What Is Self-Care in Recovery From Substance Use and Addiction?

If you’ve been abstinent from a drug or alcohol and then go back to using, you might feel like a failure. However, this is actually a very common part of recovery. About 2 out of 3 people relapse within 90 days after completing treatment. Also, recovery can take up to more than five attempts. However, recovery is still possible. 

In this post, we will cover reasons for relapse and describe the relapse process. We will also cover how to get yourself back on track to recovery.

What is relapse, and what does it mean?

Relapse is the return of symptoms of a disease after having a period of improvement. This applies to addictive behavior just as much as it does to medical diseases such as cancer. Relapse means that recovery is a process that can have setbacks.

Relapse can happen at any point. However, it is more likely to happen within the first year of treatment. This is when as many as 85% of people return to alcohol, nicotine, and other drug use. Read on to learn more about what can cause relapse.

Does relapse mean you’ve failed addiction treatment?

No, relapse does not mean that you have failed treatment. Like cancer, substance use addiction is by nature long-term and recurring, which is why relapse is common. Those dealing with substance use disorders have reported the following reasons for relapse:

• Stress

• Anxiety

• Negative mood

• Temptation

• Boredom

• Lack of positive motivators such as a job or relationship

• Drug-related cues, which are situations that bring about negative emotions, in turn leading to the desire to use again

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There are three main theories that explain why you crave a substance and relapse: biological, cognitive, and affective. Below, we’ll go into each in more detail.

Biological explanations of craving

Long-term substance use can cause changes to your brain, and these changes can make it hard to control your use. For example, heavy long-term alcohol use can change parts of the brain that result in an increase in alcohol-seeking behavior. As a result, you have an increased drive to get alcohol.

Genetics also play a role in the development of an addiction. You are at increased risk for relapsing if substance use disorders exist in your family history. 

Though these biological factors increase your risk for relapse, recovery is still very much possible. Substance use disorders are treatable with medical and psychological intervention. 

Cognitive explanations of craving

Cognition, or the way you think about your substance use, can also contribute to cravings. For example, you might crave a cigarette more if you think about the short-term consequence that it will feel good to smoke. However, if you train yourself to think about the potential long-term consequences more frequently, you can reduce your cravings.

You might also find that you judge yourself negatively for having cravings. You might feel guilty and ashamed because you think you have let yourself and your family down.

However, judging yourself can be the very thing that leads you to give in to your cravings. Negative thinking can lead us to have negative feelings. As a result, we may cope with these negative feelings in unhealthy ways.

Mindfulness-Based Relapse Prevention (MBRP) is a program that teaches you mindfulness skills for dealing with cravings. This means that you learn how to, without judgment, simply observe that you are having a craving and accept that it can be a part of having a substance use disorder. Doing so can help you to be more consciously aware of the craving and, as a result, lessen it. This helps you to have more control over the craving, rather than it controlling you.

Affective explanations of craving

Researchers have found that negative affect, or experiencing negative emotions, can lead to alcohol cravings. As humans, we don’t like to experience negative feelings, and we often try to avoid them. 

Instead, facing and managing negative emotions can reduce cravings and use. In this study of almost 800 people dealing with alcohol addiction, those who received training on managing cravings and emotions drank significantly less during treatment.

What are the stages of relapse?

Relapsing is a gradual process that tends to unfold in three stages. Becoming aware of these stages as you experience them gives you an opportunity to use coping strategies to help minimize your chance of using drugs or alcohol again.

Stage 1: Emotional relapse

In this first stage, you are not likely to think about using. You may even have your most recent relapse fresh in your mind. As a result, you think that you are motivated to stay sober. During this stage, you are experiencing emotions that could lead you to use again. Signs of being in this stage include:

• Bottling up emotions

• Isolating

• Not going to support group meetings

• Going to meetings but not sharing

• Focusing on others’ problems

• Focusing on how others are contributing to your problems

• Poor eating and sleeping habits

By keeping your emotions bottled up and isolating yourself, negative emotions grow, causing you to feel more lonely. That is when using drugs or alcohol again can be appealing. If you notice that you are in this stage, you will want to make an effort to connect with others and express your emotions to family, friends, or a therapist. 

Stage 2: Mental relapse

During this stage, you are probably battling yourself. One part of you wants to use again and the other part of you doesn’t. Some signs of mental relapse are:

• Cravings for the substance

• Thinking about people, places, and things associated with your past use

• Minimizing the consequences of use

• Glamorizing past use

• Bargaining to justify use

• Lying

• Looking for relapse opportunities

• Planning a relapse

Avoiding high-risk situations, like bars or parties, is important during this stage. Because you are conflicted about using, you are more vulnerable to temptation.

When you are in this stage of relapse, it is important to remember that cravings and thoughts of using are part of the recovery process. And just having the thoughts does not mean you have failed or that you will start using again. Furthermore, in therapy you can learn to manage your unhelpful thoughts and let go of them. 

Stage 3: Physical relapse

This final stage is when a person returns to using drugs or alcohol. Most physical relapses happen because you are faced with an opportunity to use. In therapy, you learn relapse prevention that includes planning for such situations.

I relapsed, so what do I do now?

If you relapse, there are two main actions to take: don’t get discouraged, and get back on track to recovery.

Don’t get discouraged

As we have covered so far, relapse is often part of the recovery process. You are not a failure. In fact, it happens to most people trying to recover from a substance use disorder.

You want to think of relapsing as one setback and prepare to get yourself back on track by:

• Believing in yourself: You are more likely to achieve long-term remission from a substance use disorder if you believe that you can do it. Remind yourself that you are human and there will be setbacks but that you can recover.

• Thinking positively: Be conscious of when you have negative thoughts and replace them with positive ones. For example, don’t think, “I failed.” Instead, think, “This is just one setback, but I can do this.”

• Preparing for treatment: If you are currently in treatment or looking to start, get ready to discuss your relapse with your therapist. This way you and your therapist can put a plan in place for moving forward.

Get back on track to recovery

You are more likely to achieve recovery by taking active steps toward that goal. In this study of about 460 people dealing with alcohol addiction, those who got professional help were more likely to achieve long-term remission from the disorder. To get yourself back on track:

• Join support groups: 12-step programs such as Alcoholics Anonymous or Narcotics Anonymous help many to maintain sobriety. You can attend any time: before, during and after treatment.

• Strengthen your social support network: Reach out to those you trust and tell them that you plan to seek or continue treatment. You are more likely to maintain sobriety if you have support from family and friends.

• Assess stressors: Some research has found that stress contributes to relapse. Take an inventory of everything you have on your plate, prioritize commitments, and remove the non-important ones. 

• Establish goals: Having goals and hobbies reduces boredom, giving you less time to use drugs or alcohol. This also motivates you to be healthy and recover from your substance use disorder.

• Locate treatment providers: You can find affordable substance use treatment providers.

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Written by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

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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