Signs of Alcohol Relapse

A relapse doesn’t occur all at once. There are usually 3 stages in the relapse process, and identifying them can help you avoid a full-blow return to drinking.

There are a lot of misconceptions about a relapse on alcohol or drugs. Sometimes, we think that a relapse is a failure or proof treatment didn’t work. Neither is true. Relapse is something that can but doesn’t have to be part of the recovery process. It’s also not a sudden event. Instead, there are stages of relapse. By being aware of these stages of relapse, you may be able to identify the signs early on in yourself or someone else and take steps to adjust what’s happening before there’s a full-blown relapse.

What Is an Alcohol Relapse?

Alcoholism is defined as a chronic condition that is the most severe version of alcohol abuse. When someone has an alcohol use disorder, they can’t control their drinking and continue to drink even with negative side effects. Alcohol use disorder can be classified based on severity, including mild, moderate, and severe. It’s treatable, but if untreated, it can lead to serious destruction and even death.

A person who misuses alcohol will feel like they are not able to function in their daily life without the use of alcohol. This is due to the changes in their brain chemistry due to their drinking. As with other chronic diseases, alcohol use disorder has treatment options and can be managed.

People will often go through treatment and have a period of sobriety. But what happens if, after being sober, someone starts drinking again? This is an alcohol relapse. An alcohol relapse means you go back to drinking regularly after having a period of sobriety without the use of alcohol.

Why Do People Relapse?

There are a wide variety of reasons someone might relapse. Examples of reasons for relapse can include:

• Tempting situations, like returning to a setting or environment where you used to drink.
• Stress, like insecure housing or social pressure lead to substance use as a coping mechanism
• Untreated mental or emotional health disorders
• Poor physical health, such as chronic pain
• Guilt stemming from an initial lapse

Some people relapse because of a happy situation and associate alcohol with celebrating. Relapse can also occur if there’s a belief they’re past their addiction and can control their drinking.

Understanding triggers for alcohol use is important for someone in recovery and their loved ones. If someone knows their triggers, they can better avoid them and reduce their risk of a relapse.

Some of the most common alcohol triggers include:

• Being with people you used to drink with
• Certain times of the year, like holidays or anniversaries
• Visiting places where you’d drink
• Experiencing unwanted emotions
• Alcohol exposure
• Financial changes
• Relationship issues
• Boredom

If someone is in recovery, they might feel more of a temptation to drink again than normal. It’s helpful to have a relapse prevention plan that considers these triggers, with specifically identified strategies to address them.

The 3 Stages of Relapse

When we think about a relapse, we tend to think about it as sudden, unexpected, and all at once. In reality, it’s likely a gradual progression for most people, and there are typically three stages of relapse. Relapse isn’t just the event of going back to alcohol. Relapse is a process that can begin weeks or months before someone drinks.

Stage 1: Emotional Relapse

During this stage, someone isn’t thinking about drinking, but their emotions and behaviors are setting up a potential relapse in the future. Denial characterizes the initial phase since the person isn’t actively thinking about drinking. Signs of emotional relapse can include:

• Trying to push emotions away
• Isolation
• Not going to meetings
• Focusing on other people, like their problems or how you’re affected by other people
•  A lack of self-care
• Problems with eating and sleeping habits

If you find yourself in an emotional relapse, try to learn more about how you can practice self-care. Self-care might be as simple as adjusting your diet or getting more sleep. Self-care can also mean taking better care of your emotional needs. Take time out for yourself, treat yourself with compassion, and let yourself have fun.

Stage 2: Mental Relapse

Once you reach a mental relapse stage, you might feel like there’s an internal war. Part of you could want to use, but the other part doesn’t. You may eventually have less cognitive resistance to relapse. Signs of mental relapse include:

• Drug and alcohol cravings
• Thinking about the people, places, and things that you associate with past use
• Minimizing the consequences of your past use
• Glamorizing past alcohol and drug use
• Bargaining
• Becoming deceptive
• Trying to come up with plans to keep your use under control
• Looking for opportunities to relapse
• Actively planning a relapse

If you’re in a period of mental relapse, one of the best things you can do is work to find strategies to avoid high-risk situations. You could, for example, be going over in your mind permitting yourself to use in a certain situation. It can be hard for you if you experience a mental relapse because you might have felt that you’d never think about using again after treatment.

Don’t let this situation or cravings make you feel down or like you haven’t achieved something amazing already. You aren’t doing something wrong or failing in your recovery. You can work on strengthening your coping skills to move past a mental relapse. Working with a therapist can be helpful during a period of mental relapse.

Stage 3: Physical Relapse

Physical relapse is a return to using alcohol or drugs. Some clinicians will divide this stage of relapse into a lapse and then the actual relapse. A lapse is an initial situation where you might drink. A relapse is a return to using alcohol in a way that’s out of control.

Some people feel that relapse prevention is about saying no right before they take a drink. In reality, the physical relapse stage is the most difficult to stop, and it’s a final stage rather than a standalone. If you experience a physical relapse, you might need to return to treatment or revisit your relapse prevention plan. Treatment didn’t fail, and you didn’t either, but a physical relapse can mean that your treatment plan may need to be adjusted or evolve with your changing needs.

Signs of an Alcohol Relapse

The earlier the signs of an alcohol relapse are recognized in yourself or someone you love, the sooner you can take action. The sooner you take action, the greater the likelihood of maintaining long-term recovery. Warning signs of alcohol relapse can vary depending on the person. You might notice dry drunk behavior. Dry drunk behavior means that even though someone hasn’t relapsed, they start acting very similarly to when they were drinking.

Other signs of an alcohol relapse can include:

• Not going to meetings
• Social withdrawal
• Not attending therapy appointments
• Spending time with old friends
• Neglecting hygiene or physical appearance
• Changes in behavior
• Becoming more secretive 
• Less healthy lifestyle habits, like giving up exercise or healthy eating

What To Do After a Relapse

If you’ve experienced a relapse, your next steps are important.

• Talk to someone. This might be your sponsor, a sober friend, your therapist, a trusted friend, or a family member you don’t drink with. Go through what you think the reasons for your relapse might be and how you can avoid a future situation.
• Allow yourself to feel whatever you’re going through. You might feel frustrated, embarrassed, or shameful. Don’t bury these feelings. Experience them fully because burying feelings and emotions can make a relapse last longer or make it harder to work through.
• Avoid isolation. It’s a relapse trigger, while social support from sober friends and family can help you manage triggers, like stress. 
• Consider your treatment plan. Consider whether you want to modify or add to your treatment plan. Discuss this with your treatment team.

Mitch’s Story of Overcoming Chronic Relapses

While relapsing can bring about shame and feelings of failure, a relapse is generally accepted as an expected part of the recovery process for most people. It doesn’t mean that you’ve failed in your recovery.  It can be compared to someone having a flare-up of their diabetes or hypertension symptoms.

It can be important to distinguish between a full-blown relapse and a slip-up. With a relapse, you fully go back into old patterns of out-of-control drinking, which can require going back into treatment and other steps to get back to sobriety.

With a slip-up, you might have a drink, but you quickly realize it’s the wrong path for you, and it doesn’t go further. With a relapse, the situation can become dire because of the shame and guilt, particularly if it’s not dealt with early on.

How To Prevent Drug or Alcohol Relapse

There are a lot of things that can help you avoid a relapse, including:

• Practice self-care.
• Understand the stages of relapse.
• See yourself as someone who is a non-user.
• Practice honesty with yourself and others.
• Accept that you are someone with an addiction.
• Develop healthy alternatives to using alcohol like yoga, running, or anything you find enjoyable.
• Continue to engage in self-help groups, even if you’re feeling more confident in your recovery.
• Give back to others through volunteering and other similar opportunities.
• Re-evaluate your lifestyle at certain intervals to make sure you’re on track.
• Avoid the people, places, and things you associate with alcohol use.
• Ask for help instead of trying to do everything on your own.
• Do things to reward yourself, like getting a massage, watching a movie, or simply finding time to relax.
• Don’t try to find loopholes in your recovery or bend the “rules.”
• Express yourself through art or crafts.
• Do tasks that are empowering around the house, like cleaning or laundry.
• Find a hobby you love, like reading, DIY projects, or a sport.

Helping a Loved One Avoid Relapse

As the loved one of someone in recovery, there are ways you can help preserve their recovery and prevent a relapse.

• Keep communication open. Without a solid communication foundation, your loved one may not feel comfortable telling you when cravings and unwanted thoughts start. Ensure the person knows you are available day and night to aid the process.
• Offer love and support. Employing anger, guilt, and shame will not encourage your loved one in their recovery. You cannot force someone into recovery. Your loved one needs to know you will provide love and support without judgment to assist their recovery.
• Reinforce the prevention plan. You should have a copy of your loved one’s relapse prevention plan. When you see signs of a relapse, you can take action or encourage them to use their recovery skills.
• Know your limitations. Some people become so focused on maintaining their loved one’s recovery that they take too much responsibility. No one can stop your loved one from a relapse. If they relapse, it is not because of something you did or did not. Only they are responsible for their actions.

Remember, you are an important part of the treatment team with enormous power to do good for your loved one. Taking these steps can help make their long-term recovery a reality.

Get the Help You Need Today

If you need help or feel like you could be on the cusp of a relapse, remember that addiction is a chronic disease.  You wouldn’t expect that you could self-treat hypertension or diabetes without the help of medical professionals. You should keep the same in mind with addiction. If you need support, help, or have questions, please contact our team at The Recovery Village. You don’t have to do it alone.

Editor – Melissa Carmona

As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more

Medically Reviewed By – Danielle Boland

Danielle is licensed clinical social worker, currently living and practicing in central Connecticut. Read more