Recognizing Relapse Warning Signs in Others

Naomi Carr
Dr. David Miles
Written by Naomi Carr on 02 August 2024
Medically reviewed by Dr. David Miles on 23 October 2024

Relapse is common in addiction recovery and can occur several times during this process. Friends and family of the individual may be able to notice warning signs that relapse could be imminent and may be able to implement early support to avoid this. Below are some tips on how to support a loved one who may be experiencing a relapse.

Key takeaways:
  • Common relapse warning signs include changes in mood and behavior, becoming secretive or impulsive, and declining self-care.
  • Supporting someone before, during, and after relapse can include having positive and encouraging conversations, prompting them to seek or return to treatment, and offering to attend meetings or treatment sessions with them.
  • Many treatment options are available for people going through an addiction recovery process, including support groups, therapy, and rehab facilities.
woman in light brown sweater looking over at a man in a brown hoodie worried over whether he has relapsed into addiction once again

Warning signs of a relapse

You may be able to spot some warning signs in a loved one who is potentially heading towards a relapse. Being aware of these signs can help you implement extra support strategies early to help them avoid relapse.

These signs might include negative beliefs about their sobriety process, negative attitudes toward life, changes in emotions, and changes in behaviors.

Changes in beliefs about sobriety

A relapse might be preceded by changes in the individual’s thoughts and beliefs about their sobriety process. This could include:

  • Becoming overconfident and stating that they have overcome their addiction. This might result in them feeling that they no longer need to continue their treatment or put work into their sobriety process.
  • Feeling nervous or stressed about their ability to remain sober. They might repeatedly mention that they don’t believe they can stay abstinent, that it is too difficult, or that they are not good enough.
  • Feeling that they need to use substances to cope with challenges or distressing circumstances. They might state that they cannot cope without drink or drugs.
  • Thinking about using. They might tell you that they are considering using alcohol or drugs again, even if they don’t want to relapse.
  • Missing meetings, therapy sessions, or not using prevention strategies.

Negative attitude toward life

Negative thought patterns are likely to precede a relapse. The individual might start feeling more negative about their life and achievements, such as:

  • Feeling that they have many problems and are becoming overwhelmed.
  • Focusing on one specific aspect of their life that is not going well.
  • Feeling as though their plans and goals cannot be achieved or never work out.
  • Feeling uncertain or trapped in their life.

Increase in negative emotions

Emotional changes, particularly an increase in negative emotions, are often an early indicator of a potential relapse and can precede thoughts and actions relating to a return to substance use. The following may be signs that a relapse is becoming likely:

  • Sadness and depression
  • Irritability
  • Confusion
  • Ambivalence about the self or life choices
  • Loneliness
  • Anger
  • Self-pity or self-loathing
  • Hopelessness
  • Worthlessness
  • Shame
  • Stress

Changes in behavior and declining self-care

Individuals who may be considering or entering a relapse might display changes in their behaviors that their friends and family can spot. This might include:

  • Acting impulsively or with a decline in care for safety
  • Changes in sleep patterns
  • Poor diet
  • Decline in self-care and hygiene
  • Impaired concentration or focus
  • Lying to loved ones
  • Isolating from others
  • Spending time with people or in places that are associated with their past substance use

What triggers a relapse?

A relapse can be triggered by various circumstances which may vary from person to person. Triggers can include experiencing challenging or distressing situations, emotional difficulties, exposure to substance use, and mental or physical health issues. 

Being able to recognize triggers and implement prevention strategies can help individuals avoid a relapse. This can be easier with support from friends and family, who can help spot early relapse signs and provide consistent reassurance and encouragement.

Relapse is common for many people going through addiction treatment and recovery and can occur several times throughout this process. Some people may be more predisposed to relapse than others, such as those who do not have or utilize a support system, professional treatment, or prevention strategies.

Relapse is common and is not a sign of failure, although it can bring up some challenging emotions for the individual. During and following a relapse, loved ones, group meetings, and professionals can help individuals accept these emotions and learn from their setbacks to improve their relapse prevention plan.

Common relapse triggers to watch out for

This will vary depending on the individual but in many cases, the following are the most common relapse triggers. It can be helpful for loved ones to be aware of these triggers. This way, they can help the individual avoid them or manage their impact when they occur, helping prevent or shorten a relapse and implementing early support and coping strategies.

Common relapse triggers to watch out for include:

  • Being in an environment in which the individual is exposed to people, places, or things that remind them of their past substance use
  • Spending time with people who are using substances and are pressuring the individual to join them
  • Experiencing a stressful circumstance, such as relationship difficulties, financial issues, or work problems
  • New or worsening mental health issues, such as anxiety, depression, or trauma-related conditions
  • New or worsening physical health conditions
  • Becoming isolated from friends and family
  • Celebrations, such as weddings, birthdays, parties, and holidays
  • Withdrawal symptoms

How to support a loved one during a relapse

If you notice signs that your loved one might be at risk of or is experiencing a relapse, they will likely benefit from your support. Support systems composed of family and friends can be crucial factors in managing and recovering from a relapse. The following tips might be helpful when supporting a loved one during and after a relapse.

Early detection support

If you recognize signs of relapse before it occurs or in the early stages, you might be able to help your loved one manage their triggers and prevent a full relapse.

This might include:

  • Encouraging them to use their coping strategies to manage emotional distress
  • Supporting them to improve their self-care, such as diet, sleep, and exercise habits
  • Spending time with them to help them increase their social interactions
  • Help them remove temptations from the home
  • Encourage them to attend meetings or contact their sponsor
  • Regularly engage in open conversations to provide opportunities for them to discuss their triggers or cravings

Short-term support during a relapse

If your loved one has relapsed and has resumed using substances or alcohol, you may be able to support them by:

  • Engaging in non-judgmental and supportive conversations about their use
  • Be encouraging and motivating about their ability to overcome this relapse
  • Reassure them and provide positive information, such as reminding them that relapse is common for people overcoming addiction and can be seen as a positive learning opportunity
  • Give them time to talk about their thoughts and feelings, particularly letting them express their guilt and shame. Acknowledge these emotions and help them understand how to use these feelings to motivate them back to their recovery process.

Relapse recovery support

After relapse, or when your loved one is attempting to return to their recovery process, the following may be helpful:

  • Discuss their prevention plan with them, helping them to recognize aspects that may need altering
  • Be positive about their progress and help them believe in their ability to return to abstinence
  • Remind them of the importance of attending meetings, therapy, and other treatments
  • Continue to spend time with them and engage in enjoyable activities
  • Continue to engage in open conversations about recovery and how to avoid relapse
Emergency support: In case of overdose during relapse
  • Call 911 for emergency medical attention
  • Stay with them until help arrives
  • Administer naloxone in the event of opioid overdose, if they have an accessible injection or nasal spray

How does treatment help in reducing the risk of relapse?

Someone experiencing a relapse may find it difficult to admit that they have relapsed or need help returning to treatment. Gently encouraging them to seek and utilize treatment can be an important step and remind them that they are not alone.

Recovered offers a directory of treatment options that may be helpful in addiction treatment and relapse prevention.

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Resources:

  1. Bennett, G.A., Withers, J., Thomas, P.W., Higgins, D.S., Bailey, J., Parry, L., & Davies, E. (2005). Addictive Behaviors, 30(6), 1111-1124. Retrieved from
  2. Miller, W.R. & Harris, R.J. (2000). A Simple Scale of Gorski's Warning Signs for Relapse. Journal of Studies on Alcohol, 61, 759 – 765. Retrieved from
  3. 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
  4. Guenzel, N., & McChargue, D. (Updated 2023) Addiction Relapse Prevention. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from
  5. Alcohol and Drug Foundation. (Updated 2024). Relapse. ADF. Retrieved from
  6. Albuquerque, N. (Reviewed 2023). Alcohol Relapse Prevention. UK Addiction Treatment Centres. Retrieved from
  7. We Are With You. (n.d). What To Do If Someone You Know Relapses. With You. Retrieved from
  8. 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

Activity History - Last updated: 23 October 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 30 July 2024 and last checked on 23 October 2024

Medically reviewed by
Dr. David Miles

Dr. David Miles

PharmD

Reviewer

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