Relapse Triggers and How To Manage Them

Naomi Carr
Dr. David Miles
Written by Naomi Carr on 02 August 2024
Medically reviewed by Dr. David Miles on 05 November 2024

During addiction recovery, you are likely to experience triggers and cravings as you navigate your sobriety journey. Learning how to recognize and manage your triggers can help you feel more in control and prevent or reduce relapse signs. Below are some of the most common relapse triggers and techniques to manage them, although this can vary from person to person.

Key takeaways:
  • Common relapse triggers can include negative emotions, challenging events, and people, places, and events that provide exposure to substance use. Learning how to recognize and cope with these triggers can help prevent relapse.
  • Managing triggers can include techniques such as mindfulness, distraction and avoidance of known triggers, physical exercise, attending meetings, and talking to trusted friends.
  • Various treatment options are available to support your recovery process, including inpatient and outpatient rehabilitation, therapy, support groups and 12-step programs, and medications.
man in white shirt sitting at the bar contemplating and struggling whether to give in and relapse into drinking alcohol

What are relapse triggers?

Recovery is an ongoing process and can involve many fluctuations and challenges. During this process, thoughts, feelings, or situations, sometimes referred to as high-risk situations, can cause you to be reminded of past substance use and feel tempted to return to these behaviors. This is known as a relapse trigger.

During addiction recovery, it is common for people to experience a relapse. The National Institute on Drug Abuse (NIDA) states that relapse occurs in 40-60% of individuals who engage in addiction treatment. Being aware of your triggers can help you manage them, improving your chances of avoiding relapse.

Often, addiction recovery treatment involves creating and implementing a prevention plan, which can be used when triggers occur and signs of relapse emerge. This includes being aware of potential triggers and the strategies you can use to reduce their impact on your recovery.

Types of addiction triggers

Addiction triggers include internal triggers related to emotions and thought patterns and external triggers related to people, places, events, and things. Triggers can also be considered under the following categories:

  • Emotional: Emotions such as sadness, anxiety, stress, loneliness, anger, or fear are often triggers for people in addiction recovery. Positive occurrences such as celebrations may also stir triggering emotions. In particular, very strongly felt emotions can cause the onset of cravings and a desire to avoid or numb emotions with substances.
  • Psychological: Negative thought patterns and beliefs are linked to emotional triggers and can lead to a loss of control over abstinence. This might include beliefs about the self, such as thoughts of being a failure, worthlessness, shame, ruminating on past mistakes, or challenges related to the recovery process.
  • Environmental: People or places that involve active substance use or associations with past use can be particularly triggering. Similarly, events can be an environmental trigger, such as interpersonal conflicts, financial issues, work problems, or even celebratory occasions.
  • Behavioral: Addictive behaviors are often linked to habits and routines formed over time, which can act as behavioral triggers. This might include going to the pub with colleagues after work every day, persistent boredom due to too much free time, or skipping therapy or meetings.

The most common relapse triggers

Below is a list of common triggers that recovering individuals typically struggle with. When exposed to any of these triggers, it can be helpful to check in with yourself and consider any changes in emotions or thoughts that might indicate a sign of potential relapse.

Exposure to substances or peer pressure

Being around people who are actively using substances can be particularly triggering. It can be difficult not to give in to temptation when you want to join in with your friends or when they are trying to convince you to join them. This also applies to places and events that expose you to substance use, such as parties or bars.

What to do when you are exposed to substance use

Firstly, it is a good idea to avoid people and places that remind you of or expose you to substance use. It will inevitably create difficulties in your recovery process to be exposed to these situations.

However, if there are events or occasions during which you are exposed to substance use, the following tips might be helpful:

  • Walk away from the person using substances and engage in conversation with others.
  • Speak to a trusted friend about your cravings, who can support and reassure you.
  • Practice saying no.
  • Engage in a healthy alternative behavior, such as physical exercise, meditation, or breathing exercises.
  • Take time to consider how this moment is making you feel and reflect upon these thoughts and feelings in the context of your sobriety.

Stress

Many studies indicate that stress is a significant factor in addiction relapse and can greatly contribute to the onset of emotional, mental, and behavioral relapse signs. This might include stress related to work, finances, friends, family, or your recovery process itself. Often, people turn to substance use as a way to escape from or reduce feelings of stress.

What to do when you experience stress

Unfortunately, life can be stressful at times and there is no way to completely avoid challenges. Learning and utilizing skills to manage this stress can help you avoid feeling overwhelmed and turning to substance use behaviors to manage these issues. This might include:

  • Engaging in regular physical exercise can help reduce physical and emotional symptoms of stress and improve resilience.
  • Mindfulness techniques such as meditation and yoga can help reduce stress, improving your ability to self-reflect and cope with stressful situations.
  • Incorporating healthy habits into your daily routine can help you manage stress, such as keeping a consistent sleep pattern, eating healthily, and maintaining self-care.
  • Attending therapy can help provide you with skills to identify and manage stressful situations.

Negative emotions and beliefs

Feelings of sadness, anxiety, anger, fear, worthlessness, and shame are all closely linked with increased chances of relapse. These emotions can contribute to a decline in self-care, reduced interest in hobbies and socializing, and persistent and troubling thought patterns. Substance use is often used as a coping strategy for these issues.

What to do when you experience negative emotions

Several techniques can be used before and during the onset of negative emotions which can help you feel more capable of coping with emotional issues and avoiding potential relapse. This includes:

  • Attending therapy, such as cognitive behavioral therapy (CBT), can help you recognize and adapt to negative thought and behavior patterns, resolve underlying trauma, and learn positive coping skills. This can help reduce the frequency and severity of negative emotions and provide you with techniques to utilize when these emotions arise.
  • Speaking with friends and family can help you feel more supported and give reassurance during difficult times.
  • Utilizing mindfulness techniques and breathing exercises can help regulate emotions and reduce negative thought patterns. These techniques can also provide an opportunity to self-reflect and check in with mental and physical sensations and changes, helping to recognize relapse signs.
  • Engaging in healthy habits, such as sleep schedules, healthy diets, and self-care, can help improve and maintain a positive mental state.

Isolation

Various factors can contribute to individuals becoming isolated from friends and loved ones. Studies show that engaging with others and utilizing a support system can be a significantly positive factor in addiction recovery, whereas isolating from others can be particularly triggering.

What to do when isolation occurs

Isolation can occur due to several emotional, psychological, and behavioral factors. To avoid or manage isolation and prevent potential relapse, the following may be helpful:

  • Practice self-care and healthy habits to help regulate emotions and reduce the likelihood of negative emotions contributing to isolation.
  • Attend meetings, particularly if this is the main support system in your life. These groups, such as Narcotics Anonymous and Alcoholics Anonymous, can provide support, accountability, advice, and community to those in recovery.
  • Practice coping strategies learned in therapy to help prevent negative thought patterns and ruminations that lead to isolation from others.
  • Join local groups to engage in activities with others in your area. This can help you feel a sense of community, find new hobbies to enjoy, and incorporate new routines and goals into your life.

Celebrations

It is not just negative thoughts and feelings that contribute to relapse triggers. Celebrations and positive occurrences, such as weddings, birthday parties, and work successes, can also be triggering. This can be an important trigger to be aware of as it may arise unexpectedly, even when things are going well within your recovery progress.

What to do when celebrations occur

Avoiding celebratory occasions may not be as easy as avoiding other environmental triggers, as these can be enjoyable events with important social aspects. Creating a plan before attending a celebration may be useful to help you manage any cravings that emerge, such as:

  • Setting sensible and manageable limitations for yourself, such as a set time to leave the event or a limit to the amount of time you converse with someone who is using substances.
  • Having an alternative to the substance, such as non-alcoholic beverages, to help you feel as though you are not the odd one out.
  • Finding out if the event is taking place somewhere that will be too tempting or triggering for you, realistically considering if you will be able to manage this situation.
  • Having a list of techniques and coping strategies with you that you can refer to if you feel triggered during the event, such as breathing exercises, meditation, or going for a brief walk alone.

Identifying your personal triggers

The triggers listed above might not apply to everyone and could vary depending on individual circumstances. Learning your own specific triggers can be important in relapse prevention planning and can help you manage cravings and triggers when they occur.

It can be helpful to keep a journal with the following details:

  • Record the trigger you experienced. As you notice a desire to use substances, analyze and consider the external situation you were in when the desire kicked in.
  • Thoughts and emotions. Reflect on the underlying circumstances and the thoughts and emotions that came about. You may also write down unhelpful patterns that you recognized.
  • Coping strategies. Write down helpful coping strategies you used or plan on using should you be confronted with a similar situation.

For example, did you see a previous drinking buddy and it made you crave alcohol? It might be helpful to reflect and record if it reminded you of a more laid-back and seemingly fun time, while also remembering your reasons for pursuing recovery. Considering the situation that preceded the craving can help you identify the specific aspects of the circumstance that caused it.

Managing triggers: Relapse prevention plan

During treatment and throughout the recovery process, it can be helpful to write a relapse prevention plan that you can refer to and utilize during challenging moments. This can help you manage triggers and cravings when they arise and help prevent potential relapse. Relapse prevention plans might include strategies such as:

  • Talking to friends or family about your cravings
  • Talking to a sponsor or attending a meeting
  • Utilizing mindfulness exercises
  • Engaging in physical exercise
  • Spending time with friends who are positive influences in your recovery
  • Referring to your list of coping strategies and implementing these techniques
  • Using the acronym HALT (hungry, angry, lonely, tired) to check in with yourself and consider if any aspects of self-care are being neglected and should be improved

Continuing support in recovery

Addiction recovery is often a long process that requires consistent vigilance and awareness. Throughout this process, triggers, cravings, and relapse are likely to occur. However, gaining the skills to recognize and cope with these occurrences, along with utilizing a strong support system, can significantly improve recovery chances.

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Resources:

  1. National Institute on Drug Abuse. (2020). Treatment and Recovery. NIDA. Retrieved from
  2. Menon, J., & Kandasamy, A. (2018). Relapse Prevention. Indian Journal of Psychiatry, 60(Suppl 4), S473–S478. Retrieved from
  3. Melemis, S.M. (2023). Relapse and Relapse Prevention. In: Cooper, D.B. (eds) Alcohol Use: Assessment, Withdrawal Management, Treatment and Therapy. Springer, Cham. Retrieved from
  4. Melemis, S.M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332. Retrieved from
  5. Fernández-Montalvo, J., Lópezgoñi, J.J., Illescas, C., Landa, N., & Lorea, I. (2007). Relapse Precipitants in Addictions: Results in a Therapeutic Community. Journal of Addictive Diseases, 26(4), 55–61. Retrieved from
  6. Sinha, R. (2001). How Does Stress Increase Risk of Drug Abuse and Relapse? Psychopharmacology, 158, 343–359. Retrieved from
  7. Linke, S.E., & Ussher, M. (2014). Exercise-Based Treatments for Substance Use Disorders: Evidence, Theory, and Practicality. The American Journal of Drug and Alcohol Abuse, 41(1), 7–15. Retrieved from
  8. Atadokht, A., Hajloo, N., Karimi, M., & Narimani, M. (2015). The Role of Family Expressed Emotion and Perceived Social Support in Predicting Addiction Relapse. International Journal of High Risk Behaviors and Addiction, 4(1), e21250. Retrieved from
  9. Guenzel, N., & McChargue, D. (Updated 2023). Addiction Relapse Prevention. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from

Activity History - Last updated: 05 November 2024, Published date:


Reviewer

David is a seasoned Pharmacist, natural medicines expert, medical reviewer, and pastor. Earning his Doctorate from the Medical University of South Carolina, David received clinical training at several major hospital systems and has worked for various pharmacy chains over the years. His focus and passion has always been taking care of his patients by getting accurate information and thorough education to those who need it most. His motto: "Good Information = Good Outcomes".

Activity History - Medically Reviewed on 31 July 2024 and last checked on 05 November 2024

Medically reviewed by
Dr. David Miles

Dr. David Miles

PharmD

Reviewer

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