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What are Some Common Warning Signs of Drug or Alcohol Relapse?

common signs of drug and alcohol relapse

Relapse is a normal part of recovery from drug and alcohol addiction. Though it may be normal and expected, relapse can be extremely dangerous, especially for those recovering from addiction to substances like opioids that come with a high risk of overdose.

Knowing common relapse warning signs can help keep friends and family members safe if they are recovering from addiction. Continue reading to learn more about relapse signs and what you can do to help friends and family who may be at risk.

What is Drug or Alcohol Addiction Relapse?

The National Institutes of Health (NIH) defines addiction relapse as a return to drug use after an attempt to stop. Drug relapses may occur at any time after completion of a substance abuse treatment program or after a period of abstinence from drug use regardless of treatment.

According to the NIH, the relapse rate for substance use disorders and drug addiction is between 40% and 60%—lower than rates associated with other chronic illnesses, including asthma and high blood pressure. Relapse after drug or alcohol addiction treatment doesn’t necessarily mean that treatment has failed. Instead, it means that the person who relapsed usually needs to resume treatment, modify their existing treatment plan, or try another treatment that may work better.

The NIH states that newer addiction treatment programs get designed to address relapse prevention, which can help more patients stay sober for extended periods and reach final stages of sobriety before relapses occur. Today, relapse prevention training is included in most addiction treatment programs and behavioral health settings to help patients achieve long-term (or potentially lifelong) sobriety despite compulsive behaviors.

What are the Stages of Relapse?

According to a well-known study published in the Yale Journal of Biology and Medicine, the key to relapse prevention is understanding that relapse happens gradually and often begins weeks to months before it eventually leads to use of alcohol or drugs. 

Furthermore, patients trained to recognize early relapse warning signs can develop strong coping skills to avoid relapse and stay sober. The study mentions three main stages of relapse: emotional relapse, mental relapse, and physical relapse.

3 stages of relapse

Signs of Emotional Relapse

During this stage of relapse, your friend or family member isn’t thinking about using drugs or alcohol, as the memories surrounding their last relapse are fresh in their head, and they may not want to repeat the experience. However, according to the Yale study, their emotions could be setting them up for a relapse down the road. Signs of emotional relapse in your loved one include:

  • Keeping their emotions bottled up
  • Spending more time in isolation
  • Skipping support group meetings
  • Attending support group meetings, but not sharing or actively participating
  • Focusing on other people’s problems
  • Adopting poor eating and sleeping habits

Signs of Mental Relapse

During a mental relapse, your friend or family member may want to resume drug or alcohol use, but at the same time, a part of them doesn’t. As they go deeper into mental relapse, their resistance may go away, and they may feel a stronger need to “escape” and return to using drugs or alcohol. Warning signs of mental relapse include:

  • Having intense cravings for drugs or alcohol
  • Thinking or reminiscing about people, places, and things associated with past use
  • Glamorizing past drug use or minimizing consequences of past drug use
  • Bargaining
  • Lying
  • Thinking of ways to better control their drug or alcohol use
  • Looking for opportunities to relapse
  • Planning a relapse

Signs of Physical Relapse

Physical relapse is when your friend or family member starts using drugs and alcohol again. According to the Yale study, those in recovery who experience a physical relapse view their relapse as an opportunity to use drugs or alcohol without getting caught. That is often the most challenging stage of relapse to overcome, as it requires strong coping skills and training to resist.

Other Warning Signs of Addiction Relapse

Addiction affects each person differently. Therefore, some people may experience triggers that are different than those mentioned above that influence them to relapse and resume drug or alcohol use.


Stress is one of the most common relapse triggers. Poor stress management or failure to acknowledge or cope with stress can often lead to relapse due to how drugs and alcohol often can make stress go away temporarily. 

Many addiction recovery centers include stress management training in their treatment programs to teach patients how to effectively manage stress without resorting to drug and alcohol use.

Recurrence of Withdrawal Symptoms

According to the World Health Organization, alcohol withdrawal symptoms typically only last between two and 10 days. However, some people may experience recurring symptoms long after their acute symptoms have gone away. This is known as post-acute withdrawal syndrome (PAWS).

Those who experience PAWS may relapse and resume drug and alcohol use to make their symptoms go away. However, these symptoms can last for many months or years after stopping drugs and alcohol, reports the Department of Veterans Affairs

If your friend or family member recently received treatment for alcohol abuse, look for symptoms of PAWS, which may include difficulty sleeping, extreme tiredness, loss of pleasure in activities, irritability, and worsening memory or concentration.

Loss of Daily Structure

Developing a new daily structure is essential during the earliest recovery days. It helps patients establish a new, healthy routine that doesn’t include drug and alcohol use. Many rehab centers help patients get into a new daily routine beginning on day one of their treatment programs. 

Loss of daily structure is a common warning sign of relapse, as it could indicate your friend and family member is resuming old habits, including drug or alcohol use.

Loss of Control

Loss of control is a sign of addiction that is also a sign of relapse. Your friend or family member may start making irrational decisions and feel confident they can return to occasional drug or alcohol while being able to control it. In reality, they cannot. Look for signs that indicate the person may be losing control over their life or their ability to stay sober.

What are the Stages of Addiction Recovery?

According to the Yale study, recovery is a process of personal growth, and everybody goes through the stages of recovery at their own unique pace. The three stages of addiction recovery are abstinence, repair, and growth.


The abstinence stage begins when a person stops using drugs and alcohol and typically lasts for between one and two years. During this recovery stage, your loved one will focus mainly on coping with cravings and staying sober.

The abstinence stage encourages patients to accept they have an addiction, stay active in self-help support groups, and develop healthy outlets to replace drug and alcohol use. Your loved one will also be encouraged to practice honesty and self-care, view themselves as non-users, and eliminate friends or family members in their lives who were also using.


The repair stage of recovery usually lasts about two to three years and focuses on helping the person repair the damages in their life that were caused by drugs and alcohol. Your loved one may experience fair amounts of guilt and other negative emotions, which is a normal part of the healing process.

This recovery stage aims to help patients repair their relationships with loved ones and receive behavioral therapy that allows them to modify harmful attitudes and behaviors, including negative self-labeling. It will also focus on helping your loved one develop a balanced and healthy lifestyle and feel more comfortable with being uncomfortable.


The growth stage focuses on helping your loved one develop new skills that address the root causes of their addiction. This may involve facing past trauma, learning mind-body relaxation techniques, and setting healthy boundaries. According to the Yale study, the growth stage is a lifetime path that usually begins three to five years after your loved one has achieved sobriety.

What’s the Best Relapse Prevention Plan?

An accredited and reputable addiction treatment center will help each patient develop a customized relapse prevention plan based on their unique triggers and situations. For your loved one, this may involve learning specific skills that offer them the best chance of staying sober.

The best relapse prevention plans usually involve cognitive therapy, helping patients modify negative thinking patterns and develop healthy coping skills. Cognitive therapy teaches people how to:

  • Overcome fearful thinking, such as fear of being judged, fear of success, and fear of relapse.
  • Redefine fun, such as viewing activities like hiking and reading as fun, instead of drug and alcohol use.
  • Learn from setbacks such as not asking for help, not practicing healthy self-care, and not avoiding high-risk situations.
  • Become comfortable with being uncomfortable, such as accepting that negative feelings are a normal part of life and present the opportunity for growth.

When searching for an addiction treatment center for your friend or family member, ask each facility about relapse prevention programs to help your loved one achieve long-term abstinence from drugs and alcohol. Most quality substance abuse programs will offer relapse prevention training.

Indiana Center for Recovery offers drug and alcohol detox alongside a wide range of customizable rehab programs to heal from addiction and prevent relapse. We provide dual diagnosis therapy for those with co-occurring mental health disorders and cognitive-behavioral therapies that can address the root causes of your loved one’s addiction. Contact us today at (844) 650-0064 to learn more about our addiction treatment programs.

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