Just as addiction is a progressive disorder, when a relapse occurs, it is progressive as well. The stakes are high. According to the National Institute on Drug Abuse, 40 to 60 percent of people in recovery experience a relapse.1
There is good news; if you recognize the common signs of relapse, especially the early ones, you can get help before it progresses to the point of using again. The more information you have, the better you can spot the signs. This article reviews the stages of relapse in the order they happen.2
During an emotional relapse, recovering people still have their last relapse in mind and aren’t consciously thinking about using. Subtle changes in emotions and attitudes are happening that can set them up for a relapse in the future. Denial is a large part of emotional relapse.
Signs of emotional relapse include bottling up emotions, feelings of isolation, not attending meetings or going to meetings without participating, focusing on other people’s problems or on how others are making the recovering abuser feel. Poor eating and sleeping patterns are also typical at this stage. The common factor within all these symptoms is these individuals aren’t caring for themselves properly.
The progression from emotional to mental relapse is a natural outcome of taking poor care of oneself. Restlessness, irritability and discontentment rise, tension builds, and they begin to have thoughts about using as an escape.
There is now a battle going on inside people’s minds. While one side wants to use, the other side doesn’t. As people slide further into mental relapse, thoughts of resisting temptations decrease while their need for escape increases.
Signs of mental relapse include craving for substances, thoughts of people and places which are associated with past substance use, false memories glamorizing past use or minimizing consequences, thinking of situations where it would be acceptable to use, false beliefs that this time using will be different, seeking out relapse opportunities and making a plan to relapse.
Lastly, physical relapse occurs when individuals begin using again. First, there is the initial drink or drug use, which if left unaddressed leads to uncontrolled using, and now total relapse is complete. Most physical relapses are relapses of opportunity. These physical relapses often happen when individuals think they can use and not be found out.
It’s essential for recovering individuals to know that relapse prevention is not simply refusing temptations or avoiding opportunities. Much has gone on before a person stops saying no to using and decides to do it. If a person stays in emotional relapse long enough to progress to mental relapse, and stays there for enough time without any intervention or calling on the needed coping skills, research has shown they are much more likely to use drugs or alcohol simply to get away from their chaos, confusion and agitation. Getting help when any of these common signs of relapse appear can help stop relapse.