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Alcohol Relapse: Understanding the Causes, Signs, and Prevention

Alcohol Relapse: Understanding the Causes, Signs, and Prevention

Alcohol relapse is possible, even after an extended period of sobriety. Learn all about alcohol relapse, as well as how to prevent it, here.

Alcohol relapse can be a part of the recovery process for many people. While some may view it in a negative light, the truth is that alcohol relapse after years of sobriety is nothing to be ashamed of. Relapse simply means that it’s time to try something different, or return to treatment to get back on track. Below, learn about ways to prevent alcohol relapse, including participating in medication-assisted treatment or working with a recovery coach. 

What Is A Relapse?

The National Institute on Drug Abuse (NIDA) defines relapse as a return to substance misuse after an attempt to stop. Relapse does not mean treatment has failed, and in fact, relapse rates for substance misuse are comparable to those seen for medical conditions like asthma and high blood pressure.

Relapse in recovery from alcohol misuse may mean returning to drinking after a few weeks without alcohol, or it could even mean resuming drinking after several years of abstaining. 

People can relapse to alcohol use for a number of reasons. For example, relapse triggers include stress, spending time with people who are still actively drinking, or being exposed to alcohol during holidays or other celebrations. 

Types of Addiction Relapse 

When people experience a drinking relapse, it may present in one of two ways. For instance, people typically use the terms lapse and relapse interchangeably, but they are actually worth separating.

A lapse typically refers to a “temporary slip-up.” In a lapse, a person may have a drink or two after a period of being in recovery, but if they have strong coping skills, they immediately get back on track with abstaining from alcohol consumption.

In a relapse, on the other hand, a person experiences a complete return to alcohol misuse. You can think of a relapse as being a full return to drinking, whereas a lapse is only a temporary or partial return. When a person experiences a full-blown relapse, they return to meeting diagnostic criteria for an addiction. 

What Is Alcohol Relapse?

Alcohol relapse occurs when a person has been in recovery for any period of time, and then returns to drinking. While there are various definitions of “relapse,” most experts define a relapse as a return to heavy drinking, or a return to alcohol misuse, after abstaining for a period.

In the case of alcohol misuse, a person could be said to have relapsed if they are active in recovery for a period, and then return to drinking heavily enough that they again show signs of an alcohol use disorder, which is the clinical term for an alcohol addiction. 

Alcohol relapse is common. In fact, a review of the research shows that under 30% of people have been continuously abstinent one year after completing treatment, and over the course of seven years, around half of people with an alcohol use disorder achieve remission.

A study published in 2020 found that 25.9% of patients relapsed one month after being discharged from the hospital for alcohol use disorder treatment. 

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Stages of Alcohol Relapse 

Relapse is said to occur in three stages, which are described in more detail below.

Stage 1: Emotional Relapse 

The first stage of alcohol relapse is labeled as emotional relapse. During this stage, people are not thinking about drinking. In fact, they are remembering the last time they relapsed or drank, and they do not want to return to that stage. However, once emotional relapse creeps in, people are heading toward physical relapse, perhaps without even realizing it.

During the emotional relapse stage, people may begin holding their emotions inside, isolating from others, skipping support group meetings, or failing to share during meetings. They may also shift their attention to other people’s problems and stop practicing self-care. Poor eating and sleeping habits crop up during this stage. 

Stage 2: Mental Relapse

Once a person makes it to the mental relapse stage, they are starting to think about drinking again. They experience alcohol cravings, think about the people they used to drink with, and even begin planning a relapse. They tell themselves lies about drinking and may glamorize their past alcohol misuse. 

During the mental relapse stage, a person is on the verge of drinking again. They may even engage in bargaining, trying to convince themselves that they can drink just once or twice and learn to control their alcohol consumption. 

Stage 3: Physical Relapse

During the final drinking relapse stage, a person returns to physically consuming alcohol. At first, a person may just have a temporary lapse, but they can quickly slip into a full-blown relapse if they do not recognize the need to seek help after that first drink. Physical relapse typically occurs because a person finds themselves in a situation in which they have an opportunity to drink without being caught or having negative consequences. 

Signs Of Alcohol Relapse 

There are several signs of alcohol relapse, which suggest that a person may be drinking again, or at least headed toward relapse. These signs include:

  • Withdrawing from others
  • Skipping support group meetings or appointments with a counselor 
  • Practicing poor stress management skills
  • Making comments such as, “Drinking isn’t so bad.”
  • Trying to convince others that they can drink in moderation
  • Engaging in secretive behavior
  • Spending time with people they used to drink with before entering recovery
  • Giving up other activities they enjoyed in recovery 
  • Physically smelling like alcohol, or having bottles of alcohol among their personal belongings 
  • Beginning to miss work or fail to fulfill important obligations 

What Triggers Alcohol Relapse?

Alcohol relapse triggers are situations, events, or other factors that may drive a person to drink again after a period of being in recovery. Some common relapse triggers include life stressors, the loss of a loved one, mental health problems, financial troubles, and spending time with people a person used to drink with, or in places where they used to drink. 

Risk Factors for Relapse

Experts often name “people, places, and things” as being top risk factors for relapse. This refers to spending time with people a person used to drink with, going to places where they drank, or coming into contact with things associated with their past use, such as a corner store where they used to purchase alcohol. 

Beyond this general risk factor, the following can increase the risk of an alcohol relapse:

  • Having a low level of education
  • Being unemployed
  • More severe drinking problems throughout a person’s lifetime
  • Frequent alcohol consumption 
  • Relying on drinking to reduce stress
  • Poor coping skills
  • Lack of social support 

What To Do After An Alcohol Relapse

People often view drinking again after sobriety as an indicator that they have failed or that treatment does not work, but this is not the case. As with any health condition, an alcohol use disorder may worsen or return at times. After a relapse, it is important not to view yourself as a failure. It’s also important to avoid minimizing your past problems with alcohol or convincing yourself that you can continue to drink heavily without consequences.

What you should do is recognize that it might be time to do things differently. This could mean returning to addiction counseling, spending more time going to support group meetings, or developing healthier stress management strategies. Rather than hiding the relapse and attempting to bottle up your emotions, it’s important to reach out for help after an alcohol relapse. 

How To Recover From An Alcohol Relapse 

The best way to recover from an alcohol relapse is to be honest with yourself and your treatment team. Remaining in denial may lead you from a lapse to a full-blown relapse. On the other hand, admitting to the relapse and making a plan for moving forward can help you to recover and get back on track as soon as possible. Your treatment team can help you to strengthen your relapse prevention plan and develop healthier coping skills. 

Treatment And Prevention

Staying actively engaged in alcohol use disorder treatment is important for avoiding relapse. Working with a counselor or recovery coach keeps you connected to sources of support and allows you to develop coping skills for resisting triggers for drinking. You may also benefit from participating in medication assisted treatment for alcohol use, as prescription drugs used in alcohol use disorder treatment can keep cravings at bay.  

While in alcohol use disorder treatment, your team will help you to develop a relapse prevention plan to help you stay committed to recovery. Some common relapse prevention strategies include practicing good self-care through a healthy diet and regular exercise, establishing connections with people who are not drinking, attending support group meetings, and developing a plan for managing stress. 

Another critical part of relapse prevention is planning ahead for situations in which you may be tempted to drink. Develop coping strategies you will employ or something you can say when you are faced with an opportunity to drink. 

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The following commonly-asked questions provide additional information related to alcohol relapse.

Is It Normal To Relapse?

For some people, relapse is a part of the recovery process, but there are steps you can take to reduce your risk of alcohol relapse. According to NIDA, 40-60% of people who are treated for a substance use disorder relapse at some point. Chronic alcohol misuse causes lasting changes in the brain, which can make it difficult to stop drinking. Staying engaged in treatment and following a relapse prevention plan can reduce the risk of relapsing to drinking. 

What Should You Do When You Feel Like Relapsing?

If you feel tempted to relapse, it’s important to turn to your relapse prevention plan. You might choose an activity such as calling a supportive friend, taking a walk, or practicing a relaxation exercise when you feel like relapsing. Ideally, you should rehearse situations in which you may be tempted to relapse and plan for how you will respond. 

How Long Does Relapse Last?

The length of relapse can vary from person to person. Some people may experience only a brief lapse, and then return immediately to participating in recovery. Others may have a full-blown relapse, in which they return to demonstrating symptoms of an alcohol use disorder. A relapse is shorter when people return to participating in treatment. 

What Are The Chances Of Recovering From Alcohol Use Disorder?

With treatment, many people successfully recover from alcohol use disorder and reach a state of remission. A review of the research shows that over the long-term, about half of people with alcohol use disorders achieve remission. Research also suggests that people who obtain treatment are less likely to relapse.

How Often Do People With An Alcohol Use Disorder Relapse?

The relapse rates for alcohol use disorder can vary, depending on the population studied, as well as the length of time for which they are followed. A 2020 study found that 25.9% of people relapse one month after being discharged from inpatient treatment. Additional research from NIDA suggests that 40 to 60% of people relapse at some point. 

What Happens During A Relapse?

When someone experiences an alcohol relapse, they return to drinking after a period of being in recovery. They may have just a few drinks and then quickly return to recovery. However, if a person does not return to treatment and continues to drink, relapsing may mean turning to heavy drinking, even when it comes with consequences. 

What Should I Say To Someone Who Relapses?

If a loved one relapses to drinking after being in recovery, it’s important to be supportive. Do not criticize or blame them. Instead, empathize with their situation, and encourage them to get back into treatment. Remind them that relapse is sometimes a part of recovery, and that asking for help shows strength. 

Consult With Confidant Health For Alcohol Use Disorder Treatment

If you’re looking for treatment to reduce the risk of alcohol relapse, Confidant Health has numerous options. We offer online medication assisted treatment for alcohol misuse, and we can link you to a recovery coach to provide you with additional support as you recover from drinking.

Download our app today to get started. We are available on both the App Store and the Google Play Store. 

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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