Relapse (Return to Substance Use)

What is the definition of a relapse?

A relapse is using a substance (like alcohol or drugs) that you’re trying to avoid or have quit. Usually, it means resuming using a substance that causes addiction. Some people refer to it as a slip-up or lapse. These days, healthcare providers prefer to call it returning to substance use.

Returning to substance use looks different for each person. You might resume using alcohol or drugs again after a period of avoiding them. Some people start using different substances. Either way, a relapse happens when you use a substance you don’t want to.

Substance use disorder is a health condition you have. It’s not a judgment about who you are as a person. Almost everyone living with substance use disorder experiences a return to use at some point.

Getting the healthcare and help you need to avoid using drugs or alcohol is the most important thing after you’ve returned to substance use. If you’ve returned to substance use (or feel like you might soon), talk to someone you trust. Loved ones, support groups, a mental health professional or a healthcare provider are all great resources to support you when you need it. They won’t judge you or be ashamed of you. They want you to be safe, healthy and to achieve your recovery goals.

What does having a relapse mean?

Having a relapse means you’ve used a substance you want or need to avoid. It can be a one-time slip-up or resuming regular use of drugs or alcohol.

It’s important to remember that returning to substance use doesn’t mean you’re a failure or a bad person. Recovery is a lifelong process. And it’s not something you can pass or fail like a class in school.

Having a health condition like substance use disorder doesn’t define who you are. Returning to substance use can be dangerous to your health, and it’s important that you stay safe. But that doesn’t mean you’ve permanently failed to reach your recovery goals.

What triggers a relapse?

Everyone has different triggers. Some of the most common relapse triggers include:

• Being around certain people or places. Seeing people from your past or visiting places that have lots of meaning to you (or used to) can be triggering. You might have grown apart from some friends or relationships as part of your recovery. Seeing those people can trigger familiar feelings from when you used substances in the past.
• Changes in your health. Finding out you have a new or different health condition can trigger a relapse (especially if you’ve used substances to manage pain or health issues before).
• Important dates. Holidays, birthdays, religious dates or other celebrations can all trigger substance cravings.
• Life changes. Starting or leaving a job, changes in your family or romantic relationships, or a loved one’s death can trigger the desire to use substances again.
• Stress or other intense emotions. Stress, anger, fear, guilt or any other strong emotion may make you think about using substances. This can be especially true if you used to use a substance to cope with your feelings in the past. Positive feelings can be triggers, too, if substances used to be part of how you had fun, celebrated an accomplishment or were part of your regular social life. It can take time to learn that it’s possible to have a good time or make happy memories without using.

What are the stages of a relapse?

It can feel like returning to substance use happens suddenly. But experts have identified a few stages that most people progress through before having a relapse. Knowing these stages can help you recognize warning signs in yourself or others.

Emotional relapse

The first stage of relapse can happen without your even noticing. You might not even be thinking about using again. But experiencing a trigger can make you feel waves of guilt, anger, frustration or other powerful emotions. Processing these kinds of feelings can be hard. You might:

• Avoid support groups or loved ones who usually help you feel more in control of your feelings
• Bottle up and hide your feelings from loved ones
• Change how much you’re eating
• Isolate yourself from positive people, activities or hobbies
• Start sleeping more or less

Mental relapse

The mental stage of a relapse happens when your thoughts start drifting to resuming substance use.

Drugs or alcohol can permanently change how your brain functions if you have a substance use disorder. This can make it feel like you can’t control your thoughts or desires. Even if you know you don’t want to use substances, it might feel like your brain is playing tug-of-war with you.

Craving a substance doesn’t mean you’re weak or powerless. There’s never a wrong time to ask for help. Reach out to someone you trust as soon as you sense any of these feelings.

Physical relapse

This final stage of a relapse happens when you resume using substances. This might be a one-time slip-up or a more continual return to using drugs or alcohol.

Remember, almost everyone living with a substance use disorder experiences a return to using at one point. It doesn’t mean you can’t stop again. If your long-term goal is not to use substances, you can achieve it. Talk to a healthcare provider and other support systems about stopping.

What are relapse prevention strategies?

Staying in treatment is the most important way to help prevent a relapse. You’ll learn over time which treatments work best for you. Everything from taking your medications to talking to a mental health professional or support group can help you stay focused on your recovery goals.

It’s also helpful to understand your triggers. For example, many people feel lots of stress, guilt and other potentially triggering emotions around holidays or important personal dates. If you know when you’re more likely to feel pulled toward resuming substance use, you can prepare yourself with support and other resources ahead of time.

Many people experience a relapse when there’s a specific moment or window of opportunity that gives them the chance to use again. Try to recognize thought patterns like planning out when you could start using again without loved ones noticing. It might feel like your brain and body are pushing you. Reach out for help from someone you can trust in these moments.

In the U.S., you can call the Substance Abuse and Mental Health Services (SAMHSA) hotline anytime at 1.800.662.4357. Trained staff are available 24/7 to talk, refer you to local resources and support you, no matter what you’re feeling.