Creator: Sara Schapmann
Published: 2021-06-07T16:59:46+00:00

Alcohol relapse happens — a lot. It can be a normal part of the recovery process, and it doesn’t mean that treatment didn’t work or you’ve failed at sobriety. Addiction is a chronic, relapsing disease that changes the brain in ways that make resisting alcohol and drugs feel nearly impossible in certain situations.

Addiction relapse rates hover around 40 to 60%. This may sound disheartening, but relapse isn’t cause to throw in the towel on recovery. At Footprints to Recovery, we’ve seen countless people recover and learn from relapses, emerging stronger in their sobriety.

What Are Signs of Alcohol Relapse?

You may think of alcohol or drug relapse as something that happens out of the blue, but often there are signs of relapse well before it happens. People in recovery and their loved ones should be aware of certain behaviors and warning signs. Substance abuse experts have identified three common stages of relapse: emotional relapse, mental relapse, and physical relapse.

Phase 1: Emotional Relapse

This is the earliest sign of addiction relapse. During an emotional relapse you haven’t begun thinking about substance abuse as an option, but you’re experiencing difficulties that can put you at risk for relapse. For example, you’re under a lot of stress, going through relationship problems, or you’re just feeling down and unmotivated to go to recovery support groups, keep up with self-care, and follow other healthy practices. This puts you at risk for relapse because you likely dealt with these uncomfortable feelings by drinking alcohol in the past.

Some alcohol relapse signs during this stage include:

Isolating – You’re avoiding friends and family, not responding to texts and calls, and skirting social activities. You haven’t been attending Alcoholics Anonymous or SMART Recovery groups regularly, or at all, and you might be canceling therapy appointments. Isolation is a proven relapse risk factor, so look out for it.
Poor self-care – You’ve been slacking on the things you know keep you well and feeling stronger in sobriety. This might include neglecting nutrition and exercise as well as not getting enough sleep or foregoing activities that fulfill you.
Mood changes – Co-occurring disorders put you at higher risk for addiction relapse. If you’re not managing mental illness symptoms with therapy, medication, and healthy practices, you may feel an urge to self-medicate with alcohol. Similarly, feelings of irritability, low mood, and discontent that often accompany early sobriety can trigger a relapse as well.

Phase 2: Mental Relapse

If you don’t get help during emotional relapse, it could progress to mental relapse. During a mental relapse on alcohol, you’re not using it, but it might preoccupy your thoughts. You’re thinking about how good it would feel to relieve difficult emotions, boredom, or stress with a drink. At first, you might try convincing yourself you wouldn’t actually do it, but toward the end of a mental relapse, substance abuse becomes almost inevitable.

Some alcohol relapse signs during this stage include:

Feeling nostalgic for alcohol – You have on rose-colored glasses when you remember days from active alcohol addiction. You only focus on the good times and gloss over all the heartache and misery alcohol abuse brought.
Hanging out with old friends – Seeing old drinking friends or going by places where you used to drink is pretty much throwing down the gauntlet at addiction recovery. You’re well aware of this if you’ve been to alcohol rehab or any recovery support group.
Overconfidence in your addiction recovery – During a mental relapse you can become confident in your ability to drink in moderation. You start telling yourself things like, “Just one or two drinks won’t hurt. I can handle it.” This is where you need to remember that addiction is a disease and there’s no such thing as just a little alcohol or drugs when you’ve had a substance use disorder.
Developing substitute addictions – The underlying issues behind compulsive behaviors are similar. Eating disorders, drug and alcohol abuse, compulsive gambling, and other destructive behaviors are all ways of self-medicating emotional pain and other issues. In a mental relapse you might “trade in” one addiction for another or move to another substance because you convince yourself it’s not as bad (i.e., marijuana).
Cravings – Over time, addiction affects brain health, rewiring the reward system so that it develops strong associations between the people, places, and situations you associate with alcohol abuse, even triggering cravings. If you’re in a mental relapse, you’re probably not going out of your way to avoid these triggers, putting yourself at risk for cravings and urges.
Planning a relapse – When you’re on the brink of an alcohol relapse, you might be planning how it will all happen. This could mean mapping out where you will go, who you will be with, how much you will drink, and when you will do it. This is your last chance to prevent relapse before it happens. Call your sponsor, tell a loved one, or return to an alcohol treatment program.

Phase 3: Physical Relapse

A physical relapse is the point where you’re drinking again. Some recovery communities like SMART Recovery, distinguish between a slip and relapse. A slip is usually a one-time event where you immediately feel regret and want to get back on track right away. A relapse is a longer, more intentional return to alcohol abuse. You start falling back into your old patterns and lifestyle with no plans to quit drinking anytime soon.

What Causes an Alcohol Relapse?

Relapse occurs for many reasons. Many people in recovery believe the first year of sobriety is when you’re most at risk for relapse, but relapse also happens to people with years of sobriety under their belts. Some of the factors that can lead to relapse include:

#1 The Nature of Alcohol Addiction

Addiction is a chronic disease and just like other chronic diseases, there is always a risk for relapse. Repeated alcohol abuse rewires the brain. The reward center tells your brain and body that you need alcohol to survive. Under these conditions, it is extremely hard to resist urges and cravings to drink.

#2 Addiction Triggers

The associations your brain makes with people, places, feelings, and situations tied to alcohol use are strong. You can’t just talk yourself out of drinking when you run into these triggers. It takes a lot of time and work in recovery and sometimes medications to retrain your brain’s reward center.

#3 Alcohol Withdrawal

Physical alcohol withdrawal symptoms usually dissipate within days or weeks, but psychological symptoms can linger for several months. This is known as post-acute withdrawal symptoms, or PAWS. Post-acute withdrawal happens because it takes time for the central nervous system to rebalance itself after repeated alcohol abuse. During PAWS you may experience:

Anxiety
Irritability and agitation
Depression
Insomnia
Confusion
Memory problems

The psychological discomfort during PAWS may tempt you to cope with alcohol.

#4 Lack of Support

Recovery is not a solo sport. A network of peers in recovery, loved ones, and behavioral health professionals are critical to long-term sobriety. If you’re isolated and don’t believe you have people invested in you and your recovery, you’re more vulnerable for relapse. Components of support for long-term recovery include:

Supportive relationships with loved ones.
Recovery groups like SMART Recovery or 12-step-based Alcoholics Anonymous.
Continued care like individual therapy, group therapy, family therapy, and psychiatry appointments for medication management.
Involvement in alumni programs from the alcohol rehab you attended.

#5 Co-Occurring Mental Health Disorders

People with co-occurring mental health disorders are at higher risk for alcohol relapse. Untreated or undertreated mental illness symptoms are one of the underlying issues that can lead to substance abuse in the first place. Common co-occurring disorders with drug and alcohol abuse include:

Depression
Anxiety
Bipolar disorder
Personality disorders

If symptoms from these mental health symptoms flare up, you could be tempted to self-medicate with alcohol like you did in the past.

#6 Poor Self-Care

Poor self-care like lack of sleep, unhealthy eating, and not enough movement and exercise can play a role in alcohol relapse. Letting other healthy self-care practices fall by the wayside can put you at risk too. This could include neglecting things like spiritual needs, mindfulness, therapy, taking prescribed medications, and participating in activities you enjoy. When you ignore the things that keep you feeling well, you may lack the energy and motivation to resist triggers.

#7 Boredom and Isolation

Addiction recovery can feel lonely sometimes. You have likely cut out former friends and places from your drinking days. It takes a while to build a new circle of friends and hobbies. You also probably focused most of your time and energy on alcohol. Even though it was a destructive behavior, there’s a void without it. Research shows that loneliness and boredom put people at high risk of relapse, so pay attention to these relapse warning signs.

Getting Help When You’ve Relapsed

A relapse is not a failure, it’s a chance to learn and move forward in sobriety — stronger and with a greater understanding of yourself and your triggers. What happens next depends on the severity of your relapse, your support system, and you. Returning to some form of addiction treatment may be necessary. Outpatient rehab can give you the support you need to get back on track. If your relapse has been going on for quite some time, alcohol detox and time at an inpatient rehab center may be necessary to provide the structure and space from triggers that you need to gain footing in recovery again.

If you or a loved one is struggling, we can help. Footprints to Recovery provides evidence-based addiction treatment that addresses underlying issues like trauma and mental health disorders that fuel substance abuse. We help clients learn the healthy coping skills to face challenges in recovery and create comprehensive relapse prevention plans that support long-term recovery. With several types of treatment and levels of care, we meet you wherever you are in recovery. Contact us today for a free, confidential consultation.

Sara Schapmann

Sara has over a decade of experience writing about behavioral health and addiction. She earned a bachelor’s degree in psychology from The University of Illinois and has written for organizations such as Elements Behavioral Health, LIVESTRONG, The Chicago School of Professional Psychology, and Everyday Health. As someone who has seen loved ones struggle with addiction, Sara is passionate about writing content that may help others find their way to recovery. Learn More

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Medically Reviewed by Laurie Woodard, MA, LAC, LPC

Alcohol Relapse: Why Does It Happen and What Are the Signs?