Heroin Relapse Is Common

Heroin addiction is very powerful, and heroin’s interaction with opioid receptors and its reinforcing influence on your brain’s reward centers result in such profound feelings of euphoria and pleasure that it sometimes feels impossible to quit.¹ Even after someone has successfully completed a treatment program, they may continue to struggle with cravings and thoughts about using. Sometimes, a rise in the intensity of these cravings and thoughts leads to a heroin relapse.

The National Institute on Drug Abuse reports that 2.1% of adults aged 26 and older have used heroin at least once in their lifetimes.² Anyone can develop a heroin addiction—it’s not limited to a specific demographic—but once you develop an addiction, it can be difficult to overcome it, and the heroin relapse rate is often high.

What Percentage of Addicts Stay Clean?

One study examined heroin relapse rates among participants who were discharged after successfully completing an opiate detox program. 91% reported a relapse, 59% of which occurred within 1 week of discharge. Earlier relapse was associated with younger age, heavy use before treatment, a history of injecting, and not following up with aftercare.³

Despite the high heroin addiction relapse rate, many people don’t realize that relapse is often considered part of the recovery process.

What Is a Relapse?

Heroin relapse is defined as the resumption of heroin use after a period of abstinence. It frequently occurs in connection with strong cravings or in response to a stressor.

The book Relapse and Recovery in Addictions states that addiction is a disease and that relapse is an unrelenting part of recovery.⁵It also presents the idea that relapse is a part of a larger learning process that may ultimately lead to abstinence, in that each relapse highlights areas that can be strengthened to prevent future relapses.

Although it can take multiple relapses before a person is truly able to remain abstinent, a strong aftercare program is an essential component of recovery.

Why Do People Relapse on Heroin?

Substance abuse expert Terence Gorski believes that relapse is a progressive issue resulting from a compounding series of behaviors, thoughts, and problems. In other words, the triggers and problems that led to an addiction don’t simply disappear when a person gets clean.⁶ Each problem that occurs during recovery is a relapse warning sign, which, after a while, becomes too much to handle. The person feels that life has become unmanageable and the only solution is to start using again.

An alternative perspective on the relapse process views it as having three phases: emotional, mental, and physical:⁷

During the emotional phase, a person isn’t necessarily thinking about using, but their emotions may be setting the stage for relapse. They might feel isolated, stop going to meetings, or develop poor eating and sleeping patterns.
In the mental phase, they experience internal conflict: part of them wants to use, but part of them knows how destructive their addiction was.
And finally, during the physical phase, a person starts using again when the pull of the addiction becomes too strong to resist.

Relapse Warning Signs

Some common warning signs of heroin relapse include:^6,7

Experiencing a distressing event.
Denying a need for help.
Leaning on other compulsive behaviors, such as overeating or oversleeping.
Becoming overly emotional instead of relying on intellect to stay sober.
Acting and feeling out of control in day-to-day life, such as at work or in relationships.
Thinking negative or dysfunctional thoughts, such as “I’ll never be able to stay clean.”
Not having a supportive family or helpful social network.
Not following up with aftercare.
Stopping attendance of 12-step groups or individual counseling.
Experiencing intense physical cravings.
Using “just once,” which can lead to a cycle of uncontrolled use.

What to Do When You Relapse on Heroin

If you should experience a heroin addiction relapse:⁷

Stay calm. Don’t beat yourself up. Remember that relapse is a part of recovery and you’re not the first person ever to relapse.
Take action right away. Don’t let days or weeks go by before you reach out for help.
Reach out to a trusted and supportive friend, family member, or sponsor.
Commit to regularly attending 12-step meetings. For example, you might aim for 90 meetings in 90 days.
Begin (or resume) individual counseling.
Engage in positive activities that take your mind off using. You might consider exercise, getting out of the house and spending time in nature, reading, or seeing a movie.
Avoid negative or all-or-nothing thinking. This might include thoughts such as, “I can’t handle life without using,” or “life is no fun if I don’t use.”
Enter a professional substance abuse treatment program.

Going to Treatment After a Relapse

After a relapse, it’s often wise to consider reentering a treatment program. Your support system, which might include your therapist, psychiatrist, family, friends, or sponsor, may decide that treatment is the smartest and most helpful way for you to get back on track. In spite of their best intentions, you might feel some resistance to this idea.

man contemplating treatment after heroin relapse

Some of the more common emotional and mental blocks to reentering treatment after a heroin relapse can include:⁷

Feeling like a failure. Instead of viewing relapse as a failure, try to see your relapse as a small detour on your recovery journey that will end up teaching you more about what you need to stay sober.
Fear. You might be fearful of being judged or not measuring up, or even of success. Participating in cognitive therapy in a treatment program can help you learn to replace these fearful thoughts with more positive and realistic thought patterns.
Thinking that recovery isn’t “fun.” While you might think that staying clean isn’t a good time, it may help to realize that redefining your view of “fun” could help you stay sober. Keep in mind that your expectations play an important role here. Research has shown that if people think something won’t be fun, it usually isn’t. On the flip side, if they expect it to be fun, it usually is.
Not wanting to face your demons. Everyone has problems, but not everyone has the courage to face them. Entering treatment can provide you with an opportunity to further work on the issues that first led to your addiction and eventually contributed to relapse.

If you have relapsed on heroin, you might not know where to turn. American Addiction Centers (AAC) can help. Call our treatment consultants at to find out about the recovery options best suited to your needs.

How to Create an Effective Relapse Prevention Plan

A heroin relapse prevention plan can provide you with the tools you need to stay sober. A well-thought-out plan can help you identify and manage the signs of heroin relapse before things get worse. You can implement some of the elements of a relapse prevention plan on your own, while others are performed during addiction treatment.

Find Heroin Addiction Treatment Programs

If you or a loved one is struggling with heroin addiction, help is available and recovery is possible. Professional treatment can start anyone battling a substance use problem on the path to a healthier and happier life. Rehab programs are located throughout the U.S., and a variety of treatment types is available. You can use SAMHSA’s Find Treatment tool to search for facilities. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’

American Addiction Centers (AAC) is a leading treatment provider and has trusted rehab programs across the country. For helpful advice, information, or admissions, please contact a caring AAC representative free at .

Heroin Relapse Warning Signs, Prevention, and Addiction Treatment