Learn / But What if I Relapse?

But What if I Relapse?

By 
Hannah Friedman
|
 November 4th, 2022|   Clinically Reviewed by 
Rajnandini Rathod

If you’re healing from addiction, it makes sense to worry about relapse. This can be a concern at every stage of recovery, whether you’re just starting detox or years into sobriety. Cravings and triggers don’t just disappear. But with the right type of addiction treatment, you can make a plan to keep yourself safe.

Notice the Warning Signs

Everyone’s triggers are different. And in recovery, you’ll learn to recognize and work through them as they arise. Some of them you can simply avoid—like going to the bar, or missing a night of sleep. Others are inescapable. But because these situations are so common, you can often see them coming. And that foresight can help you navigate them more skillfully.

Stress

Stress is a natural part of life. And that’s not always a bad thing. Even positive events can be stressful,1 like buying a new car or planning a wedding. You can’t avoid all big changes—and you shouldn’t try to. But you can manage your emotional response to them.

As you return to life after treatment, try to be gentle with yourself. Data shows that people with addiction are more vulnerable to stress.2 And what’s more, unmanaged stress can increase your risk of relapse.3 That’s why it’s important to have a plan for how you’ll handle these situations when they come up.

According to experts, emotion regulation skills can help you get through stressful situations.4 You can learn these skills in rehab or from a therapist, and practice them on your own. For example, you might meditate, do breathing exercises, or try other mindfulness techniques. These coping strategies can keep you centered during intense moments.

Trauma

Even in times of stability, you might be distracted by painful memories. And unprocessed trauma is linked to addiction.5 This is true whether it occurred in childhood, in recent years, or as a result of drug use. Working with a trained therapist can help you move forward, but it won’t undo the past. You may still confront triggers from time to time. When that happens, you can use skills to work through your emotional response.

Addiction is a common response to trauma.6 Taking drugs can make you feel like you have control of your own mind, even though the opposite is true.  And if you’ve ever used drugs to deal with trauma, you might be more likely to fall back on that behavior. Scientists have established a clear link “between craving, relapse, and PTSD symptoms.”7

Traumatic memories and events might always trigger your cravings. But in trauma-informed rehab, you’ll learn coping skills that work better than drug use. And when you put those skills to use, it’s more than damage control. It can also be empowering.

Know Your Triggers

Recovery from almost anything is the process of getting to know yourself again. That’s true for addiction, mental health issues, trauma, and even some physical conditions. Maybe your energy levels are different, or you have new needs and boundaries. Maybe you want to pick up different hobbies, or restructure your relationships. There’s no wrong answer, as long as you stay present, honest with yourself, and focused on living a healthy life.

Understanding your own triggers is a big part of this process. And triggers aren’t always easy to predict or even explain. If you were once in a car crash, you might be triggered by loud noises or getting stuck in traffic. But you can also be triggered by relationship dynamics, sensations, and even emotions.

Learning to anticipate triggers and cravings can be confusing at first. But over time, it becomes intuitive. The first step is just paying attention to your own emotional reactions. Then, you can discuss your feelings with your therapist or another provider. With this information about your own impulses, you can start planning healthy ways to respond.

Guard Against Relapse by Planning Ahead

From the moment you enter rehab, your team will help you prepare for the risk of relapse. During treatment, you’ll amass resources and coping strategies to help you guard against it. And if you do relapse, you’ll already have a plan for what comes next.

Build an Emotional First-Aid Kit

Cravings aren’t convenient. They won’t always happen in the comfort of your home, or when you’re about to have a day off. In fact, because of the link between relapse and stress, you might be at a higher risk while you’re doing something important.

When you’re already feeling stressed, it can be hard to think clearly. That’s why some people in recovery make emotional first-aid kits. Your kit can take any form, from an actual first-aid kit to a post-it note to an art project. Just make sure it’s easily accessible, and has genuinely helpful information. You can start by including a few standard resources:

  • a list of activities that help you calm down, like exercising or playing games
  • a list of distress tolerance skills you find helpful, like breathing exercises or listening to a song you love
  • a comfort object, like a soft pillow or a worry stone
  • a copy of your favorite book
  • a mantra you can repeat to yourself during meditation
  • the phone numbers for trusted contacts, like your therapist, your sponsor, or your best friend

Connect With Your Community

Strong relationships decrease the risk of relapse.8 And you can start building your support network as soon as you enter recovery. That could mean meeting new people, or recommitting to loved ones. In many programs, you can even do family therapy during rehab.

Your support system can include several different types of relationships. Friends, family, and chosen family members are a great place to start. But you can also join more formal communities. Both 12-Step and non-12-Step groups  (like SMART Recovery groups) offer peer support. In these meetings, you can share your concerns about relapse with people who likely feel the same way.

When people expect things from you, they’ll hold you accountable. This even applies to low-stakes situations. If you miss a friend’s birthday party, they might ask if you’re ok. In the long term, these gentle nudges can help you stay on track. And, after you build trust over time, you’ll have people to lean on in crisis situations.

Stick With (or Revisit) Your Continuing Care Plan

Personal relationships are essential, but they’re just one piece of the puzzle. While you can ask friends for emotional support, you can’t depend on them for clinical treatment. It’s important to find a team of mental health providers who can see you through recovery.

If you attend residential rehab, you can start planning for aftercare during treatment. In some cases, you can continue seeing the same therapist after you return home. But most of the time, you’ll need to look for a new one. You might also find other specialists, like a psychiatrist or a medical doctor who understands addiction.

These experts can help you plan ahead. They might notice behavioral warning signs, and suggest you take action even before you relapse. And if you’re in crisis, they can connect you with valuable resources, and help you focus on healing.

Responding to Relapse

Relapse happens. Healing is complex, even if you have great coping skills. And your path toward recovery might not be a straight line. And that’s okay.

If you do relapse, it’s important to face the issues behind it. Shame and addiction are related,9 and hiding your problems can exacerbate them. Instead, it’s best to find help as soon as you can. Reach out to your support network and your care team to let them know what’s happening. You can also call your original treatment center and ask them for advice.

Depending on your circumstances, you might need to kickstart recovery again. This could mean going through detox, returning to rehab, or trying something new. Your mental health provider can help you decide on the best way to move forward.

Recommitting to the Recovery Journey

Whatever comes after relapse, you can rely on one thing: you won’t be starting from scratch. Even this bump in the road is a step toward recovery. Relapse gives you important information about your triggers, needs, and recovery goals. And you can use that information to make even better choices about what comes next.

See our searchable directory of rehabs to get support at any stage of recovery, from detox to continuing care.

Reviewed by Rajnandini Rathod

  1. Why stress and anxiety aren’t always bad. (n.d.). Https://Www.Apa.Org. Retrieved October 27, 2022, from https://www.apa.org/news/press/releases/2019/08/stress-anxiety []
  2. Stocker, S. (1999). Studies Link Stress and Drug Addiction. The Science of Drug Abuse and Addiction Research Findings, 14(1). https://web.archive.org/web/20170829165640id_/https://www.centerforaddictionrecovery.com/stress/Studies-Link-Stress-and-Drug-Addiction-NIDA.pdf []
  3. Sinha R. (2012). How does stress lead to risk of alcohol relapse?. Alcohol research : current reviews, 34(4), 432–440. Retrieved October 27, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788822/ []
  4. Langer, K., Hagedorn, B., Stock, L.-M., Otto, T., Wolf, O. T., & Jentsch, V. L. (2020). Acute stress improves the effectivity of cognitive emotion regulation in men. Scientific Reports, 10(1), 11571. https://doi.org/10.1038/s41598-020-68137-5
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  5. Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751 []
  6. Schneiderman, N., Ironson, G., & Siegel, S. D. (2005). Stress and health: psychological, behavioral, and biological determinants. Annual review of clinical psychology, 1, 607–628. https://doi.org/10.1146/annurev.clinpsy.1.102803.144141
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  7. Gielen, N., Krumeich, A., Tekelenburg, M., Nederkoorn, C., & Havermans, R. C. (2016). How patients perceive the relationship between trauma, substance abuse, craving, and relapse: A qualitative study. Journal of Substance Use, 21(5), 466–470. []
  8. Ellis, B., Bernichon, T., Yu, P., Roberts, T., & Herrell, J. M. (2004). Effect of social support on substance abuse relapse in a residential treatment setting for women. Evaluation and Program Planning, 27(2), 213–221. https://doi.org/10.1016/j.evalprogplan.2004.01.011 []
  9. Matthews, S., Dwyer, R., & Snoek, A. (2017). Stigma and Self-Stigma in Addiction. Journal of bioethical inquiry, 14(2), 275–286. https://doi.org/10.1007/s11673-017-9784-y []

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