According to the 2014 National Survey on Drug Use and Health (NSDUH), approximately 913,000 Americans met the criteria for cocaine addiction as outlined by the Diagnostic and Statistical Manual of Mental Disorders within the 12 months prior to the survey 1. Cocaine is a psychostimulant with powerful effects on the brain’s limbic system, creating feelings of reward, pleasure, and motivation in users. Because cocaine is highly addictive, many people relapse due to strong cravings and uncomfortable withdrawal symptoms 2.
What Is a Relapse?
Relapse is defined in its broadest terms as suffering deterioration after experiencing improvement. In terms of drug addiction, a drug relapse refers to returning to drug use after a period of abstinence or sobriety. It is important to understand that relapsing does not mean that a person failed at recovery. On the contrary, many schools of thought consider relapse to be a part of the recovery process 3.
Relapse rates for cocaine addiction and other drugs are similar to those for chronic diseases such as asthma, diabetes, and hypertension. Like these diseases, addiction is chronic in nature and is often recurring. This means that relapse is not only possible but likely for most people completing drug addiction treatment. For this reason, substance abuse treatment is usually a continuous process. Relapsing doesn’t mean that treatment didn’t work; rather, it means that treatment may need to be reinstated 4.
Why Do People Relapse on Cocaine?
Cocaine relapse statistics indicate that relapsing on cocaine is relatively common. According to research, approximately 24% of people relapse back to weekly cocaine use within a year following treatment. Another 18% of people end up returning for treatment following a relapse. Cocaine relapse rates are typically higher among those with more severe addictive problems and those who attend addiction treatment for shorter periods of time 5.
There are many reasons why a person may experience a cocaine relapse. Stress plays a large role in addiction relapse and may initiate cravings for the drug. As stress can increase the frequency with which cravings arise, a person may be more likely to give in to cravings, especially if they are not actively using other coping skills 6.
Terence T. Gorski doesn’t see relapse as a single event but rather a progressive process that is akin to knocking over one domino and experiencing the ripple effects that it creates until the last domino falls.
In this scenario, a person feels their only choice is to relapse and use drugs to cope. The first domino may be something as simple as a single stressful event or a mistake that leads to more stressors or poor choices, which ultimately leads to cocaine relapse 3.
Cocaine Relapse Warning Signs
Fortunately, there are many warning signs that typically occur during the relapse process. Those completing addiction treatment should be aware of the warning signs of cocaine relapse to help prevent one from occurring. Some of the most common warning signs include 3,5,7:
- Not following up with aftercare programs (counseling, support groups, 12-step programs).
- Feeling overly stressed and not dealing with it effectively (using healthy coping skills learned in treatment).
- Experiencing an increase in drug cravings.
- Engaging in other compulsive behaviors such as gambling, overeating, overworking, and over exercising.
- Spending time with drug-using friends or going to places or events where you once used.
- Feeling a lack of support from your family and friends in your desire to stay sober.
- Return to addictive thinking and negative thoughts.
- Bottling up emotions and isolating oneself from others.
- Having a poor self-care routine (not eating healthy, sleeping well, or taking care of oneself).
- Glamorizing past use and minimizing the reality of negative consequences.
- Lying to others or engaging in secretive behavior.
- Planning a relapse or looking for a relapse opportunity.
What to Do When You Relapse on Cocaine
Cocaine relapse is not the end of the line. Should a relapse occur, people shouldn’t react as if they’ve been given a green light for unbridled cocaine use. Rather, relapse is a stumbling block to longer-term recovery and should signal to the individual that some changes need to be made—renewed engagement with various treatment outlets can get someone immediately back on track. Diligent aftercare program participation following cocaine addiction treatment can make a big difference for someone struggling with fears of relapse, and can help that individual create a plan of action for what to do in the event of an actual relapse.
If you have recently relapsed on cocaine, do not give up. Here are some steps you can take to get back on track toward long-term recovery 3,7:
- Don’t beat yourself up. Practice forgiveness and compassion.
- Monitor yourself for negative or extreme thinking. Remember the unhealthy thinking styles you likely learned about in cognitive behavioral therapy, and try to keep your thoughts realistic and positive.
- Do not engage in all-or-nothing thinking that tells you because you relapsed once you have already failed and might as well keep using. Just because you had a relapse does not mean that you have to keep using.
- Remind yourself of the reasons you quit using in the first place (the negative consequences of your drug use).
- Reach out to a supportive person such as an addiction sponsor, a trusted friend, or a family member.
- Attend a 12-step meeting or other related support group.
- If you aren’t currently attending counseling, schedule an appointment with your counselor ASAP.
- If you don’t already have one in place, create a relapse prevention plan to help prevent further relapses.
Going to Treatment After a Relapse
You are NOT a failure if treatment didn’t work the first time.
Sometimes after a relapse you or your support system (counselor, sponsor, psychiatrist, family, or friends) may agree that reentering treatment is the best course of action. This does not mean that you are a failure or that your treatment didn’t work the first time.
Cocaine relapse rates and statistics indicate that returning to treatment is a common occurrence. One research sample of more than 300 people who completed cocaine addiction treatment revealed that 44% of people were readmitted into a treatment program within 2.6 years after completing their initial treatment 8.
How to Create an Effective Relapse Prevention Plan
To help create safeguards against relapse, it is crucial that people have an effective relapse prevention plan in place before completing treatment. Most rehabilitation centers and aftercare facilities assist patients in creating their relapse prevention plan before they discharge.
An effective relapse prevention plan typically includes some combination of the following elements 7:
- Recognize and outline the early stages (warning signs) of a relapse.
- Be aware of your obstacles to recovery and the tools and skills you have acquired to help you overcome them.
- Know your triggers, and make a plan to avoid them when possible and to effectively cope with those you cannot avoid.
- Have a specific plan in place to help you manage cravings (journaling, distraction method, urge surfing).
- Expect setbacks, and be prepared to handle them appropriately.
- Make a definitive plan to follow up with aftercare programs (12-step programs, cognitive behavioral therapy, group counseling, and learning mind-body relaxation and stress-management techniques).
- Practice good self-care (adequate nutrition, sleep, exercise).
- Write down a list of people, places, and situations you may need to avoid in order to prevent relapse.
- Redefine fun. Have recreational activities and hobbies readily available for you to engage in to help prevent you from glorifying past drug use out of boredom.
- Set healthy boundaries with others.
- Have a list of people you can call upon for support and ask for help when needed.
- Have a specific plan in place for how you will handle a relapse if it occurs.
To learn more about treatment options following a relapse, contact our recovery hotline by phone at 1-888-744-0069Who Answers?.
- National Institute on Drug Abuse. (2016). What is the Scope of Cocaine Use in the United States?
- Nestler, E. (2005). The Neurobiology of Cocaine Addiction. Science and Practice Perspectives, 3(1): 4–10.
- Gorski, T. (2001). Understanding Relapse. GORSKI-CENAPS Web Publications.
- National Institute on Drug Abuse. (2012). How Effective is Drug Addiction Treatment?
- Simpson, D., Joe, G., et. al. (1999). A national evaluation of treatment outcomes for cocaine dependence. Archive of General Psychiatry, 56(6): 507–14.
- Sinha, R. (2007). The Role of Stress in Addiction Relapse. Current Psychiatry Reports, 9(5), 388–95.
- Melemis, S. (2015). Relapse Prevention and the Five Rules of Recovery. Yale Journal of Biology and Medicine, 88(3): 325–32.
- Grella, C., Hser, Y. & Hsieh, S. (2003). Predictors of Drug Treatment Re-entry Following Relapse to Cocaine Use in DATOS. Journal of Substance Abuse Treatment, 25(3): 145–54.