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Addiction: What to Know About Relapse

Medically Reviewed by Neha Pathak, MD on May 10, 2021

Addiction is a long-term condition, like asthma, diabetes, or high blood pressure. Of course, the goal is to stop using drugs or alcohol completely and not relapse. But when you see your addiction as a chronic disease, you can look at relapse from that perspective, too.

About 40% to 60% of people who get treatment for substance use disorder have a relapse. That’s about the same as relapse rates among people with asthma or high blood pressure if they stop taking their medicine. What’s key is to recognize the early signs of relapse, so you can stop a backslide before it starts.

Your Brain After Addiction

Every day that you do not use, you beat a powerful opponent: your brain. After all, addiction rewires your brain.

A healthy brain releases chemicals that give you pleasure when you do something rewarding, like exercising or meeting up with your friends. Drug use produces those same chemicals. As you become addicted, your brain demands more and more of the drug to get that same feeling. In fact, at some point, if you don’t use the substance, you may feel worse.

Brain scans also show that changes in your brain after addiction can make you less able to use self-control and good judgement. That only makes it harder to stay clean. These problems may be worse in teens because their brains are still developing.

Why Relapse Happens

Since your brain makes recovery harder for you, as you try to stay clean, you may start to justify why a bit of substance use could be OK. You might think of reasons such as:

  • One last time can’t hurt.
  • Your job or home life is too stressful.
  • You live with physical or emotional pain.
  • People around you are still using.

A relapse does not usually happen suddenly. You may notice early clues if you’re watching out for them. Some clues might be:

  • A change in your attitude or thinking, such as a loss of desire to recover
  • Falling back into poor behaviors, such as being too quick to get angry
  • Skipping your recovery support meetings

Relapse Prevention Strategies

If you notice some of these warning signs of relapse, you can take steps to guard against it. First, take a close look at what situations boost your cravings to use. Be specific. Write them down if you can. Think of:

  • Activities that can be triggers, whether that’s watching sports or attending parties
  • Thoughts or feelings that cause cravings, such as financial stress or social anxiety

Everyone’s list will be different. Once you figure out your own triggers, think about something you can do instead of substance use for each one. Could you wrap up each day with a long walk instead of a cocktail? If paying the bills makes you too cranky, be ready to call your sponsor when they’re due.

You may have to experiment a bit to find new approaches that work best. The goal is to develop new routines that are rewarding rather than leaning on the drug.

A Risky Relapse

A relapse moves you away from your goal no matter what the substance. But with some drugs, starting up again can seriously hurt or even kill you. After you stop using, your body changes. It can no longer cope with the same amount of drug that you used to take. That makes it easier to overdose. Once you overdose the first time, research shows that it’s more likely to happen to you again.

Relapse is particularly dangerous with opioids, including prescription painkillers and heroin. Those drugs can slow your breathing to the point that you die. If you are worried about a relapse, there’s a medication, called naloxone, that you can keep handy. If you start to overdose, naloxone can reverse an opioid overdose when someone gives it to you in time. You can keep it in your home or with you. Make sure the people closest to you know where to find it and how to use it.

Even if you survive, an overdose can leave you and your family members with lots of feelings to sort through. They may include fear, guilt, anger, and hopelessness. You or your loved ones may dwell on what happened. Consider talking to someone, such as a counselor or people in your support group.

Seeking More Help

If you are worried about relapse, you can always seek out more treatment. Along with recovery groups, there are also several types of therapy, such as:

Cognitive behavioral therapy: To better recognize and avoid situations where you are more likely to use.

Family therapy: To look at how your drug use affects the whole family.

To find a nearby treatment program, call 800-662-HELP (800-662-4357) or search https://findtreatment.samhsa.gov/.

Like other chronic diseases, there’s no cure for addiction. But you can learn how to ease stress, avoid risky situations, and manage your disease. Relapse does not mean that you or your treatment has failed. It is a temporary setback in a recovery process that will one day lead you to live your life free of drugs.

WebMD Medical Reference

Sources

SOURCES:

Academic Emergency Medicine: “Identifying Injection Drug Users at Risk of Nonfatal Overdose.”

Hazelden Betty Ford Foundation: “Preventing Relapse.”

JAMA: “Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation.”

National Institute on Drug Abuse: “Drugs, Brains, and Behavior: The Science of Addiction: Treatment and Recovery,” “The Science of Drug Use and Addiction: The Basics,” “What is a relapse?” “Where can someone find treatment and recovery resources?”

National Institutes of Health: “Biology of Addiction: Drugs and Alcohol Can Hijack Your Brain.”

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