Why Do People Relapse?
What is a Drug or Alcohol Relapse—and How is It Different from a Lapse?
A relapse—which is often called a “recurrence” or a “return to substance use”—is simply an instance of substance use that occurs following a significant period of abstinence.1 When someone experiences a relapse, they may return to the same level of use prior to abstinence, or the levels can be higher or lower than previously experienced.
Some people also use the term lapse, which describes a short, perhaps one-time return to substance use during a period of abstinence. An example might be if someone in sobriety experiences a stressful event, consumes several drinks on one night, but then seeks treatment or attends a support group and immediately returns to prolonged abstinence.
While more of a slang term, a freelapse is a lapse that occurs unintentionally. For example, if someone is abstaining from alcohol but they’re accidentally served a beverage that contains alcohol, this might be called a freelapse.
Is a Drug or Alcohol Relapse a Failure?
Recovery is a process, and relapse is a common part of this process.1 That is, people often cycle through different stages of recovery, including relapse, before they settle into long-term recovery. So a recurrence of substance use doesn’t mean treatment has failed.
In fact, a relapse can be a learning opportunity. Each time a patient has a setback, they can learn from the experience. In the future, they can apply newfound skills and knowledge to help them cope with their disorder, potentially allowing them to make significant forward progress.1
Why Do People Relapse, and What Are Some Common Triggers?
According to insights from the National Institute on Drug Abuse, some of the most common triggers for relapse are contact with substances and stress cues linked to drug use. The latter includes people, places, things, and even moods.2
The Substance Abuse and Mental Health Services Administration breaks out some of these recurrence triggers into the following internal and environmental factors.1
Internal Factors Associated with Increased Risk of Relapse
- Ineffective coping responses.
- Cognitive distortions (i.e., irrational thoughts that often launch states of depression or anxiety).
- Intense negative or positive feelings.
- Low self-efficacy (i.e., a person’s belief in their ability to overcome a challenge).
- Feelings of guilt and shame related to recurrence.
- Ongoing positive thoughts and feelings associated with drinking or substance use.
External Factors Associated with Increased Risk of Relapse
- Social influences (e.g., peers, co-workers, events, etc.).
- Access to substances.
- Exposure to cues/triggers for past substance use and/or risk behaviors.
Additional triggers that may prompt a relapse include:
- Withdrawal—Some people start using a substance again simply to avoid symptoms of withdrawal. (Note, however, that a medically managed detox can assist in keeping patients as comfortable as possible throughout the withdrawal process.)
- Poor Self-Care—Poor diet, sleep, and exercise habits can create a slippery slope that ultimately leads to depression, anxiety, stress, and more—all of which can work to trigger a relapse.
- Overconfidence—Overconfidence in one’s recovery can lead people to place themselves in the wrong place at the wrong time, where some of the aforementioned external factors can result in recurrence.
- Lack of Ongoing Support—While recovery is certainly possible without the support of friends, family, and/or professionals and sober peers, it’s not as easy. And for some, the lack of support can erode their sobriety.
- Stress and Interpersonal Issues—High levels of stress and/or conflicts with family and friends can take a toll on a person’s mental health. Paired with poor coping skills, these factors can sometimes lead to recurrence.
- Pain—Well-meaning physicians often prescribe opiates for pain related to injuries and medical conditions. However, for those with a history of a substance use disorder, it may be difficult to control their use of them.
What Can You Do if You Relapse?
If you relapse, first remember that relapse can be part of the recovery process; it’s not a failure. Also remind yourself that no relapse is too big to recover from.
Next, take immediate action to regain your sobriety. This typically involves reaching out for help, be it from family, friends, sober peers, support groups, professional treatment programs, etc. The sooner you seek help, the easier it will be for you to regain sobriety and continue the road to recovery.
While some people will return to treatment following a relapse, others may be able to cope with increased outpatient care and/or aftercare programs. Often this post-relapse care will include building the skills to recognize and manage high-risk situations that might trigger a relapse in the future. Plus, it typically involves a relapse management plan, which features positive coping strategies to lessen the impact of a relapse if it were to happen again in the future.1
If you or someone you love has relapsed, contact American Addiction Centers at to discuss treatment options and potential next steps. By working with a substance use disorder professional, you can develop a care plan suited to your specific needs and develop the skills to help you stay on the road to recovery.