How to Spot the Warning Signs of a Substance Use Relapse — and What to Do About It

If you are interested in an abstinence-based approach to recovery from alcohol and other drugs, avoiding relapse is always the goal. By avoiding a relapse, you can maintain your recovery and dodge the unwanted effects of substance use, addiction, and dependence.

Keep reading to learn more about relapse and the warning signs that show one might be coming. Though relapse is common, it is never desirable.

What do relapse and recovery mean?

You cannot learn about relapse without first learning about recovery. People in recovery are making the choice to no longer engage in drug or alcohol use. You can also be in recovery from addictive behaviors, like gambling, sex, or food. In this post, though, we’ll be talking mostly about recovery from substances like drugs and alcohol.

Recovery may look different for different people. Some people choose to avoid all drugs and alcohol. This is referred to as complete abstinence. Others have a blended recovery that involves abstaining only from certain substances. For example, a person may stop using opioids and cocaine, but continue to use cannabis (marijuana) and alcohol.

Experts may use the term relapse to mean several different ideas. A relapse can be:

• The act of using substances again after a period of recovery

• A process that may begin long before you actually use the alcohol or drugs

Sometimes, people use the term “lapse” to describe the initial drug use of a relapse. 

Is it normal to relapse?

Since addiction and substance use disorders are lifelong issues, relapses are a common part of recovery. They are never wanted, but they are typical.

Estimates show that as many as 60% of people will relapse at least once while trying to maintain recovery. Other people may relapse many times until they can achieve a period of sustained recovery.

A relapse is sometimes, but not always, a sign that your treatment plan isn’t working. It may mean that you need to reinvest in professional care and adjust your process.

What are the stages of relapse?

Although not universal, some people may experience their relapse in a series of stages. By paying attention to the development of these relapse stages, you may be able to catch a relapse before it happens.

The stages of relapse are:

• Emotional: During an emotional relapse, you aren’t even thinking about using drugs or alcohol again. But you could have experience, like denial of emotions, that are setting you up for the next relapse.

• Mental: In this stage of relapse, you are beginning to think about using. You are considering your options and thinking more about the “good times” of past use. It could feel like a battle between the part of you that wants to use substances and the part that wants to stay in recovery.

• Physical: The final stage of relapse begins when you actually use alcohol or drugs. Often, it occurs because of the situation you find yourself in. Other times, you could actively seek out the substance.

What are the warning signs of a relapse?

When you begin moving through the stages of a relapse, there will be warning signs. Some warning signs of relapse will be obvious to you and the loved ones in your life. Other signs could be subtle and challenging to notice. Below, we will go into each of the three stages of relapse: emotional, mental, and physical.

Emotional relapse

Some common warning signs of an emotional relapse include:

• Being in denial about substance use and risk of relapse

• Boredom

• Feeling depressed, anxious, or struggling with other mental health conditions

• Isolating yourself and withdrawing from healthy relationships

• Not attending professional treatments or support groups

• Not taking care of your physical and mental health

Emotional relapses center around the idea of poor self-care. You may overly focus on others and not tend to your own needs.

Mental relapse

Some common warning signs of a mental relapse include:

• Obsessing about substances and craving their effects

• Thinking about the people, places, and things connected to use

• Glamorizing past drug or alcohol use

• Looking for opportunities to relapse

• Thinking that you could use again and better control it

• Lying to others

• Bargaining with others or yourself

Physical relapse

Some common warning signs of a physical relapse include:

• Restarting or maintaining relationships with people you’ve used drugs or alcohol with

• Being around drugs or alcohol — or places where people are using, like bars, clubs, or parties

• Using alcohol or other drugs that you are trying to avoid

Many people experience these relapse warning signs, no matter who the person is or what substances they use. Even behavioral addictions — like a porn addiction or sex addiction, shopping addiction, and video game addiction — can share similar warning signs. 

What triggers a relapse?

Triggers are the signals or cues that you link with past use. They are risk factors that create warning signs and increase cravings to use. Triggers are usually people, places, or things that remind you of using and elicit cravings.

Triggers tend to be personal and unique. They could come from the outside world or within you. 

Some people could have only a few triggers. You could have dozens. Some of the most common triggers are:

• The people you used drugs or alcohol with, bartenders, or drug dealers

• Certain neighborhoods or parts of town

• Days of the week or weekends

• Getting paid or having money

• Feelings, like sadness, happiness, jealousy, or frustration

• Stressful events like loss of a loved one, divorce, or a breakup

• Anniversaries of significant events

Frequently, a relapse will occur because of a combination of factors. Maybe you are feeling sad because of the anniversary of a loved one’s death while driving past your old favorite bar. In that case your triggers can be overwhelming and may lead to a relapse.

What is HALT related to relapse?

HALT is an acronym that refers to some of the most common experiences that can lead to a relapse. It stands for:

• Hungry

• Angry

• Lonely

• Tired

When you feel any of these states, you may be at greater risk of relapse. By taking care of yourself and tending to your needs, you could reduce these feelings and the odds of relapse.

What should I do if I notice these warning signs of relapse?

Take action right away if you notice the warning signs of relapse in yourself. Changing your thoughts and behaviors could be the difference between recovery and relapse.

To avoid relapse, you should:

• Increase your self-care. Eat well, set aside time for sleep, and fit in some exercise.

• Talk to others. Disconnecting from supports increases your relapse risk. Gather support from friends, loved ones, and sober connections. Consider attending a self-help meeting. 

• Reinvest in treatment. Call your therapist or prescriber to schedule another appointment and communicate your concerns.

• Avoid your triggers. Make a list of your triggers and find ways to avoid them whenever possible.

• Stay determined. Relapses are common, but they are not inevitable. Put in the effort to stay sober. View your recovery as something too precious to give up on.

What should I do if a loved one is relapsing?

If you see a loved one showing warning signs of a relapse, you should also take action. Be cautious, though. You will have to walk a line between being supportive and being honest.

Let your loved one know the signs and symptoms you notice. Express your concerns clearly and respectfully. Encourage them to refocus on treatment.

It might be tempting, but never try to treat your loved ones yourself. Addiction is a mental health condition that requires professional treatments.

Why trust our experts?

Written by:

Eric Patterson, LPC

Eric Patterson, LPC, has been a professional counselor in school and outpatient settings for over 15 years. Patterson has been cited as a mental health expert in publications such as Today.com, Good Housekeeping, and InStyle.

Reviewed by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

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