Guest post by Karen Kuhlman, LSW, CADC
Recovery from any kind of addiction often involves relapse. Addiction relapse is common whether it be substance use or process addictions, such as gaming or eating disorders. Relapses occur in almost every course of addiction treatment. According to the National Institute on Drug Abuse (NIDA), 85 percent of individuals relapse within one year of treatment, and two-thirds of individuals return to drug use within weeks of beginning addiction treatment.
That might seem disheartening if you have an addiction or love someone with an addiction. But there is hope – mostly from what we now know about addiction and how that informs treatment today.
Historically, in the 1950s it was thought that addiction was a moral and/or lifestyle failing. By the 1980s, addiction became viewed as a disease that is chronic, progressive, subject to relapse, and treatable. Now there is widespread understanding in the treatment field of addiction recovery services that recovery is not linear nor is it an isolated event. Instead, recovery can be conceptualized as a dynamic, ongoing process. It requires consistent effort, learning opportunities, and resilience. Relapse is normalized as a part of the recovery process.
Recovery and the Change Process
The working definition of addiction recovery according to the Substance Abuse and Mental Health Services Administration (SAMHSA), states that recovery is “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.” It further states that addiction recovery is characterized by “managing setbacks because setbacks are a natural part of life, and resilience becomes a key component of recovery.”
To understand the process of change in addiction recovery, it may be helpful to understand the specific stages of behavioral change. These stages, also known as the transtheoretical model of change, were initially developed during a study on smoking cessation in the early 1970s by Prochaska and DiClemente. This model of change has been widely adopted in the behavioral health sciences and addiction recovery world.
The stages of change are:
- Precontemplation (you are fully engrossed in your addiction and change is not really on your radar)
- Contemplation (you are beginning to think about making a change)
- Preparation (also known as the planning stage of what you will do to accomplish change)
- Action (you seek and obtain support for the change and take the actions necessary for the change)
- Maintenance (you commit to continual management of the change)
It is now recognized that few people work through the model once in a linear fashion, but rather it is normal to bounce back and forth, especially in early recovery.
Related Reading: How to Help Someone with Drug Addiction
Relapse Rates
So why do addicts relapse? Addiction relapse rates differ depending on many factors, including:
- The substance or activity chosen
- The severity of prior use and dependence
- The degree of cognitive or physiological impairment
- Other health concerns
- Trauma history
- Stress and coping strategies
- Availability of support system
- Length and type of treatment
Addiction Relapse Triggers
As you can see, relapse in addiction can happen for a myriad of reasons and is often fueled by both internal and external factors. However, if you boil it down, addiction relapse triggers commonly involve these high-risk situations:
- The internal experience of negative emotional states coupled with a lack of coping and emotional regulation skills
- Interpersonal conflict or an inability to engage
- Social pressure
Addiction Relapse Warning Signs
If you are an addict or if you love an addict, it can be helpful to know that there are three stages of relapse leading up to the actual return to the addictive behavior. These are key in understanding the early warning signs of relapse.
- Emotional relapse: While you are not consciously thinking about using or returning to addictive behavior, you feel the emotional pull of the substance or behavior and, most importantly, do not acknowledge these feelings to yourself or to others.
- Mental relapse: Thinking patterns begin to evolve both consciously and unconsciously which can be predictive of a future relapse. This can show up in behavior, such as not prioritizing daily recovery habits or skipping support group meetings. An example of this can be the wishful thinking that “one time won’t hurt.”
- Physical relapse: You start using again.
Relapse Prevention in Recovery
A good treatment program encompasses a thorough Relapse Prevention Plan (RPP) which is completed during the treatment process. The RPP typically involves an exploration of lifestyle issues and what matters to you, such as how you spend your time and what are important priorities in your life.
This plan also helps you understand your biggest challenges in terms of your triggers and 
warning signs. A good plan also enables you to lessen cravings and urges that are a part of the addiction recovery process and, in turn, can lead to relapse. In essence, the RPP is an individualized roadmap for relapse which leads to long-term recovery success.
So to summarize, the better you can identify your own triggers and warning signs, the better prepared you will be to mitigate some of the more challenging situations along the recovery journey. Most relapses can be associated with three such high-risk situations mentioned above. So be sure your relapse prevention plan addresses those three situations.
Related Reading: Addiction Treatment and Recovery
Addiction Recovery Services
There are several good resources for finding appropriate care for a variety of addictions. Some of these include:
- Substance Abuse and Mental Health Services Administration
- National Institute for the Clinical Application of Behavioral Health
- National Institute on Alcohol Abuse and Alcoholism
- Eating Recovery Center
- Gambling Addiction Resources
- Mental Health
Relapse – often multiple relapses – are a normal part of the recovery process. Relapse is personal, individualized, and can occur at any level of care or stage of treatment. It’s important to remember that recovery is a process and not a destination. As in all of life, you will get knocked down – it is how you get up that lends itself to consistent improvement and lasting recovery results.
Additional Resources
Life Care Wellness is a mental health practice specializing in addiction and trauma treatment, including services for family members. If you are in northern Illinois please reach out to us in our Glen Ellyn, Chicago (Jefferson Park), Sycamore, or Yorkville locations.
Karen Kuhlman is a licensed therapist and addiction specialist at Life Care Wellness. Karen specializes in substance use and process addictions (eating disorders, shopping, gambling, etc.) and firmly believes that the greatest challenges in our lives are also our greatest opportunities for growth and healing.
