For clinicians and medical staff treating individuals with substance use disorders, the term relapse can carry a different meaning than it does for the general public or even those in the 12-step community. Medically, relapse refers to a return to behavior where a person could once again be diagnosed with an active substance use disorder.
Relapses can happen for a variety of reasons after someone has worked to change their behavior and become sober. Often, they are preceded by falling back into familiar patterns or situations that initially triggered substance use. However, in some cases, relapse occurs unexpectedly, for seemingly insignificant reasons. Ideally, a relapse should not lead to ongoing substance use or a loss of hope. Instead, it should be viewed as a temporary setback and an opportunity to seek additional treatment or realign with a recovery plan.
Lapses and Relapses
Within the recovery and 12-step community, opinions on relapse may vary. Some differentiate between minor lapses—where a person briefly slips but is able to self-correct—and a full relapse, which involves a return to the behavioral patterns that define active substance use. Others argue that for someone with a substance use disorder, any lapse qualifies as a relapse. However, it is widely agreed that an individual who experiences repeated lapses followed by brief abstinence would benefit significantly from seeking clinical treatment.
The Reality of Relapse After Inpatient Alcohol Rehab
Understanding that relapses are not uncommon is crucial. According to the National Institute on Drug Abuse, relapse rates among those recovering from substance use disorders are comparable to those seen in other chronic health conditions like hypertension, asthma, and diabetes. Relapse rates for these conditions, including substance use disorders, range from 40 to 60 percent, varying by the type of condition and substance involved.
It’s also important to recognize that a relapse should not be seen as a failure to recover. While it is something to strive to avoid, a single relapse does not mean the fight against addiction is lost. Recovery is a day-to-day process, and just as there are days where you win the battle, one relapse does not erase the progress made.
Addiction Isn’t the Final Chapter
A day of relapse doesn’t mean addiction has won the next day or the days to come. Recovery is about setting goals and working toward them. While it’s preferable to stay on track with sobriety goals, slipping up doesn’t mark the end of progress. Achieving significant goals often involves overcoming occasional setbacks.
Those in recovery must stay committed, even when challenges arise. Relapses shouldn’t be dismissed lightly, especially for those who have completed inpatient alcohol rehab. It’s important to examine the circumstances and emotions surrounding a relapse and communicate them with the treatment center. This allows clinical providers to offer strategies and coping tools to help prevent future relapses and avoid being caught off guard.
Preventing Alcohol Relapse After Inpatient Rehab
Dr. G. Allan Marlatt, a leading psychologist in the field of substance use disorder recovery, has developed valuable insights into relapse prevention. His work, widely used by clinical providers, focuses on helping individuals overcome the feelings of guilt and shame that often accompany relapse. While his research is primarily aimed at clinicians, Dr. Marlatt’s strategies can also provide practical guidance for those navigating recovery. Below are some of the recommendations suggested by Dr. Marlatt and his colleagues.
Stay Engaged in a Structured Treatment Program
Continuing with a treatment program after completing inpatient alcohol rehab, such as intensive outpatient programs or 12-step meetings, has been shown to reduce relapse rates and improve recovery outcomes. The foundation of alcohol use disorder treatment lies in structure and support. Group-based post-treatment programs help individuals maintain sobriety by building a support network, while therapy with a licensed therapist can also be highly beneficial.
Recognize Your Triggers
Effectively managing cravings and triggers after completing inpatient alcohol treatment is crucial for long-term success. Developing strategies to navigate these situations can be the deciding factor between relapse and continued recovery. Much of the time spent in formal treatment is focused on building these techniques, and equipping individuals with the tools they need.
Change Your Environment
After completing alcohol rehab, many individuals face significant changes in their daily lives. While they may have grown during treatment, their home environment often remains the same. It’s important to make positive changes to reduce the risk of relapse. This may involve finding new social circles, adopting new hobbies, or even relocating. Although it can be difficult to leave behind old friendships or familiar places, doing so may be necessary if those connections are unhealthy. Many in recovery find comfort in support groups or new activities that engage both mind and body.
Urge Surfing
“Urge Surfing” is a technique used to help individuals in recovery break negative thought patterns. Many who have maintained sobriety for some time may start romanticizing their past alcohol use, focusing on the pleasurable aspects while minimizing the harm it caused. Common thoughts like “It wasn’t that bad” or “I’ve quit before, I can do it again” can trap those in recovery. Urge Surfing involves recognizing these romanticized thoughts and countering them by recalling the harmful experiences associated with alcohol use. Reflecting on the darkest moments can serve as a powerful reminder to stay sober.
Stress Management
Stress is one of the leading triggers for relapse, making stress management a crucial component of recovery. Many treatment programs incorporate cognitive behavioral techniques to help individuals manage stress, such as mindfulness meditation, progressive muscle relaxation, and diaphragmatic breathing. Practicing these techniques can equip individuals with the tools they need to handle stress effectively and avoid relapse.
Address Co-Occurring Disorders
Many individuals with alcohol use disorder also experience co-occurring psychological conditions such as anxiety, depression, bipolar disorder, or PTSD. Some may be aware of one disorder while being unaware of the other, or they might not recognize either. Successful recovery requires addressing both conditions holistically. Attempting to treat substance use disorder without tackling the co-occurring disorder is often ineffective and may lead to relapse.
Build a Strong Social Support Network
During rehab, individuals often find strength in connecting with peers and sharing their experiences. After completing treatment, however, it can be harder to maintain such a supportive environment. This makes seeking out local support groups crucial. Peer support and involvement in recovery communities play a key role in maintaining sobriety. Finding a sponsor, regularly attending support meetings, and actively participating in the recovery community can significantly bolster a person’s recovery plan.
Stay Busy
Idleness and boredom can be as harmful to recovery as stress. Many recovering individuals find they have more free time after giving up drinking. Developing new hobbies can help fill that void with positive, fulfilling activities. Engaging in team sports, learning a new skill like playing an instrument or cooking, taking college courses, or volunteering can replace time previously spent on addiction with productive and enjoyable pursuits.
Health and Fitness
Drug and alcohol addiction can severely disrupt the balance of a healthy diet and exercise routine. Engaging in regular aerobic exercise has been shown to reduce the risk of developing or relapsing into addiction. Research indicates that individuals who maintain consistent exercise habits are less likely to abuse illicit drugs, with exercise providing protective behavioral and neurological effects against substance use disorders. For those in recovery, regular exercise offers numerous benefits, including providing structure, occupying the mind and body, producing healthy neurochemicals, improving mood and self-image, enhancing sleep quality, combating cravings, supporting physical health and weight maintenance, reducing stress, and boosting memory.
Avoiding Triggers After Rehab
Triggers are situations or emotions that create cravings to use substances again. For alcoholics, triggers can range from receiving bad news to visiting a bar and seeing others drink. Cravings are powerful urges to use, even with the knowledge of potential harm. While cravings are often easy to identify, they can be challenging to resist. Recovering alcoholics must learn to recognize and manage situations that provoke the desire to drink. It’s important to remember that:
You Suffered a Relapse—What’s Next?
Whenever a relapse happens, it’s essential to have a plan in place that you can follow immediately. If this is your first relapse or you don’t yet have a plan, here are some general steps to guide you:
Step 1: Stop Drinking
If you’re in a bar, party, or any setting where more alcohol is available, leave immediately. Call a ride, step away, and remove yourself from the situation as quickly as possible. If you’re drinking alone, pour out the alcohol to prevent further consumption.
Step 2: Reach Out to Your Sponsor
Contact your sponsor, or if you don’t have one, call someone in your recovery network or support group. This person will understand your situation and provide advice and support.
Step 3: Notify Your Treatment Center
Inform your treatment center about the relapse. They are the best equipped to help you get back on track with your recovery. Speak with your therapist or counselor to explore your options, which may include re-entering treatment based on your needs.
Step 4: Let Go of the Guilt
It’s normal to feel ashamed after a relapse, but dwelling on guilt is counterproductive. In fact, self-pity may only push you toward more drinking. Instead, try to view the situation objectively—relapses happen to many people in recovery. The focus should be on finding a way to move forward.
Step 5: Recommit to Sobriety
Setbacks can highlight areas for growth and improvement. Use this relapse as a learning experience to better understand the situations that trigger you. Reflect on the benefits sobriety has brought you and renew your commitment to staying sober. If needed, consider returning to rehab or enrolling in an intensive outpatient program.
Relapse Is Just a Step on Your Journey
Remember, relapse is only a small part of your overall recovery journey. It provides an opportunity to address any underlying issues affecting your sobriety. For more relapse prevention strategies, visit the Sunrise Recovery website. Our treatment programs offer the support and resources needed to help individuals overcome addiction through residential treatment, outpatient programs, and medical detox. If you or a loved one is struggling with addiction, reach out to our admissions team for assistance.
