Recovering from alcohol dependence and addiction can be a long and challenging process and you may experience several triggers, cravings, or relapses along the way. This guide helps you recognize early signs of alcohol relapse and implement prevention strategies to aid in avoiding relapse. Additionally, this article includes coping strategies if you or someone you know might have relapsed back into alcohol use.
- Alcohol relapse is prevalent during the recovery process but with the use of effective coping strategies, you can maintain and restore your recovery and abstinence.
- Recognizing triggers and signs of each relapse stage can help you implement prevention strategies early and avoid relapse.
- Professional treatments are available to help you in this process.
Understanding alcohol relapse
Alcohol is a very addictive substance, particularly after heavy and prolonged use. People who consume large quantities of alcohol for a long time may be likely to develop addiction and dependence. [1]
Chronic alcohol consumption causes biological and psychological changes that contribute to the maintenance of addiction, including changes to the activity of the neurotransmitter dopamine. This effect causes cravings and withdrawal symptoms during abstinence, which cause an increased likelihood of relapse. [2]
It is common for people in recovery to experience numerous relapses following chronic alcohol use and addiction development. Additionally, when people relapse, they may be likely to return immediately to heavy alcohol consumption, potentially increasing health risks. [3]
Studies suggest that repeated periods of abstinence can worsen subsequent withdrawal symptoms, which may increase the risk of relapse. This can include withdrawal-related anxiety, increased susceptibility to stress, and higher rates of cue-related relapse triggers. [1]
- In terms of all substance use, 40-60% of people relapse in the year following treatment. Studies indicate that alcohol relapse rates may be higher and occur sooner, particularly in those with co-occurring mental health issues. For example, one study shows a 40-60% relapse rate within three months of treatment and 70-80% within one year. [4][5]
Despite these figures, recovery from alcohol use disorder is possible when appropriate and effective treatment is utilized. Outcomes are reportedly improved in those who remain in treatment longer, utilize therapeutic interventions, learn and implement coping strategies and emotion regulation skills, and access support from friends and family. [3]
Identify your triggers
During the recovery process, you are likely to encounter many triggers that may cause you to think about drinking again. Being aware of your triggers and having strategies and skills in place can help you manage these situations and avoid relapse.
Common triggers for alcohol relapse may include: [1][2][3]
- Stress
- Consuming a small amount of alcohol
- Exposure to others who are consuming alcohol
- Being in an environment associated with past alcohol consumption
- Celebrations
- Negative emotions such as anxiety and sadness
- Isolation and loneliness
- Boredom
- Withdrawal symptoms and cravings
Warning signs you might be headed for a relapse
Relapse can occur even after many months or years of abstinence. Typically, individuals will go through three stages–emotional, mental, and physical relapse. As such, relapse does not occur suddenly and it may take several weeks or months from the first warning signs before full relapse occurs. [6]
Being able to recognize the early warning signs during emotional and mental relapse can allow for early prevention strategies to be implemented and help avoid full relapse.
Stage 1: Emotional relapse
Emotional relapse refers to the first stage of warning signs where emotional changes–which may be influenced by pre-existing mental health conditions, physical health issues, environmental cues, or distressing circumstances–are experienced by the individual. While the need to drink alcohol is not conscious for the individual yet, emotional changes cause the individual to become more vulnerable to relapse if they are not managed effectively. [7]
Signs of an emotional relapse can include: [3][6]
- Declining self-care, such as changes in hygiene, dietary intake, and sleep patterns
- Mood swings
- Psychological and physical symptoms of anxiety
- Low mood
- Irritability, anger, or agitation
- Increased stress
- Feelings of shame, guilt, worthlessness, or hopelessness
- Reduced engagement with professional treatment or group meetings
- Reduced social interactions
How to take care of your emotions
Utilizing coping strategies and healthy behaviors to help manage and regulate emotional distress can reduce the impact of these symptoms and help prevent the relapse stages from progressing. This can include: [4][6]
- Attending therapy to discuss and manage emotional distress, learn or adapt coping strategies, and alter negative thought patterns
- Engaging in physical exercise and spending time outdoors
- Socializing with sober friends
- Talking with friends and family about emotional distress
- Managing stress with relaxation and mindfulness exercises
- Managing sleep and dietary intake
- Checking in with emotional and physical changes using the HALT acronym (hungry, angry, lonely, tired) to recognize aspects of self-care that need managing
Stage 2: Mental relapse
Mental relapse tends to occur following changes to emotional well-being and involves thoughts of drinking alcohol. During this stage, the individual will likely want to continue with their sobriety but may begin making excuses or bargaining with themselves about the possibility of having a drink.
Signs of a mental relapse can include: [6][8]
- Thinking about spending time with friends you used to drink with or in places you used to drink
- Rationalizing with yourself that having one drink will be fine
- Making plans to buy or drink alcohol
- Thinking about occasions in the past when you drank and ignoring the negative aspects of these situations and focusing on the positive aspects
- Lying to friends and family, your sponsor, or in meetings about thoughts of drinking
How to manage your thoughts
During the mental relapse stage, implementing coping strategies and distraction techniques can help you avoid a relapse. This might include: [4][6]
- Using skills learned in therapy to help recognize and adapt thought patterns that contribute to alcohol cravings
- Engaging in activities to help distract from thoughts of drinking, such as exercise, mindfulness, and socializing with sober friends
- Recognizing thoughts as they arise and allowing cravings to pass without acting on them
- Speaking with friends or sponsors about wanting to drink
- Considering triggers that might have led to these thoughts and referring to your prevention plan to manage these triggers
- Avoiding situations that might be triggering, such as people and places associated with alcohol
Stage 3: Physical relapse
Physical relapse is the stage in which the individual returns to drinking alcohol, often in significant quantities. This can occur within a short period of abstinence or after several months or years and is more likely if prevention strategies are not utilized within the previous two stages.
A ‘lapse’ may occur in this stage, during which the individual has one drink or one occasion of drinking and then returns to abstinence. In some cases, a lapse can result in feelings of guilt and shame, thinking that you have failed at sobriety, thereby potentially resulting in a full relapse. [6][8]
How to get back on recovery
Whether you experience a lapse or full relapse, it can be important to recognize, accept, and let go of any emotions that arise, as these negative feelings can impair the ability to return to recovery if not managed effectively. Forgiving yourself for this setback can be crucial. Additionally, during or after relapse, the following can be helpful: [4][6][7][9]
- Seeking professional help to stop drinking, such as inpatient rehab or recommencing therapy sessions
- Contacting your sponsor for support in returning to abstinence
- Attending meetings, where you can admit to and accept your relapse and feel supported in returning to recovery
- Reviewing your prevention plan, recognizing any triggers you experienced, and how you can adapt your plan to help you manage these triggers better in the future
- Reinstating healthy habits, such as sleep schedules, exercises, and proper diet
- Being honest with loved ones about your relapse and discussing any emotional or environmental triggers that contributed
Signs a loved one has relapsed
If you are supporting a loved one throughout their recovery, you may be able to help them notice signs of impending relapse or recognize when they have started drinking again. Signs that a loved one has relapsed might include: [7][10][11]
- Clear signs of alcohol use, such as empty bottles, smelling of alcohol, or speaking or behaving as though they are under the influence
- Changes in mood and behavior
- Anger, irritability, or aggression
- Lying about where they have been or with whom
- Speaking negatively about themselves, their life, or their achievements
- Becoming distant from loved ones
- Spending time with people associated with their past drinking habits
- Changes in appearance, such as poor hygiene, appearing unkempt, or extreme tiredness
- Lack of interest in socializing or engaging in hobbies and activities with sober friends
- Refusing to attend meetings or therapy sessions
Helping someone who started drinking again
If your loved one has started drinking again after a period of abstinence, you can support them by: [10]
- Being positive and non-judgmental, supporting them to return to their recovery
- Reminding them of their progress and the steps they had taken to get there, prompting them to revisit their coping strategies
- Gently encouraging them to return to meetings, therapy, or other professional treatments
- Giving them a safe space to talk about and acknowledge any negative emotions that have arisen due to their relapse
- Offering to spend time with them, encouraging them to socialize in environments away from alcohol
Treatment and support for alcohol relapse
Relapse can cause many psychological and physical challenges that may be difficult to overcome alone. Seeking professional assistance can help you return to your recovery, manage any emotional distress or withdrawal symptoms, and teach or adapt your coping strategies so that you can better deal with triggers and cravings in the future.
Treatment for alcohol relapse can include: [4][6]
- Rehab facilities
- Alcohol detox programs
- Therapeutic interventions, such as cognitive behavioral therapy (CBT) or motivational interviewing (MI)
- 12-step programs such as Alcoholics Anonymous
You can find a directory of treatment providers through Recovered. These treatment options can help you overcome and prevent alcohol relapse with professional support.
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