Relapse, like addiction, has a complex definition. It is a three-stage, sometimes long-term, process and does not necessarily mean that a recovering alcoholic or drug user has fallen back into their old ways. To understand why your loved one entered relapse, it is important to comprehend what causes relapse and how it progresses. Drug and alcohol relapse statistics show us that addiction is a chronic, relapsing disease – so it is critical to identify the early signs of alcohol relapse or drug relapse and address these as soon as possible.
Relapse refers to returning to alcohol, drugs or addictive behaviour after a period of abstinence. In addition to this general definition, relapse is much more than a step back in recovery, and has a complicated explanation.
The process of relapse is categorised into three stages: emotional relapse, mental relapse and physical relapse. A relapsing alcoholic or drug user will experience periods of non-using during which they become more vulnerable to the physical relapse, the last stage, when they actually start to use again. Even though physical using doesn’t happen in the two preceding stages, they are also considered relapse. It is critical to be aware of this, and recognise all the signs of alcohol relapse or drug relapse. Because the earlier that problems are addressed, the less likely that a physical relapse will happen, or continue.
Relapse begins without actual thoughts of using. This is referred to as emotional relapse, or post-acute withdrawal. During this period, the person will experience mental distress which can trigger mental and physical relapse in the long-run. A relapsing alcoholic or drug user can enter emotional relapse weeks or months before they physically relapse.
Once the person enters mental relapse, they will start to bargain with the idea of using again. Half of them wants to use; the other half doesn’t. They may briefly consider using again, or toy with the idea that “one more time won’t hurt”. They may also experience addictive thought patterns, such as denial, which includes minimising the seriousness of their addiction. Or glamourising the “good old days” when they were using drugs or alcohol. They may not even be aware of what is happening or the consequences of their actions. For example, if they think “I’ll just go and see how Peter is getting on” but not consider the fact that Peter is an old drinking buddy.
Ignoring or not addressing emotional and/or mental relapse will likely lead to physical relapse, which is the toughest to recover from. That’s why at Castle Craig, we spend a lot of time helping patients to prepare a good and thorough continuing care plan. Our plans include a section on relapse prevention strategies that the individual has decided to employ. Where these have been well thought out and when they are rigorously followed, the chances of relapse will be significantly reduced.
Both the relapsing alcoholic or drug user and their loved ones need to remember that relapse is not failure. It is an opportunity to improve one’s chances of recovery. Relapse should be used as a chance to learn from one’s mistakes and prevent problems in the future.
Relapse can happen to anyone, even to someone who has been sober for decades. However, the chances of relapse are also the highest for a recovering alcoholic or drug user at the beginning stages of treatment. This is why continuing care is vital for retaining recovery, and why we provide aftercare as part of the Castle Craig programme. We should always remember that addiction is an incurable disease that can be successfully held in remission. But it will always have the potential to return.
In addition to preventing relapse, one should create a plan of action in case relapse does happen. Remember, all problems are best addressed in the beginning, before they progress.
The implications of relapse are different for each person. For some, the consequences may be minimal, while for others they can be devastating. It is important to understand why a recovering alcoholic or drug user doesn’t want to admit to relapsing.
Undoubtedly, people will experience guilt and shame when they begin the relapse process. They will feel like they have failed and are a disappointment to their loved ones. Because of this, the relapsing alcoholic or drug user may be less inclined to ask for help, even if they know they need it.
Relapse can also mean complications at work or school, especially if the relapsing alcoholic or drug user needs to go back to treatment. If relapse hits hard, they may even lose their job or drop out of school.
In some situations, relapse can have severe consequences. For example, staying sober may be part of their parole. If they relapse, they may go back to jail.
Addiction is known as a family disease because loved ones are affected as much if not more than the addicts themselves. The self-help fellowships recognise this fact with the provision of family support groups such as Al-Anon and Families Anonymous. At Castle Craig Hospital, we encourage participation in treatment and recovery through family therapy and attendance at self-help family support groups.
In addition to the relapsed alcoholic or drug user, relapse affects loved ones just as hard, and can cause a lot of distress for friends or family. This is especially true if the initial period of addiction treatment wasn’t easy.
In such cases, those around the relapsed alcoholic or drug user may be in denial about their relapse, be unsupportive, or even shame the addicted person. This can worsen the situation, and threaten the possibility of long term sobriety. Statistics and research on shame in addiction indicate that it may be a core factor in the cause of addiction, and can be a roadblock to recovery. Instead, focus on how to help a relapsed alcoholic or drug user back into recovery.
Relapse can happen to anyone for a number of reasons. Even a recovering alcoholic or drug user who has been sober for many years can fall back into their addiction. Remember, addiction is a chronic mental illness and one is never cured completely from it. Recovering from addiction is a lifelong battle, and relapse is always a possibility.
Daily stress and overwhelming circumstances are a major trigger for relapse. Sometimes stress and/or anxiety can feel too much and going back to alcohol or drugs seems like the only option of escape. A recovering alcoholic or drug user’s ability to handle emotional distress, or physical pain in some cases, will affect their likelihood of relapse.
Depression, exhaustion, isolation and even hunger are all known factors that can cause relapse. Lack of self-care is exhausting on its own, and can worsen one’s physical and mental well-being.
Guilt can drive someone to relapse completely if they have a moment of weakness, or a slip. The relapsing alcoholic or drug user may feel like a failure and give up on recovery all together.
In some cases, withdrawal symptoms from alcohol or drugs may last for months and months, triggering relapse as well.
“Some patients feel the need to test themselves one more time”
On the other hand, people may not notice that they are being triggered, or realise that they are relapsing, and unintentionally return to old habits.
Others may feel overly confident in their ability to remain abstinent. Alternatively, they may not have enough faith in themselves. Both states of mind are self-sabotaging.
Relapse can also progress if the recovering alcoholic or drug user doesn’t have proper support. Maybe they notice that they are struggling, but don’t have anyone to reach out to. That is why it is important to involve self-help fellowships, friends and loved ones in the aftercare plan. Proper support can increase a person’s chances of recovery.
Therapist’s comment: At Castle Craig Hospital, it is noticeable that upon completing treatment, some patients seem to feel the need to test themselves one more time, to see if they can somehow miraculously control their addictive behaviour. In that context, a relapse after treatment can confirm once and for all that complete abstinence is the only solution and therefore the relapse becomes a turning point, the moment of final acceptance of their illness.
Relapse is common, and happens to 40-60% of people on average, even after successfully completing a treatment programme. According to the National Institute on Alcohol Abuse and Alcoholism, this is especially true for a recovering alcoholic. Alcohol relapse statistics show that around 90% of people in recovery relapse within four years of treatment completion.
However, patience is a virtue. The relapse rates drop after accomplishing one year of sobriety from about 50 percent to 30. After five years of abstinence, the chances of relapse are less than 15%.
In terms of drugs, heroin, cocaine and meth all have higher-than-average relapse rates, of 78%, 62% and 52% respectively.
The same report also concluded that smoking, family drug/alcohol use, low self-esteem, unemployment, and having ties to old drug-related friends are the major factors that increase the likelihood of relapse.
Drug and alcohol relapse statistics show that the chances of relapse are the highest during early recovery. This is especially true in the first few months while the person is still experiencing post-acute withdrawal.
Get Help Now
If you think that your loved one has relapsed, or is close to relapsing, you should get help now. At Castle Craig, we have 30 years of experience, and success, helping people get sober. Whether this is addiction treatment for the first time, the second time, or the seventh time, we are here to listen, treat, and guide your loved one back to recovery.