Chronic Relapse in Addiction: Symptoms and How to Avoid It

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Certified cognitive-behavioral therapist, expert addiction and chemical dependency counselor, certified for more than twenty years of experience in adolescent, adult and family psychotherapy.
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If you are or have known someone who has relapsed, you’ll know how challenging it can be. But chronic relapsing with a cycle of addiction, treatment, sobriety and then substance use is even more difficult to overcome. In this article, I describe what chronic relapse is, how it happens, common stages and symptoms and dangers of relapsing.

What is Chronic Relapse?

Many people with a Substance Use Disorder (SUD) or addiction, are at risk of relapse. That is, they return to heavy, consistent drug use after trying to stop. This is different from a lapse or slip-up which is short-lived, often accidental, and is followed by a return to their previous recovery goals. A lapse typically is the result of inadequate coping strategies. 

A person relapses when they stop maintaining their goal of reducing or avoiding use of an addictive substance and returns to their previous levels of use.

But viewing any level of substance use as a relapse can increase the likelihood of future substance use. It reinforces people seeing themselves as failures, unable to control various internal factors, reinforcing feelings of guilt and shame 

How Common is Chronic Relapse?

From 40-60% of people with an addiction relapse, according to the National Institute on Drug Abuse. [1]. The rate of relapse for drug and alcohol use is similar to that of other chronic illnesses like asthma, hypertension, and diabetes. It’s even higher for cocaine and heroin. If someone stops following their treatment plan, they will likely relapse.

Relapse is best viewed as a normal part of the recovery process, and not as a failure. It is essentially a sign that someone needs to consult with their doctor, enroll in an addictions treatment program or engage more with their support group and mentors who are successfully in recovery.

Why Does Relapse Happen?

The process of substance use involves a gradual rewiring of the brain’s circuitry as it learns to respond to new stimuli. Similarly the process of recovery involves learning new patterns of living. This is not a straightforward process. And relapse is part of the journey for many people.

Stopping to use a substance is only the very first step in recovery. Relapse most commonly occurs in the first 90 days after beginning recovery, typically within the first year. The risk of relapse is highest before someone has adopted a new set of strategies and routines to cope with cravings, but also to deal with normal life stressors. 

Relapse happens for a number of reasons:

  • Emotional Relapse: The person does not pay attention to self-care, which helps minimize stress. 
  • Mental Relapse: Prolonged lack of self-care can contribute to a build up of discomfort with weakening mental resolve. Bargaining with themselves about when to have a drink or use can escalate into breaking down and relapsing.
  • Physical Relapse: Once someone begins drinking or using again, it can be very hard to stop.

Circumstances that may stimulate relapse include:

  • Withdrawal symptoms discomfort
  • Places and circumstances that tempt substance use e.g. where they would have used drugs, seeing old friends who use
  • Circumstances that trigger substance use as a way of coping e.g. inadequate housing
  • Unpleasant feelings of hunger, anger, loneliness, fatigue
  • Mental health or emotional issues e.g. being isolated, alone with one’s thoughts
  • Past unresolved traumas
  • Physical health issues often causing use of non-prescription drugs
  • Guilt from lapsing which then causes more substance use
  • Relationship issues and breakups
  • Being over confident that all is under control

Stages of Chronic Relapsing Disease

Relapse is both an event and a process. Relapse generally occurs for the three reasons mentioned above. These can be viewed as stages with the following specific characteristics:

Emotional Relapse

People increase their susceptibility to relapse, often not knowing they’re in it. Signs include:

  • Poor self-care, eating and sleeping habits
  • Self-isolation
  • Holding emotions
  • Not attending group support meetings

Mental Relapse

This occurs when a person actively thinks about and wishes to use substances again. Signs include:

  • Bargaining
  • Lying
  • Drug and alcohol cravings
  • Planning relapse and looking for places to do so
  • Glamorizing previous drug use
  • Reassociating with previous places or people they used substances with

Physical Relapse

People actually relapse and use substances again. Most try to hide their relapse due to embarrassment and guilt.

Symptoms of Chronic Relapsing

Chronic relapsing describes the continued tendency for a person’s addictive behaviors to re-emerge after periods of successful treatment or abstinence. It consists of a cycle of addictive behavior, withdrawal and relapse. This chronic pattern often doesn’t become apparent until after a period in addiction treatment. This is why managing addiction requires long-term strategies.

Symptoms of chronic relapsing include:

  • Feeling hopeless
  • Not completing an entire treatment program
  • Not accepting underlying issues in treatment
  • Lying
  • Craving to use substances or using substances again
  • Unable to apply knowledge learned in treatment e.g. about addiction and sobriety
  • Choosing to not attend support groups
  • Not believing in the effectiveness of recovery
  • Believing that sobriety is a struggle

Dangers of Relapsing

Relapse can be quite dangerous for some drugs and even deadly. By using as much of the drug as they did before, a person can easily overdose because their bodies are no longer used to the previous level of drugs being consumed.

How to Help a Relapser

Lifelong recovery or sustained recovery requires a long-term view of recovery and sobriety. Stopping substance use is just one part of a long and complex process of recovery. Relapse is not a sign that your recovery has failed. It is a step towards a goal. With support from friends and family and appropriate treatment, it is possible to overcome. 

Recognizing triggers, having a support network, getting help from a counselor, good nutrition, balanced sleep and exercise are all essential elements to prevent or cope with relapse.

At The Encino Recovery and Detox Center, we don’t just treat addiction; we nurture the spirit, heal the mind, and empower individuals to reclaim their lives. If you or a loved one is relapsing and on the precipice, seeking a way out of the darkness of substance abuse, remember that help is just a call away. Your journey to wellness, purpose, and a brighter tomorrow begins with that first step. Reach out to our Admissions team now.

Sources

[1] National Institute on Drug Abuse (NIDA). 2023. September 25. Treatment and Recovery. 

Relapse. Psychology Today.
Relapse. Alcohol and Drug Foundation.

Administrator / Chief Clinical Officer
Certified cognitive-behavioral therapist, expert addiction and chemical dependency counselor, certified for more than twenty years of experience in adolescent, adult and family psychotherapy.
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