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The Stages of Relapse: Recognizing the Warning Signs

Substance use disorder

Relapse is a significant concern for anyone recovering from a substance use disorder. Understanding the stages of relapse and recognizing the warning signs can be crucial in preventing a full-blown return to substance use.

Relapse is not an event but a process that begins long before an individual picks up a drink or drug. It happens in three stages: emotional, mental, and physical.1 By identifying these stages early and employing effective relapse prevention strategies and skills, one can significantly reduce the risk of relapse.

Emotional Relapse Stage

In the emotional stage of relapse, individuals are not actively thinking about using substances. Whether they are worried about relapsing for the first time or have experienced relapse before, their emotions and behaviors can set them up for a potential relapse. Denial plays a major role during this stage as well because individuals often do not recognize the emotional signs that can lead to relapse.

Signs of Emotional Relapse Include:

  • Bottling up emotions. When individuals suppress their feelings, they may feel overwhelmed and isolated. This can lead to increased stress and anxiety, making them more vulnerable to relapse.
  • Isolating from others. Withdrawal from social interactions can create feelings of loneliness and disconnection. Without a support system, it becomes easier to fall back into old habits.
  • Not attending meetings or going but not sharing. Meetings provide a crucial support network and an opportunity to share experiences. Avoiding them or not participating fully can result in a lack of accountability and support.
  • Focusing on others’ problems. Shifting attention to others’ issues can be a way to avoid dealing with personal challenges. This distraction can prevent individuals from addressing their own needs and emotions.
  • Poor eating and sleeping habits. Neglecting physical health can lead to decreased energy levels and overall well-being. Poor self-care can exacerbate emotional distress and make it harder to maintain sobriety.

Strategies to Prevent Emotional Relapse Include:

  1. Have self-care awareness. Understand and practice self-care. Make time for activities that bring joy and relaxation. This might include hobbies, exercise, or simply taking time to rest.
  2. Attend regular meetings. Attend and actively participate in group therapy and support group meetings. Sharing experiences and hearing others’ stories can provide valuable insights and encouragement.
  3. Implement a healthy lifestyle. Maintain a balanced diet, get regular sleep, and exercise. Physical health directly impacts emotional and mental well-being, making it easier to stay on track.
  4. Do emotional check-ins. Regularly assess emotional well-being and seek help if needed. This could involve talking to a therapist, confiding in a trusted friend, or using journaling as an outlet for feelings.
  5. Set boundaries. Learn to set healthy boundaries with others to protect your emotional well-being. This might mean saying no to certain social situations or limiting interactions with people who may trigger negative emotions.

Mental Relapse Stage

During mental relapse, a war rages inside the mind. Part of the individual wants to use substances, while the other part resists. As mental relapse deepens, cognitive resistance diminishes, and the need for escape increases.

Signs of Mental Relapse Include:

  • Craving drugs or alcohol. Intense desires to use substances can become overwhelming, making it difficult to focus on anything else.
  • Thinking about past substance use. Reminiscing about previous times of substance use can glamorize those experiences and make the present seem less appealing.
  • Minimizing consequences or glamorizing past use. Downplaying the negative effects of past use or romanticizing it can create a distorted view that using again might not be so bad.
  • Starting to bargain. This involves making deals with oneself, such as promising to use only on special occasions or believing that controlled use is possible.
  • Lying and thinking of ways to control using. Deception and attempts to rationalize or manage substance use are common during mental relapse.
  • Planning for relapse opportunities. Actively seeking out situations where using might be possible without immediate consequences indicates a deepening mental relapse.

Strategies to Prevent Mental Relapse Include:

  1. Avoid high-risk situations. Identify and steer clear of environments that trigger the urge to use. This includes places, people, and activities associated with past substance use.
  2. Develop coping skills. Develop and practice healthy coping mechanisms for stress and cravings. Techniques such as deep breathing, exercise, and talking to a supportive person can be effective.
  3. Find therapeutic support. Engage in therapy sessions to address underlying issues and thoughts leading to relapse. Cognitive behavioral therapy (CBT) can be particularly helpful in changing negative thought patterns.
  4. Try mindfulness and meditation. Use techniques to stay grounded and present, reducing the power of cravings. Practices like mindfulness meditation can help individuals stay focused on the present moment and manage their thoughts more effectively.
  5. Engage in journaling. Keep a journal to track thoughts and feelings. This can help identify patterns and triggers that lead to mental relapse.

Cognitive behavioral therapy

Physical Relapse Stage

Physical relapse is the final stage of relapse where an individual starts using substances again. This can be a lapse (initial use) or a full-blown relapse (return to uncontrolled use). Recognizing the signs of physical relapse and acting quickly can prevent further harm and facilitate a return to recovery.

Signs of Physical Relapse Include:

  • Opportunity relapse. Using substances in situations where they feel they won’t get caught, such as when alone or in secret.
  • Loss of control. After the initial use, the individual quickly loses control over their substance intake, leading to frequent and heavy use.
  • Changes in behavior. Noticeable changes in behavior, such as neglecting responsibilities, withdrawing from loved ones, or engaging in risky activities.
  • Physical symptoms. Reappearance of physical symptoms associated with substance use, such as bloodshot eyes, changes in weight, or tremors.

Strategies to Prevent Physical Relapse Include:

  1. Develop exit strategies. Rehearse scenarios and plan how to avoid using substances. For example, have a plan for what to do if offered a drink at a social event.
  2. Stay connected. Maintain strong support networks and reach out when feeling vulnerable. Regularly check in with a sponsor, therapist, or trusted friend.
  3. Have regular monitoring. Continuously assess mental and emotional states to prevent reaching the physical relapse stage. Use tools like mood trackers or self-assessment checklists to stay aware of your state of mind.
  4. Take immediate action. If a lapse occurs, take immediate steps to get back on track. Contact a support person, attend a meeting, or engage in a coping strategy.

Seeking Help During Relapse

Recognizing the warning signs of relapse is crucial, but knowing what to do after a relapse and how to seek help is equally important. If you or a loved one is in the beginning stages of relapse or has already relapsed, reaching out for professional support can make a significant difference.

Early Stages of Relapse

Contact a therapist or counselor. Professional guidance can help you navigate the early signs of relapse and develop an effective relapse prevention plan.

Join support groups. Engaging with others who understand your experiences can provide invaluable support and encouragement.

Use helplines. Many organizations offer helplines where you can talk to someone who can offer immediate support and resources.

After a Relapse

Reach out immediately. Don’t wait to seek help. Contact a sponsor, therapist, or trusted friend as soon as possible.

Evaluate triggers. Work with a professional to identify what led to the relapse and develop strategies to avoid these substance use triggers in the future.

Recommit to recovery. A relapse does not mean failure. Recommit to your recovery plan and take it one day at a time.

Get Relapse Support From Lumina Recovery

Relapse prevention is about understanding the stages of relapse and recognizing the warning signs early. Emotional and mental relapses are precursors to physical relapse, and addressing them promptly with effective strategies is crucial.

Lumina Recovery offers comprehensive support to help you regain control of your life. Explore our detox programs and individual therapy to start your journey towards recovery.

If you or a loved one is in the beginning stages of relapse or has already relapsed, connect with our team of professionals today.



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