Alcohol Relapse Rates & How to Get Off the Merry-Go-Round

Updated May 2022

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), over 15 million American adults have an alcohol use disorder (AUD) at any given time, marked by frequent drinking with the inability to control the amount consumed or stop easily. When a person receives treatment for addiction to any substance, relapse is common, but alcohol relapse rates are thought to be much higher than in other substance use disorders.

Alcoholics, more than addicts to other substances, often try to get sober without professional treatment from a dedicated facility, whether inpatient or outpatient. Here’s a look at why alcohol relapse is so common and how treatment facilities can work to help alcoholics achieve long-lasting sobriety.

Alcohol Relapse Rates

To understand the numbers pertaining to alcohol relapse, we first have to look at relapse rates for substance use disorders (SUDs) as a whole. According to the National Institute on Drug Abuse (NIDA), an addict who gets clean through any means will relapse at about a 40 to 60 percent rate. Of course, not all detox and treatment are created equal, but these numbers are consistent with other common chronic diseases.

When taken alone, however, relapse rates are thought to be considerably higher than in SUDs as a whole. According to the NIAAA, 90 percent of those who detox from an alcohol use disorder will relapse at least once within four years.

The numbers on alcohol relapse are not all so discouraging: the numbers consistently showed that the more time that passed without a relapse, the better the odds were that a given person would experience permanent recovery.

Relapse Rates in Perspective 

In order to truly understand the meaning of relapse rates for alcohol — especially when considering how high they are — we have to look at relapse rates for other, similar diseases. 

In society, addiction is heavily stigmatized. People who struggle to control their alcohol use are often looked at as “less than,” a lower social class. For this reason, relapse is viewed as yet another failure to stay clean. But in medicine, addiction is classified differently and may lend some perspective to the seemingly high likelihood of relapse, especially among alcohol users. 

Comparing Alcohol Relapse Statistics With Other Chronic Diseases 

In clinical communities, alcoholism and addiction in general are classified as chronic diseases, not moral failures. In this case, alcohol relapse rates are compared to other diseases that are treated on an ongoing basis, similar to addiction. 

Returning to the statistic that says people who get treatment for substance abuse relapse at a rate of 40% to 60%, this seems very high on its face, but less so when compared to other chronic diseases. 

For example, asthma and high blood pressure, both chronic disorders for which treatment can have a positive impact, face similar rates. In fact, the range for these is even higher: The likelihood of relapsing during long-term treatment is around 50% to 70% for each. This shows that suffering relapse during addiction recovery is not a failure or a sign treatment doesn’t work — it’s simply a common setback in a longer-term process. 

Why Are Alcohol Relapse Rates so High?

As reported by US News & World Report, drugs and alcohol actually change the chemistry of the brain so that when a person becomes dependent, it’s extremely difficult to function without the presence of the substance in question. Rates seem to be even higher because of a few factors. It’s socially acceptable to start drinking as a young adult. Binge drinking on college campuses is common, and some studies are finding new and increased danger when it comes to teens and young adults taking part.

Alcohol is also not like many other illicit substances, which are used in private for the most part. American society has very few issues with drinking, and alcohol is sold at sporting events, bowling alleys, arcades and nearly every restaurant, making it extremely difficult to avoid for those in recovery.

Most Common Causes of Alcohol Relapse 

The most common causes of alcohol relapse are similar to other substances, but with an important exception. Alcohol is the most commonly abused legal substance, making it harder to avoid. Here are some of the reasons alcohol relapse rates are so high. 

Cravings During Alcohol Withdrawal 

Withdrawal is the earliest phase of recovery, when the body is initially exposed to the absence of alcohol in the system. For many users, this is one of the most difficult times to avoid relapse. 

The characteristics of withdrawal — fever, increased blood pressure and heart, nausea, vomiting and flu-like symptoms — are accompanied by intense cravings. This can compel people to start using again to feel better. Undergoing detox alone can cause issues, and anyone trying to get clean should explore our options for supervised medical detox services. 

Availability of Alcohol 

This one is the most obvious, but valid at the same time. Alcohol is virtually everywhere in society and pop culture. Beer distributors commonly buy up expensive ad space during major sporting events. In the largest cities, there are entire neighborhoods filled with bars. In colleges, it’s viewed as a badge of honor to be able to drink more than your peers. 

If you’re a recovering alcoholic, you can promise to avoid alcohol, but it’s much more difficult to do this with the saturation of drinking culture in society than it is to avoid prescription medications or harder street drugs. 

Mental Health

Mental health conditions are known to be linked with substance abuse issues. In many cases, each can cause the other to progress and worsen. This is why we see it a necessity to treat both in accordance with each other as part of our dual diagnosis treatment path.  

Mental health issues like depression, anxiety or bipolar disorder can make it more difficult to stay committed to sobriety, increasing the likelihood of alcohol relapse. 

Common Triggers like Stress, Peer Pressure and Isolation

In treatment, there’s a heavy focus on trigger handling and developing coping mechanisms when triggers are unavoidable. Still, though, triggers are pervasive and dangerous to a person’s sobriety, especially in early recovery. 

Something like a stressful job or rejoining a social circle that’s not respectful of your sobriety can make it more difficult to resist having a drink, especially when you’re not used to a sober routine. 

Lack of Consistent Support

When people in recovery don’t remain in some sort of support or recovery group, they’re more likely to start using again. This is understandable for two key reasons. 

One, because with something like ongoing outpatient therapy or a 12-step group, people in treatment start to lose the vigilance and perspective that help them stay sober in the face of their triggers. 

Two, because lack of support from family or an understanding social circle can be isolating, which may cause a person in recovery to drink as a coping method. 

Why Quitting on Your Own Is Unsuccessful

Another reason why alcohol relapse rates may be higher than rates for other substances is the belief that alcohol is easy to detox from, causing many alcoholics to do so without professional help from dedicated addiction medicine specialists.

As studies show, this can make it even more difficult to stop drinking and stay sober. One study, published in a journal entitled Addiction, found that short-term relapse rates were lower when subjects received assistance with detox than those who tried to do it on their own.

It can also be dangerous to detox from alcohol on your own. The process of detoxing from alcohol is very taxing on the body. The withdrawal symptoms and side effects can be severe and potentially fatal when done without proper supervision.

How a Treatment Center Can Support Alcohol Detox and Sobriety

The addiction treatment community as a whole will benefit from the understanding that no matter the quality of care that a given facility can offer patients struggling with alcohol use disorders, relapse is inevitable.

The best way to prepare for the eventuality that a patient will relapse is to do as much as possible in the way of relapse prevention during inpatient care. Here are a few examples:

• Therapy and counseling that addresses triggers. Triggers for relapse can come from all angles, especially for alcoholics. Considering the ever-presence of alcohol in American society, recovering addicts need to be prepared for the temptations outside the treatment environment before they come face to face with them.
• Development of creative outlets and positive coping methods. There will be some potential triggers that aren’t expected. Grief and trauma are two major factors in relapse, so therapy programs that help patients develop positive coping methods and healthy outlets can help with this eventuality.
• Integration with 12-step and support groups. Treatment facilities can only control so much. Giving patients access to lifelong support groups and 12-step groups that connect them to a network provides consistent support, even if they relapse after treatment.

What If I Relapsed After Inpatient Treatment?

Average relapse rates for all substances are between 40-60 percent, which means patients in recovery are about as likely to relapse as they are not to relapse. There are a few publications, including Psychology Today, working to change the perception of relapse within the addiction treatment community and society as a whole, convincing people that relapse doesn’t equate to failure.

Addiction is categorized as a chronic disease, and like all chronic diseases, relapse is inevitable for some patients. If you suffer a relapse, it doesn’t mean that you were cured and your addiction came back. There’s no cure for addiction, just as there’s no cure for asthma or high blood pressure (two chronic illnesses that have higher average relapse rates than addiction).

Recovery Is Complex

What people don’t often realize is that recovery from addiction is not as simple as admitting a problem and getting treatment for it. Recovery is a lifelong battle, and certain factors involved with recovery from alcohol use disorders suggest that it’s even harder to avoid relapse from other SUDs.

No matter how long you are able to maintain sobriety, take your recovery one day at a time. Don’t look at relapse at the end of the road. On your journey to recovery, there will be ups and downs. Even three sustained days of sobriety between relapses is progress when compared to three days of constant drinking.

Take the small victories as they come, lean on your support group for help wherever you can and don’t hesitate to use a recovery facility as an asset in rebounding from alcohol relapse.

To learn more, contact FHE Health (formerly the Florida House Experience) for details and information about the addiction and mental health treatment services we offer. Our trained staff can talk to you about your addiction and how our services and treatment plans can help with long term recovery.