Relapse Prevention and Recovery

Understanding the symptoms of relapse and how to avoid it.

Relapse Prevention and Recovery

Article Contents

What Is Relapse?

Regarding addiction, relapse is a return to substance use after a period of nonuse. This reinstatement of drug-seeking behavior is common and does not mean that individuals who relapse have failed to recover from drug addiction or drug dependence. Relapse is merely a part of the recovery process.1

Although these definitions make relapse sound like a singular event, it is a gradual process. There are three stages of relapse:2

Therefore, while the most obvious sign of relapse – physical relapse – may manifest as driving to the liquor store or going to see a drug dealer, the beginning of that relapse occurs weeks or months before the physical stage.

What is Relapse Prevention?

Addiction is a chronic disease, meaning that relapse is a possibility regardless of how long an individual has maintained sobriety. As the name suggests, the goal of relapse prevention is to help individuals avoid returning to their substance addiction after a period of sobriety. By using the right tools and obtaining proper support, recovering individuals can keep the possibility of relapse just that – a possibility – and not a probability.

Relapse Warning Signs

During an emotional relapse, individuals are not thinking about using. Warning signs of emotional relapse include:3
The transition between emotional and mental relapse is the natural consequence of prolonged, poor self-care. Increased discomfort and tension can lead to thoughts of a mental escape. Warning signs of mental relapse include:

Relapse Prevention Plan

Recognizing Symptoms

Understanding the symptoms of relapse allows you to recognize them if or when they appear. You can then take action to prevent relapse. Catching yourself in the early stage of relapse, when changing your behavior is easier, can make a world of difference.

Knowing what counts as a relapse symptom can also help with managing negative self-talk. For example, brief thoughts of using addictive substances are normal in early recovery and do not indicate that relapse is imminent or that you are doing a poor job of recovery.4

Knowing Triggers

Knowing what may trigger the desire to relapse allows you to avoid those triggers. Some of these triggers may include:

  • Social isolation

  • Celebrations

  • Seeing old friends who still use (peer pressure is a powerful force)

  • Being in high-risk situations

  • Experiencing high levels of stress

  • Entering relationships too early on in the recovery process5

Other triggers may not be so avoidable. For instance, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5) reports that withdrawal symptoms can contribute to relapse for a variety of substances. Mental illnesses, like anxiety or depression, can also be relapse triggers.

Seeking Help

Having a plan for seeking help before entering the beginning relapse stage can be extremely beneficial in avoiding a full-blown relapse. Consider making sure you know where a local chapter of a 12-step group meets. You can also acquire the contact information of other group members (or a sponsor) who can guide you through your emotions and thoughts.


Prolonged poor self-care can lead to a relapse. Mental, physical, and emotional states are tied together. For some, self-care is physical – eating well, getting plenty of sleep every night, and getting regular exercise. For others, self-care is emotional, such as putting oneself first, being kind to oneself, permitting oneself to have fun. Practicing good self-care is an important part of relapse prevention.

Positive Distractions

Distraction can be used to improve willpower, so do something to occupy yourself when you think about using. You might call a friend, go to a meeting, go on a walk, do a crossword puzzle, have a cup of coffee, or play a musical instrument. If you are not able to physically get to your distraction, you can try to imagine it.6

Peer Support Groups

12-Step Programs

Different 12-step programs like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Gamblers Anonymous (GA) use a set of principles and actions designed to help people recover from addictive and dysfunctional behaviors. While the 12 steps reference God, the programs themselves are not religious, although the 12-step philosophy does involve spirituality (for instance, a higher power may be interpreted to be something other than a religious deity).7 Meetings for 12-step programs are structured. During a session, people introduce themselves to the group using their first name only, then share their story. Crosstalk is not allowed. Each participant receives a sponsor, meaning someone who helps guide them through the 12 steps.8

SMART Recovery

SMART Recovery is a non-profit organization providing a mental health and educational program focused on changing human behavior to those who desire to achieve abstinence, free of charge.

SMART Recovery’s 4-Point Program aims to help those in recovery to:9

  • Build and maintain motivation to change

  • Cope with urges to use

  • Manage thoughts, feelings, and behaviors effectively without addictive behaviors

  • Live a balanced, positive, and healthy life.

Meetings (online and in-person) are run by volunteers and facilitators who are themselves recovered addicts, and those who “graduate” from the program are invited to volunteer.

Rational Recovery

Rational Recovery emerged in 1988 with the publication of Rational Recovery from Alcoholism: The Small Book, by Jack Trimpey. The program is based on Rational-Emotive Behavior Therapy, a type of cognitive-behavioral therapy developed by Albert Ellis, Ph.D. The program specifically avoids using spirituality or religiosity as a part of recovery, placing emphasis instead on self-examination of one’s irrational beliefs.10

In practice, a “coordinator” leads a group of 5-10 members in weekly, 90-minute meetings to learn “cognitive devices” for securing abstinence. Members write out irrational beliefs that activate their desire to use, and they can “cross-talk” about their attitude toward abstinence, vulnerability to their addiction, and ways to overcome it.

LifeRing Recovery

LifeRing Recovery is one of the less structured support programs. The only membership requirement is abstinence, there are no sponsors, and there is no compulsory model to follow. Rather, LifeRing defines the individual’s own motivation and effort as the key to recovery. Members are expected to develop their own “Personal Recovery Program”.11

A “3-S” philosophy of Sobriety, Secularity, and Self-Help is used to expose participants to ideas that have worked for others and encourage participants to try those that appeal to them. To quote from LifeRing’s website, “You do the hard work, and we offer information, advice, understanding, and lots of support.”


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