When people first get sober or clean, they’re usually on high alert for the triggers that may lead to a relapse. However, identifying these triggers can be challenging, even after going through extensive addiction treatment. Knowing the common reasons people relapse can help increase the chances of a successful recovery.
What is a relapse? Following a period of abstinence, a one-off use of drink or drugs constitutes a “lapse.” When that initial drink or drug use starts to spiral into excessive drinking or drug use, that pattern is a “relapse.”
- Relapse is common and considered part of the recovery process, not a sign that recovery has failed.
- It often begins long before any substance use, moving through emotional and mental stages first.
- The most common triggers include post-acute withdrawal, stress, sleep problems, complacency, and unmet expectations.
- Early recovery is the highest-risk window, but relapse can happen even after years of sobriety.
- A written relapse prevention plan and a sober support network are among the strongest protections.
Early Recovery Pitfalls
During early recovery, often defined as the first 90 days to the first full year or two of sobriety, many newly sober people experience relapse triggers. After completing drug and alcohol treatment, the recovery process can seem unfamiliar, frightening, and uncertain, leading to the urge to use substances again.
Recovery is a lifelong process, and relapse can start long before a person goes back to using.
- Emotional stage of relapse. People may deny wanting to return to previous drug or alcohol use, but their behaviors indicate a problem. They may gradually isolate themselves from support groups, stop engaging in helpful self-care activities, spend time in risky places such as bars or cancel therapy appointments.
- Mental stage of relapse. A person might start having conflicting thoughts about their previous drug or alcohol use. These could involve minimizing the seriousness of their addiction, romanticizing the substance or even considering themselves “cured” after “proving” they can stop.
- Physical stage of relapse. This is when the actual return to substance use happens.
Even those who’ve been through rehab numerous times aren’t immune to relapse triggers. Certain pitfalls are commonly encountered by people in recovery, making them the most frequent causes of relapse.
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What Are the 8 Most Common Causes of Relapse?
Relapse rates are high for alcohol and many substances. Although any relapse is something to take seriously, relapse is considered a part of the overall recovery process. Many individuals need to go through rehab and treatment several times following relapse before they achieve self-sufficiency and abstinence. A 2021 study found that around 40.5% of people experience a relapse within three months of completing a treatment program, rising to 74.6% at the 12-month mark.
Knowing the most common causes of relapse is valuable. It helps people in treatment and their supporters notice and address a relapse to get recovery back on track.
1. Post-Acute Withdrawal
Post-acute withdrawal, which starts shortly after the acute phase of withdrawal, is the most common cause of relapse after abstinence and into early recovery. While acute withdrawal symptoms are mainly physical, the most predominant symptoms in post-acute withdrawal syndrome (PAWS) are emotional and psychological.
PAWS symptoms include:
- Mood swings
- Anxiety
- Energy variation
- Irritability
- Lack of enthusiasm
- Concentration issues
- Sleep disturbances
Many symptoms overlap with depression, although PAWS symptoms tend to gradually improve over time.
Suggestions for Remedy
Getting immediate help managing the uncomfortable effects of PAWS can help you avoid a full relapse. While you may not need to return to treatment in a residential rehab facility, a therapist or an addiction treatment professional can help you control PAWS symptoms and focus on recovery-oriented behavior and goals. Many people with substance use disorders also experience mental health issues, and counseling can help you manage both conditions to ease recovery.
2. Stress
Another common reason for relapse is stress. While everyone experiences stress, it can make it harder to cope with the addiction recovery process. When a person is desperate for stress relief, reaching for a drink or using drugs can seem like a quick fix. This situation can escalate into continued and excessive drinking and drug use, resulting in full relapse.
Suggestions for Remedy
There are many healthy, effective remedies for managing stress. These include:
- Exercise
- Meditation, including mindfulness meditation
- Yoga
- Spirituality and prayer
- Laughter
3. Insomnia
Sleep problems are among the most persistent challenges in early recovery. Insomnia affects a large share of people recovering from alcohol use disorder, with symptoms reported in roughly two-thirds of patients during the early recovery phase, and it can persist for months or even years after sobriety begins. Research consistently identifies insomnia as a strong predictor of relapse, which is why addressing it early matters.
Suggestions for Remedy
While sleep medications are sometimes prescribed for insomnia in early recovery, many addiction treatment experts are cautious about this approach, since some sleep aids carry their own risk of misuse and dependence. Behavioral treatment, particularly cognitive behavioral therapy (CBT), has stronger evidence for treating insomnia in this population. Because untreated insomnia raises relapse risk, managing it should be an integral part of a recovery plan.
4. Changes in Expected Outcomes
Everything may be going fine following treatment and for the first half-year of abstinence. Then, something might happen that dashes your hopes of achieving certain recovery goals, leading to disappointment and feelings of failure. For some people, not being able to repair the damage their addiction caused to relationships, career, finances, and social standing is enough to send them back to alcohol and drug use. Recovery failing to go as expected can be a common cause of relapse.
Suggestions for Remedy
Avoid thinking in terms of absolutes. Not repairing a fractured personal or family relationship at this point doesn’t mean your entire recovery is a failure. It also doesn’t mean irreparable loss. In some cases, friends and loved ones may become more open to rebuilding relationships when they see long-term progress. Counseling may help if you’re struggling with broken or changing relationships.
Joining a support group with other individuals in recovery is highly recommended by addiction experts. A support group may serve as a substitute family, especially if there is a shared connection, desire to see members succeed, and ongoing encouragement to maintain sobriety.
5. Complacency and Overconfidence
Another red flag warning of an impending relapse is downplaying your addiction and entertaining the idea that you can handle moderate drinking or drug use. After successfully maintaining abstinence for a while, some people start believing that the issues that contributed to their addiction no longer apply. They may start thinking that they can manage temptations and triggers, such as seeing friends who still use, without consequences.
These thoughts can lead to relapse because most people in early recovery cannot handle high-risk situations at a time when they are so vulnerable.
Suggestions for Remedy
It took a lot to get clean and sober, including many challenging behavioral and lifestyle changes. Giving up long-term habits and friends can be tough, but it’s worth it to achieve a sober, healthy future.
You can handle misplaced confidence by sticking rigidly to newly established boundaries and reminding yourself of what you’ve gained from recovery so far. Life is better lived clean and sober, and reverting to excessive drinking and drug use likely comes at too high a cost. Keep up meeting attendance at support groups and maintain a daily recovery routine to prevent backsliding.
6. Boredom
Having no focus can zap your resolve. Without healthy, productive activities to occupy your time, you’ll likely struggle to maintain sobriety. Boredom makes it all too easy to think that going to see former drinking or drug-using friends would be a good way to pass the time, potentially putting temptation in your path.
Suggestions for Remedy
This is a time to step up by going to meetings or jumping on positive lifestyle and behavioral changes. If nothing else, get physically active. Work on a project around the house. Help out a neighbor or take on an assignment at work that will engage your mind and utilize your talents. Talk about needing positive direction with your support group sponsor.
7. Relationships
Getting into a sexual or romantic relationship too early in recovery can jeopardize your progress. Addiction experts say that beginning new romantic relationships at this time means placing faith and energy into someone else instead of working on your sobriety. If that relationship gets shaky, so does your recovery.
Suggestions for Remedy
It’s okay to make new sober friends in early recovery, especially if they share the goal of maintaining sobriety. Avoid romantic entanglement during the first full year of sobriety, though. This is a time to focus on your positive sober lifestyle and learning new ways to deal with stressors.
8. Not Having a Relapse Plan
It isn’t a question of whether the desire to drink and do drugs will return. It’s more a matter of when. While some people are stronger at resisting urges, most newly recovered people lack the skills to withstand the desire to use substances or cope with triggers. Without a plan for resisting or managing a relapse, you risk falling back into unhealthy habits when you feel your resolve wavering.
Suggestions for Remedy
Having a detailed, actionable relapse plan can help you find ways to manage triggers. It also ensures that you know exactly how to get your recovery back on track if you slip back into using substances.
What constitutes a solid relapse prevention plan? Consider the following:
- Create a written document. A relapse plan is something created with a therapist or multidisciplinary team and shared with the people supporting your recovery. It serves as a helpful guide whenever you encounter a situation that could trigger a relapse.
- Include an action plan. A good relapse prevention plan lays out steps to take to identify and deal with triggers and urges.
- Identify people to call. List trusted individuals you can call for help when you experience triggers or urges. These people should be familiar with your recovery goals and comfortable with providing support. If you feel your resolve dissipating and don’t think you can manage the situation, it’s time to contact your relapse support person.
- Start a lifestyle and personal self-care plan. Sustainable sobriety requires healthy lifestyle changes. Writing them down in your relapse prevention plan helps create accountability and reduces the need for decision making in stressful situations. Noting your daily routine, prioritizing nutrition, and planning stress management activities can all help create a healthy foundation for a sober lifestyle.
- Learn new tools and techniques. There are numerous ways to manage cravings and cope with stress. Research different techniques, determine which resonate for you, and add them to your plan. Over time, you’ll learn multiple techniques and strategies to overcome relapse triggers whenever they arise.
Tips on How to Prevent Relapse
While avoiding triggers altogether may be impossible, building a supportive recovery network and following a comprehensive recovery plan mitigates the risk. Some tips to help you cope with triggers include:
- Identify triggers. Understand what situations, emotions, or environments lead to cravings or negative behaviors.
- Build a sober network. Peer support groups are great for meeting and socializing with sober people.
- Reach out for support. When you feel tempted to use, reach out to someone you can trust for non-judgmental support.
- Set boundaries. Ask your loved ones not to drink in front of you, and make your home a substance-free zone. If you must attend certain events, have a plan in place, and leave if you feel at risk.
- Establish a routine. Create a daily schedule with positive activities, such as exercise, hobbies, and relaxation techniques.
- Use healthy coping tools. Practice healthier coping methods, such as deep breathing, journaling, or mindful meditation.
- Engage in treatment. Continue attending therapy, and stay connected with your mental health team even after you feel stable. Regular check-ins with your therapist can provide ongoing support and keep you accountable.
- Learn from mistakes. Don’t beat yourself up or give up on your goals if you have a lapse. Instead, be honest about what went wrong, and use it as a learning experience to strengthen your relapse prevention plan.
Frequently Asked Questions About Relapse
Stay Positive: Recovery is Possible
While it may not seem like it now, continued hard work and perseverance will pay off over time. Recovery is not a one-and-done activity. Instead, recovery takes time and is an ongoing process. There are often many slips or lapses along the way to a sustained and solid sobriety.
Recovery is possible, and the right support can help you avoid relapses and achieve the healthy future you deserve. If you or someone you care about is struggling with addiction, help is available. Contact FHE today for compassionate addiction treatment in Deerfield Beach, Florida.
