The general meaning of relapse is a deterioration in health status after an improvement. In the realm of addiction, relapse has a more specific meaning—a return to substance use after a period of nonuse. Whether it lasts a week, a month, or years, relapse is common enough in addiction recovery that it is considered a natural part of the difficult process of change. Between 40 percent and 60 percent of individuals relapse within their first year of treatment, according to the National Institute o
How to Prevent Relapse
Research has found that getting help in the form of supportive therapy from qualified professionals, and social support from peers, can prevent or minimize relapse. In particular, cognitive behavioral therapy (CBT) can help people overcome the fears and negative thinking that can trigger relapse.
Experts in the recovery process believe that relapse is a process and that identifying its stages can help people take preventative action.
What Does a Relapse Mean?
Relapse is not a sign of failed recovery. It’s an acknowledgement that recovery takes lots of learning, especially about oneself. Recovery from addiction requires significant changes in lifestyle and behavior, ranging from changing friend circles to developing new coping mechanisms. It involves discovering emotional vulnerabilities and addressing them. By definition, those who want to leave drug addiction behind must navigate new and unfamiliar paths and, often, burnish work and other life skills. Recovery also requires discovery or rediscovery and development of interests that have the power to drive pursuit and deliver rewards, not only spurring the addicted brain to rewire itself but giving life real meaning—the ultimate goal of every person.
The risk of relapse is greatest in the first 90 days of recovery, a period when, as a result of adjustments the body is making, sensitivity to stress is particularly acute while sensitivity to reward is low. The risk decreases after the first 90 days. It is important to know that relapse does not represent a moral weakness. It reflects the difficulty of resisting a return to substance use in response to what may be intense cravings but before new coping strategies have been learned and new routines have been established. For that reason, some experts prefer not to use the term “relapse” but to use more morally neutral terms such as “resumed” use or a “recurrence” of symptoms.
What Defines a Relapse?
There is an important distinction to be made between a lapse, or slipup, and a relapse. The distinction is critical to make because it influences how people handle their behavior. A relapse is a sustained return to heavy and frequent substance use that existed prior to treatment or the commitment to change. A slipup is a short-lived lapse, often accidental, typically reflecting inadequacy of coping strategies in a high-risk situation.
No matter how much abstinence is the desired goal, viewing any substance use at all as a relapse can actually increase the likelihood of future substance use. It can engage what has been termed the Abstinence Violation Effect. It encourages people to see themselves as failures, attributing the cause of the lapse to enduring and uncontrollable internal factors, and feeling guilt and shame . Alternatively, seeing a binge or a slipup as a lapse encourages a person to minimize the size of the lapse, to quickly return to the recovery path, to direct attention to elements that can be controlled, which often means taking time to learn more about personal triggers, beefing up coping strategies, and bolstering a support network.
Why Does Relapse Happen?
Just as becoming addicted is a process that involves learning mechanisms in the brain, so is addiction recovery a learning process, and like most learning and growth, it does not occur overnight or in a strictly linear manner. Relapse frequently occurs in response to a trigger. A person on the road to recovery encounters a person or a place associated with addiction or some other reminder of the addictive life and the extreme highs it brought (however destructive they became), and that sets off a longing for the substance.
In the absence of an emergency plan for just such situations, or a new life with routines to jump into, or a strong social network to call upon, or enhanced coping skills, use looms as attractive. Alternatively, a person might encounter some life difficulties that make memories of drug use particularly alluring.
The majority of people who decide to end addiction have at least one lapse or relapse during the recovery process. Studies show that those who detour back to substance use are responding to drug-related cues in their surroundings—perhaps seeing a hypodermic needle or a whiskey bottle or a person or a place where they once obtained or used drugs. Such triggers are especially potent in the first 90 days of recovery, when most relapse occurs, before the brain has had time to relearn to respond to other rewards and rewire itself to do so.
This is especially the case with relapse among addicted youth . They are particularly prone to relapse because they spent their formative years engaged with substances rather than developing a strong social support network, learning basic life skills, or gaining academic achievement—all positive predictors of success. Learning what one’s triggers are and acquiring an array of techniques for dealing with them should be essential components of any recovery program.
Explore More About Relapse
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