Drug addiction is a chronic disease that affects millions of people around the world. It is characterized by intense drug cravings and an inability to control drug use despite negative consequences. Not everyone who abuses drugs becomes addicted, but it can happen to anyone, regardless of whether their drug of choice is a prescription medication or an illicit drug. A 2014 national survey on drug abuse reports that 21.5 million Americans over the age of 12 had a substance use disorder in the previous year, which corresponds to about 1 in 12 people 1.
If you continue to use drugs even though it interferes with life at work, school, or at home, you may be struggling with a substance use disorder. Many people first use drugs in their teens— drug use has consistently shown to be highest among people in their late-teens and twenties—however, a drug addiction can start at any age. In fact, drug use is increasing among people in their 50s and 60s, partly due to the drug-friendly nature of aging Baby Boomers 2.
What Is a Relapse?
The most recent drug relapse prevention research suggests that, rather than being a random event, relapse is a result of an underlying process, and is a part of overall recovery. In a now widely adopted treatment philosophy, relapse is best defined as a series of setbacks along the way to recovery 4. From this perspective, mistakes or lapses are considered part of the recovery process, not a failure to recover 5.
Drug addiction is known as a relapsing disease because to relapse is common among people in recovery. Repeated drug use can cause changes in the brain that may affect an addicted person’s self-control and ability to resist cravings. Drug relapse prevention is an essential part of the recovery process because people remain at increased risk for many years 3.
The definition of drug relapse is evolving, thereby complicating efforts to explain it. Researchers debate whether drug relapse is a process or an outcome in and of itself 4. The origins of the definition of drug relapse come from a medical model that viewed addiction like a disease: a patient returns to a state of sickness after a period of remission 5. As the definition evolved, it came to encapsulate the process that leads people in recovery to return to their drug abuse.
Why Do People Relapse on Drugs?
Recent drug relapse statistics show that more than 85% of individuals relapse and return to drug use within the year following treatment. Researchers estimate that more than 2/3 of individuals in recovery relapse within weeks to months of beginning addiction treatment 6.
Why are these drug relapse statistics so discouraging? Without a long-term drug relapse prevention plan, most people will be unsuccessful in their attempts to remain sober, so having a solid plan is place is essential.
The goal of drug relapse prevention programs is to address the problem of relapse by teaching techniques for preventing or managing its reoccurrence. Drug addiction relapse prevention models are based on the idea that high-risk situations can make a person more vulnerable to relapse. A high-risk situation can include people, places, or feelings that lead to drug-seeking behavior 4.
Without a long-term drug relapse prevention plan, most people will be unsuccessful in their attempts to remain sober.
The process of relapse is sometimes compared to a circle of dominos. The first domino to fall might be unwittingly placing yourself in a high-risk situation; the second might be thinking you are in control, or denying that you ever had a real problem. While each step may feel insignificant, they are part of a chain of events leading you toward relapse 4.
Drug Relapse Warning Signs
Current research suggests that relapse is a gradual process wherein a person in recovery returns to his or her drug abuse. This means relapse can begin weeks or even months before an individual first takes a drug again 7. A good relapse prevention program helps individuals identify those early signs of relapse and develop tools and techniques for coping, so they can stop relapse early in the process. Researchers believe this significantly reduces a person’s risk of returning to drug addiction 7.
Drug relapse warning signs can be broken down into three categories: emotional, mental, and physical signs. During emotional relapse, individuals are not consciously thinking about using, but they are setting themselves up for it. They remember what relapse feels like and are in denial about the possibility of it happening again 7.
During mental relapse, individuals are thinking about using drugs again, but they are at war with themselves. Part of them wants to use, and part of them doesn’t. Eventually, this internal struggle wears them down. Physical relapse is when an individual finally returns to drug use. Some clinicians divide this phase into lapse (initial drug use) and relapse (returning to uncontrolled using). Either way, this final stage is the hardest to come back from 7.
Drug addiction relapse prevention requires identifying the following warning signs 7:
- Isolating oneself
- Not going to treatment or meetings
- Going to meetings but not sharing
- Bottling up emotions
- Poor eating and sleeping habits
- Not taking care of self mentally or physically
- Relaxing of self-imposed rules
- Drug cravings
- Thinking about people and places associated with past drug use
- Romanticizing past drug use
- Minimizing consequences
- Bargaining with self
- Lying to others
- Thinking about how to better control drug use next time
- Planning a relapse or looking for opportunities
- Using drugs “just once”
- Returning to uncontrolled use
What to Do When You Relapse on Drugs
If you have relapsed on drugs, ask for help. Relapse is part of the recovery process, but it can feel like failure. Negative thoughts are a large part of addictive thinking, which tend to be an all-or-nothing mentality. Obsessing over these negative, self-critical feelings will only push you further into relapse.
After a relapse, reach out to a family member or friend who can help you start on the road to recovery. This can be someone else in recovery who understands what it’s like, such as a sponsor or friend at Narcotics Anonymous. You can also seek professional addiction counseling. An addiction counselor often uses cognitive-behavioral therapy (CBT) to help you change your negative thought patterns and develop healthy coping skills. Numerous studies prove that CBT is an effective strategy for drug addiction relapse prevention 7.
Going to Treatment After a Relapse
For some people, the best thing to do following a relapse is to seek treatment again. If your relapse has led to uncontrolled drug use, you might have to go through detox again too. Starting over is hard, but an addiction treatment center can make the process feel less daunting. You might choose to enter an inpatient program that provides medically assisted detox followed by cognitive therapy. If you have only lapsed once or twice, an inpatient or intensive outpatient program could help you avoid the temptation to use again. You can learn new skills to cope with your cravings and mental relapse symptoms.
The negative thinking pattern you developed using drugs will try to stand in the way of your recovery. You may make negative rationalizations such as, “Since I lapsed, I might as well relapse completely,” or “Treatment obviously doesn’t work for me.” Your fear will make you blame the problem on others as you may think, “It wasn’t even my fault; if it weren’t for…” And you might bargain with yourself: “If I can abstain for 1 week, I know I’m fine.” But this is your addiction thinking 8.
If you have already relapsed, then you are in an emotional and mental state that could easily lead to further relapse. The time to seek treatment is now.
Our treatment placement specialists understand how discouraging a relapse can be. They are standing by to help you get back on track. Call our hotline today at 1-888-744-0069Who Answers? and get the help you need.
How to Create an Effective Relapse Prevention Plan
After a drug relapse, life can feel like a lot to handle. Developing an effective recovery plan can help prevent future relapse. This means developing a plan to take care of yourself physically and emotionally. It should involve small achievable goals, like staying sober, eating right, and taking time out for yourself.
After a relapse, you need to go back to the basics. Even if you have relapsed after years of sobriety, the basic tools for sobriety are where you need to start. The following are some of the tasks that will help you return to sober life 7:
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. HHS Publication No. SMA 15-4927, NSDUH Series H-50.
- National Institute on Drug Abuse. (2015). Nationwide Trends.
- National Institute on Drug Abuse. (2016). Understanding drug use and addiction.
- Hendershot, C.S., Witkiewitz, K., George, W.H. & Marlatt, G.A. (2011). Relapse prevention for addictive behaviors. Substance Abuse Treatment, Prevention, and Policy, 6, 17.
- Marlatt, A.G., Donovan, D.M. (2005). Relapse Prevention, Second Edition, Maintenance Strategies in the Treatment of Addictive Behaviors. (1-50).
- Sinha, R. (2011). New findings on biological factors predicting addiction relapse vulnerability. Current Psychiatry Reports, 13(5), 398–405.
- Melemis, S.M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332.
- Gorski, T. (2001). Understanding relapse.