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Relapse is as common to the world of substance abuse treatment as injury is to the world of professional sports. In fact, some experts estimate that up to 95 percent of people in recovery experience at least one relapse prior to achieving long-term sobriety. Unlike the arena of professional sports, however, where preparation and experience go a long way toward preventing disaster, addiction afflicts the mind and body in insidious ways, making the journey of those caught in its grips even more difficult and holding their lives in a delicate balance.

Many people erroneously assume that a relapse begins whenever someone in recovery drinks or uses. Although this assumption describes relapse in simple, technical terms—relapse is usually a slower, more gradual process that begins long before this occurs. Like addiction itself—relapse progresses in stages—and recognizing the warning signs is a critical aspect of prevention.

What is known as an “emotional relapse” is a common precursor to actual relapse and one that frequently catches people by surprise. Those experiencing an emotional relapse may not be consciously thinking of using and appear outwardly committed to recovery. Mentally, they may even be fully committed to the idea of sobriety and hopeful about their chances. However, their underlying emotions are negative, chaotic, or out-of-touch and primed to be triggered. The following are classic examples of emotional relapse signs—all of which mirror symptoms of post-acute withdrawal syndrome (PAWS):

• Anger
• Depression
• Anxiety
• Isolation
• Skipping AA or NA meetings
• Not eating or sleeping
• Avoidance
• Mood swings
• Intolerant behavior
• Noticeable changes in attitude

Once someone in recovery becomes aware of these darker, unregulated emotions, it is imperative that they begin changing them or seek appropriate help. Simple self-awareness can be extremely effective in stopping these destructive emotions and habits dead in their tracks and preventing them from wrecking the foundation of sobriety. However, self-awareness requires a certain level of clarity, balance, and perspective, and some people lack the tools necessary to achieve this integrated state. In such cases, seeking the help of a trained professional or trusted friend can be equally effective when it comes to addressing emotional warning signs.

Just as unregulated emotions can easily sabotage recovery, so can unchecked mental habits. Early recovery is an exceptionally difficult period—one characterized by denial of pleasure, self-recrimination, and unstable physiological and psychological processes. For these reasons, many people in recovery are at war inside their own minds as they struggle to adapt. Naturally, they may be conflicted between wanting to use and fear of indulging that desire. This conflictual pattern sets up a mental dichotomy, one that even the strongest, most committed initiates on the path to recovery struggle to manage.  The following are classic signs of a “mental relapse:”

• Fantasizing about past use and thinking of drug or alcohol-based social connections
• Contemplating or actively planning a relapse
• Resorting to toxic mental habits such as denial, minimization, or lying
• Socializing with friends in active addiction
• Avoiding major responsibilities and commitments

For most people, mentally entertaining thoughts of use virtually guarantees a relapse. Granted, everyone in recovery faces the heavy burden of unwanted thoughts and memories of active addiction. But this does not mean that they have to be habitually entertained. It is entirely possible to allow these thoughts to spontaneously arise, quickly process them, and re-focus on sobriety. Every person who has successfully overcome active addiction has perfected this process, many with the help of family, friends, therapists and a strong network of sober support, and some through sheer dedication and willpower. 

In recovery, it is completely normal and healthy to take “two steps forward and one step back.” No one is perfect, and there is no such thing as an easy path to sobriety. By being aware of these emotional and mental triggers, you can better prepare for the challenges ahead and, in time, become one of the 85 percent of people who remain sober after just five years of abstinence.