
  • Downplaying consequences from past use

At this stage, working toward avoiding triggers or situations for relapse is critical.

Physical Relapse

Physical relapse occurs when a person starts using again. Once this happens, it may not be easy to control behavior or stop using.

Risk Factors for Relapse

Relapse occurs for different reasons. There are several factors that can increase the likelihood of relapse, including:

  • Stress
  • Exposure to triggers
  • Peer pressure or being around people who use the substance
  • Interpersonal problems
  • Pain
  • Lack of support
  • Boredom
  • Low self-efficacy

Self-efficacy refers to a person's confidence in their own ability to achieve something. When a person's self-efficacy is low, they may have a hard time believing in their ability to maintain abstinence.

Research shows that social support indicates long-term success, while peer pressure and unsupportive relationships can lead to relapse.

Identifying Your Personal Triggers

Risk factors for relapse differ from person to person. Therefore, a key aspect of recovery is identifying potential triggers and risk factors and avoiding them as much as possible.

Dangerous Factors

The following factors make the risk of overdose especially dangerous:

  • History of overdose: A person who has overdosed before has a higher risk of overdosing again. Some factors that can increase risk are tolerance, mixing substances, or the quality of drugs.
  • Opioid use: A relapse with opioids can be dangerous because these drugs slow a person's breathing, placing them at a higher risk of overdosing or leading to death.
  • Lack of access to health care: Lack of access to health care means a person may be unable to get the treatment they require when an overdose occurs, need detox, or seek to manage addiction with medical and mental health professionals.

Relapse Is Not a Failure

A person may feel defeated when they relapse. It can bring on feelings of shame, frustration, and often cause someone to feel as if they are incapable of changing their behavior or achieving their goals. 

Viewing relapse as a failure is one perspective. However, relapse can be an opportunity to reset, develop clear needs and goals, and continue. Relapse should always be taken seriously. Refocusing on recovery and further relapse prevention with a care team is crucial.

Reaching Out for Help

If you are struggling to manage addiction and are concerned about relapse, you can get more information about treatment options by calling the Substance Abuse and Mental Health Services Administration at 800-662-HELP (4357).

If you are in crisis or feeling suicidal, you can find support through calling the National Suicide Prevention Lifeline at 988 or texting "HOME" to 741741 to chat with someone from the Crisis Text Line.

If you are experiencing a medical emergency and need immediate care, call 911.

Relapse Prevention Strategies

Relapse prevention is a vital aspect of recovery and incorporates a host of strategies, including: 

  • Lifestyle changes: Establishing a routine with regular sleep, exercising, and implementing relaxation techniques can help.
  • Cognitive and family therapy interventions: Through cognitive and family therapy interventions, patients evaluate how they view themselves, their addictive behaviors, and recovery. Additionally, they can learn skills, find support, and identify ways to navigate familial and interpersonal relationships.
  • Making a relapse prevention plan: Creating a relapse prevention plan allows people to recognize triggers and high-risk situations, explore lifestyle changes, and gain coping skills to deal with thoughts, emotions, and cravings.

Summary

Relapse is a return to a state of substance use. It often begins with a person's emotional and cognitive state. A relapse doesn't mean failure. Instead, it can be an opportunity to examine what lifestyle changes, coping skills, and adjustments may be needed to prevent relapse in the future.

A Word From Verywell

Relapse after recovery can feel devastating, but it doesn't have to be the end of your journey. If you're struggling with addiction or dealing with a relapse, it's essential to seek support, take care of yourself, tap into your ability to sustain your recovery goals, and discuss a relapse prevention plan with your care team. It is possible to reclaim your power in your recovery.

Frequently Asked Questions

  • What happens in a relapse?

    A relapse may look different for each person, depending on how much they use and the circumstances surrounding the relapse. Generally speaking, during a relapse, a person returns to using drugs or alcohol after a period of abstinence. Regarding mental or physical health, a relapse implies the worsening of a condition that has improved. 

  • Is it OK if I relapse?

    For many, relapse is part of recovery. While feelings of guilt, shame, anger, anxiety, or sadness often surface during a relapse, there can also be space for self-compassion. Recovery requires work, and it is possible with treatment, positive support, and self-care.

  • How long does it take to get over a relapse?

    This may vary from person to person and be influenced by things such as extent and length of use. Talking openly about a lapse or relapse with a care team can help you develop and strengthen your relapse prevention plan and identify how to get back on track with your recovery goals.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Menon J, Kandasamy A. Relapse prevention. Indian J Psychiatry. 2018;60(Suppl 4):S473-S478. doi:10.4103/psychiatry.IndianJPsychiatry_36_18

  2. Melemis SM. Relapse prevention and the five rules of recovery. Yale J Biol Med. 2015;88(3):325-332.

  3. Volkow ND, Koob GF, McLellan AT. Neurobiologic advances from the brain disease model of addiction. N Engl J Med. 2016;374(4):363-371. doi:10.1056/NEJMra1511480

  4. Mass.gov. Opioid overdose risk factors.

  5. Parks GA, Marlatt GA. Chapter 6: Relapse prevention therapy. In The Essentials Handbook of Treatment and Prevention of Alcohol Problems. Heather N, Stockwell T. (Eds.). Wiley; 2003.

By Geralyn Dexter, LMHC
Geralyn is passionate about empathetic and evidence-based counseling and developing wellness-related content that empowers and equips others to live authentically and healthily.