Menu

Alcohol Use Disorder: What to Know About Relapse

Medically Reviewed by Brunilda Nazario, MD on May 17, 2021

When you're recovering from alcohol use disorder, a relapse is when you start drinking again. It's not the same thing as a lapse, which is temporary and short-term -- such as when you have one drink at a party, then go back to not drinking.

Some research has found that 40% to 60% of people dealing with substance abuse disorders relapse within a year. In fact, experts consider relapses part of the recovery process. The key is to learn from your mistakes and keep trying.

A relapse may happen for many reasons, including:

  • Setbacks or challenges at work, with your health, or in your personal life
  • Situations that tempt you to drink
  • You convince yourself you have your alcohol problem under control

You're more likely to relapse early in your recovery. And you're at greater risk when you try to quit drinking on your own. A formal recovery plan gives you strategies for dealing with people or situations that could trigger relapses.

How to Identify Your Triggers

Experts say there are three main types of situations that may trigger people with alcohol use disorder (sometimes called alcoholism) to drink again:

  • Triggers in your environment. These are unique to you, but include people, places, or social events you associate with drinking. The risk for relapse is stronger if you hang out with people who urge you to indulge. But you could be tempted by seeing any friend or loved one drink in a social setting.
  • Emotional triggers. Feelings of stress, anger, sadness, hopelessness, or even boredom can set off a relapse. This is especially true when your emotions stem from conflicts with loved ones. But even positive emotions can be a trigger if you celebrate them with alcohol.
  • Exposure triggers. These are situations in which you come into contact with alcohol, like at a party or an all-inclusive resort.

Warning Signs of a Relapse

Many people think preventing a relapse means just saying "no" to a drink. But by the time you’re looking at a can of beer or a bottle of liquor, you’re in the last and most difficult stage of a relapse. At this point, it’s very hard to stop yourself.

A relapse actually starts weeks or months before any alcohol passes your lips. Experts say it helps to think of relapses as having three main stages:

  • The emotional phase, when your feelings set the stage for a relapse
  • The mental phase, when you're thinking about drinking
  • The physical phase, when you act on those thoughts

If you can recognize the warning signs of each stage, you can take action to avoid a relapse.

Stage 1: Emotions. Unresolved emotions and failure to take care of yourself can start you on the road to a relapse, even when you’re not consciously thinking about drinking.

Warning signs:

  • You keep your feelings inside
  • You’re still in denial about your alcohol use disorder
  • You skip support group meetings or therapy sessions
  • You stop following healthy lifestyle habits, like getting enough sleep, eating well, and keeping up with hygiene

All these things are common during recovery. The way you manage them makes a difference. If you start to think of yourself as a failure, you're more likely to move into the next stage of relapse. Instead, think of them as hurdles you can overcome.

What you can do: Pay attention to your physical and emotional needs. Get back to the recovery basics, like self-care and talking with your support team. A therapist or counselor can show you healthy ways to deal with your emotions.

Stage 2: Thoughts. The longer you neglect yourself emotionally, the more likely you are to start thinking about drinking again. During this stage, the part of you that knows how important it is not to drink weakens. And the part that remembers alcohol as an escape gets stronger.

Warning signs:

  • You constantly think about drinking.
  • You look back fondly on your drinking days.
  • You start thinking about deals you can make with yourself to allow yourself a drink -- like drinking only during a vacation.
  • You go to places you know are trigger spots, like a favorite bar.
  • You start planning a drinking episode and tell yourself it’ll be one and done.

Having occasional cravings or thoughts of drinking is normal during recovery. But when you keep thinking about it, and start planning to do it, it's time to get help.

What you can do: You need to regain the upper hand over your thoughts about drinking. Don't feel guilty or be afraid to talk to others about your struggles. Therapy can help.

Stage 3: Actions. This stage is the act of drinking again. It might start with:

  • Having just one drink, thinking you can control it or that no one will find out
  • Obsessive or out-of-control thinking about drinking

What you can do: It’s never too late to get help. After a relapse, if you aren’t already in a treatment program, it’s time to find one.

If you’ve been in a program, immediately connect with your counselor, therapist, support group, or mentor. Recommit to your self-care plan, especially activities that eased stress and other emotional triggers.

Think about things that led to or worsened this relapse and how to remove them from your life. If a trigger is unavoidable, consider what you can do differently next time you face it.

Above all, see a relapse as a temporary setback and not a moral failure.

Create a Relapse Prevention Plan

Preventing a relapse starts with having a strong recovery plan. It also means making the effort needed to stick with it. That means reaching out for help. Surround yourself with supportive loved ones, attend self-help group meetings, and/or go to therapy sessions.

Cognitive behavioral therapy (CBT) is an important tool for preventing relapses. It teaches you how to overcome negative thinking, which is often at the heart of a relapse. For example, you might believe that you can’t quit, that recovery takes too much effort, and that you won’t enjoy life as much without alcohol.

With CBT, you learn that recovery is based on practicing coping skills, not willpower. You can discuss trigger situations with your therapist and rehearse strategies to deal with them.

Keeping a journal can also help you stick with recovery. Write out both your recovery plan and your relapse prevention plan. Make a list of your personal triggers. Next to each, add the techniques you and your therapist or support team have come up with to manage it.

Include the names of everyone on your medical and support teams and how to contact them. Note who you can call at any hour. Keep this information up to date.

Remember that there’s no time limit on reaching out for help. Recovery is lifelong, and a relapse can happen at any time, even after years of not drinking.

WebMD Medical Reference

Sources

SOURCES:

National Institute on Alcohol Abuse and Alcoholism: “Treatment for Alcohol Problems: Finding and Getting Help.”

Yale Journal of Biology and Medicine: “Relapse Prevention and the Five Rules of Recovery.”

American Addiction Centers: “What’s the best way to deal with a relapse?” “Dry Drunk,” “Addiction as a Coping Mechanism and Healthy Alternatives,” "How to Recognize Drug and Alcohol Relapse Triggers for You and Your Loved Ones."

Journal of the American Medical Association Psychiatry: "Relative Efficacy of Mindfulness-Based Relapse Prevention, Standard Relapse Prevention, and Treatment as Usual for Substance Use Disorders."

Alcohol and Drug Foundation: "Relapse."

© 2021 WebMD, LLC. All rights reserved.