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  • Writer's pictureDr. Harold Pierre

How to Prevent Addiction Relapse and the Key to Addiction Recovery

Updated: Nov 29, 2023

How to Prevent Addiction Relapses and The Key to Addiction Recovery


Relapse is a common part of the recovery process for most people overcoming drug or alcohol addiction. However, understanding relapse and having an effective relapse prevention plan is critical for long-term success in recovery. From the first time I meet with a patient, I worry about relapses. My treatment plan has one goal in mind, to become functional and law abiding. I have invented the term, Functional Addiction Medicine because prescribing medications aren't enough. A holistic approach must be taken and adequate time must be factored in.


This comprehensive guide examines the causes, stages, warning signs, and prevention strategies for addiction relapse. It's the first of a series I will write to share my approach to helping patients achieve addiction recovery.


clip art of recovery in progress

What is Relapse and Why is it Common?


Relapse refers to a return to the problematic use of alcohol or other drugs after a period of improvement or abstinence. According to the National Institute on Drug Abuse (NIDA), 40-60% of individuals relapse within their first year after addiction treatment.

Relapse is common for several reasons:

  • Addiction is a chronic disease. Similar to other chronic conditions like diabetes or asthma, addiction involves cycles of relapse and remission. A relapse does not mean treatment has failed.

  • Recovery is a process. Achieving lasting sobriety often takes months or years of work. Relapse may occur during this time as individuals learn new coping skills.

  • Addiction causes changes in the brain. These changes make it extremely difficult to resist cravings and triggers. Medications and therapy help counteract these brain changes.

  • Triggers and stressors still exist. Even after treatment, individuals return to environments with familiar triggers and stressors. Managing these relapse risks is key.

  • A relapse is not a sign of failure. It simply means more support is needed to get back on track. With the right treatment and coping skills, many people recover after experiencing one or more relapses.

What are the 5 Common Reasons for Addiction Relapse?


Relapse is complex and often results from multiple factors converging at once. However, experts have identified 5 broad categories of relapse triggers:


1. Physical Triggers

Physical and biochemical factors can trigger substance cravings and relapse. Common physical causes include:

  • Withdrawal symptoms

  • Stress

  • Hunger, fatigue or other physical discomfort

  • Exposure to alcohol or other drugs

  • Medications that interact poorly with addiction

2. Emotional Triggers

Unresolved trauma, mental health issues, and difficult emotions often contribute to relapse. Common emotional causes include:

  • Anxiety, depression, anger, boredom

  • Loneliness or grief

  • Feeling overwhelmed or inadequate

  • Embarrassment or guilt about addiction

3. Relationship Triggers

Relationship problems, social pressure, and interpersonal conflict can trigger relapse, such as:

  • Arguments with family or friends

  • Spending time with others who use drugs or alcohol

  • Difficulty establishing a sober support network

  • Work and family responsibilities

4. Behavioral Triggers

Certain behaviors and thought patterns raise relapse risk, including:

  • Poor coping skills and self-care

  • Testing personal control over usage

  • Glamorizing past drug or alcohol use

  • Lying to yourself or others

5. Environmental Triggers

Environments with strong associations to past substance use can trigger intense cravings and relapse. Examples include:

  • Parties, bars, or other social settings

  • Places where substances were acquired

  • Major life changes like moving

The Stages of Relapse and How to Identify Them


Relapse often begins weeks or months before the actual resumption of alcohol or drug use. Understanding the stages of relapse allows individuals to recognize the early warning signs and prevent progression to full relapse.


Emotional Relapse

Emotional relapse is the first stage and does not involve any actual thoughts of substance use. However, maladaptive behaviors emerge that set the stage for relapse down the road:

  • Isolating from family, friends, and support groups

  • Bottling up emotions

  • Not asking for help when needed

  • Neglecting self-care and health

  • Blaming others for problems

  • Acting defensive or dishonest

Mental Relapse

During mental relapse, the desire to use returns after a period of abstinence. At this stage, the risk of relapse is high. The mental battle between resisting and giving into cravings intensifies:

  • Cravings increase in frequency and intensity

  • Glorifying past substance use

  • Lying or hiding behavior

  • Bargaining or justifying using ("just one drink")

  • Testing control by going to risky places

  • Making plans to use

Physical Relapse

In the final stage, alcohol or drug use resumes after a period of abstinence. A physical relapse may start with experimental use (a lapse), but quickly escalates into regular abuse:

  • Using alcohol or drugs again

  • Rapidly increasing usage and intoxication

  • Returning to uncontrolled abusive patterns

  • Feeling shame and guilt after using

5 Essential Strategies to Prevent Relapse

Panoramic shot of woman holding white jigsaw near connected puzzle pieces

While relapse is common, it is absolutely not inevitable. The following are 5 evidence-based strategies to reduce relapse risk and support long-term recovery:


1. Recognize Your Triggers

Pay close attention to high-risk situations, thoughts, emotions or behaviors that may lead to relapse. Avoid or limit exposure to identified triggers whenever possible.


2. Manage Stress and Emotions

Learn healthy coping skills like mindfulness, exercise, or relaxation techniques. Don't allow stress, anxiety, anger or other emotions to build up.


3. Attend Support Groups

Attend recovery meetings or support groups to build sober relationships and a community. Groups like AA provide shared experiences and 24/7 support.


4. Engage in Treatment

Stay involved in professional treatment, including medications like methadone, buprenorphine, naltrexone or NAC to reduce cravings and withdrawal.


5. Enhance Your Environment

Make lifestyle changes to avoid tempting environments and substances. Surround yourself with people who support your recovery.


Relapse Warning Signs and How to Respond


By learning to recognize the early warning signs, individuals can seek help before relapse progresses further:


Emotional Relapse Warning Signs

  • Feeling run-down, irritable, or disengaged

  • Bottling up emotions and isolating from others

  • Neglecting health, hygiene, nutrition, or self-care

  • Blaming external factors for unhappiness

Strategies: Practice self-care, share feelings with your support system, attend recovery meetings


Mental Relapse Warning Signs

  • Increased cravings or fixation on substance use

  • Glorifying past drug or alcohol use

  • Lying, hiding behavior, or acting defensive

  • Bargaining or rationalizing using substances

Strategies: Discuss cravings and thoughts honestly with your sponsor and treatment providers before they worsen


Physical Relapse Warning Signs

  • Obtaining or being near alcohol, drugs, or related paraphernalia

  • Making a plan to use or testing control over usage

  • Using any amount of drugs or alcohol after a period of abstinence

Strategies: Contact the sponsor immediately for support, attend recovery meetings, call the treatment provider


Long-Term Relapse Prevention Strategies

Relapse prevention must continue long after initial treatment ends. Some effective long-term strategies include:

  • Stay engaged in treatment and recovery groups

  • Maintain awareness of high-risk situations and triggers

  • Adhere to medication protocols if prescribed

  • Practice self-care and manage stress adaptively

  • Maintain honesty in relationships with supporters

  • Have a written relapse prevention plan to review periodically

  • Obtain mental health counseling for any trauma or disorders

What to Do After a Relapse Occurs

If relapse does occur, the priority is getting back on track to recovery safely:

  • Be honest with your support system and treatment providers

  • Attend meetings and ask sponsors for guidance

  • Consider inpatient or intensive outpatient treatment to regain control

  • Make any needed medication adjustments

  • Examine what triggered the relapse and make appropriate lifestyle modifications

  • Don't be hard on yourself - relapse is common and you can overcome it

Relapse is Not a Failure - Recovery Takes Time


Recovery is a long journey with occasional setbacks. The important thing is to learn from relapses, make appropriate changes, and keep moving forward. For many, repeated trial and error is necessary to achieve lasting sobriety.


With the right professional treatment, coping skills, peer support, and lifestyle changes, long-term relapse prevention is absolutely possible. Patience, perseverance and self-compassion are key. There is hope - full recovery is within reach.


I am Here to Help


I lead a team with decades of experience, and a commitment to providing you with comfort, care, and respect as you navigate this challenging time in your life. We also make treatment super convenient with hours of operation that extend from 0800 AM to 0900 PM, 7 days a week through scheduled appointments, accept most insurances, making addiction treatment accessible to practically all who call. I am waiting for your call.


Summary of Key Relapse Prevention Tips:

  • Relapse is common and doesn't mean treatment failed - most people recover after one or more relapses

  • Understand your personal relapse warning signs and high-risk triggers

  • Have coping strategies to manage cravings, emotions, stress, and triggers

  • Avoid high-risk environments and maintain a sober support system

  • Stay engaged in treatment and recovery groups - you don't have to go it alone

  • Adhere to medication protocols if prescribed

  • Have a written relapse prevention plan and review it regularly

  • Practice ongoing self-care to manage addiction long-term

  • If relapse occurs, get back into treatment and learn from the experience

  • Perseverance and self-compassion are essential - don't give up

Recovery is a process with occasional setbacks, but relapse is never inevitable. With the right professional support and personal strategies, long-term relapse prevention is absolutely achievable.


Frequently Asked Questions about Relapse in Drug and Alcohol Addiction


What are the reasons for relapses in drug addiction?

The main causes of relapse in drug addiction are physical triggers, emotional triggers, relationship problems, unhealthy behaviors, and risky environments that remind you of past drug use. Examples include stress, anxiety, poor coping skills, and spending time with friends who use drugs.


What are the signs of relapse to look for?

Early warning signs of relapse include neglecting your health, isolating yourself, feeling irritated or sad, increased drug cravings, lying or hiding behaviors, and making plans to use drugs again. Recognizing the signs early can help you get back on track before a full relapse.


How to stay sober?

Treatment programs help prevent relapse by teaching coping strategies for triggers and cravings, providing medications to reduce withdrawal symptoms, and offering ongoing therapy and group support. This helps manage the chronic disease of addiction.


What is substance use disorder and what is the risk for relapse?

Substance use disorder is when frequent drug or alcohol use leads to health and behavior problems. There is a high risk of relapse because addiction causes changes in the brain that make resisting urges difficult without treatment.


What percentage of people relapse in the first year?

According to the National Institute on Drug Abuse, 40-60% of people recovering from addiction relapse within their first year after treatment. Relapse is common but preventable.


Can a small slip lead to full relapse?

Yes, a minor slip can quickly escalate back into full relapse. The danger of relapse is that even using a small amount can trigger loss of control. It’s important to address slips right away before they become worse.


How do you get back on track after relapse?

If relapse happens, quickly seek support from your sponsors, attend recovery meetings, contact your treatment counselors, and consider returning to inpatient treatment to regain control and get back on the road to recovery.


Why do some people relapse after years of sobriety?

People sometimes relapse after long periods of sobriety because they stop using the coping strategies that supported their recovery, experience major life stressors, or underestimate the persistence of addiction’s effects on the brain.


What are some of the most common causes of relapse?

Some of the most common causes and triggers for relapse are stress, social pressure, anxiety or depression, poor self-care, drug cravings, and spending time in high-risk drug environments. Identifying your personal triggers is key.


What are some healthy ways of coping to avoid relapse?

Healthy coping strategies to prevent relapse include exercise, mindfulness practices, therapy, support groups, avoiding triggers, managing stress, engaging in hobbies, and asking for help early before problems worsen.


How can you get back on the road to recovery after a relapse?

If you experience a relapse, focus on safety first, be honest about it, get professional and social support immediately, examine what triggered it, make lifestyle changes, and don’t get discouraged – many achieve recovery after multiple relapses.


Why is having a relapse prevention plan important?

A personalized relapse prevention plan helps you identify triggers, warning signs, high-risk situations, and healthy coping strategies you can use to maintain sobriety. Reviewing it often helps you stay committed to recovery.


What are cognitive behavioral therapy techniques for relapse prevention?

Cognitive behavioral therapy helps prevent relapse by teaching techniques to control thoughts that trigger substance use, cope with cravings, avoid high-risk situations, and make healthier choices. It can identify self-defeating thinking patterns.


What type of professional help is useful for recovery and preventing relapse?

Professional treatment, therapy, support groups, relapse prevention coaching, and prescribed anti-craving medications are all helpful in promoting recovery from drug or alcohol addiction and reducing the likelihood of relapse during the lifelong recovery process.


About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.


This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.





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