Relapsing in Recovery

“I knew I had to change my life. But addiction is a f****** tricky thing. I think I relapsed within…three weeks? And within a month it had ramped right back to where it was before. That’s what really freaked me out. That’s when I knew: I ever get help, or I am going to die.”

~ Eminem

Relapsing is a real worry for many former users. American rapper and songwriter, Eminem, is certainly no stranger to it. It is something that can have serious consequences; including even death from an overdose. Sadly, most people do not stop to consider the risks when they go back to using. In Eminem’s case, relapsing gave him a renewed sense of motivation to get clean. Fortunately, he had that opportunity. But others are not so lucky.

The reality is that relapses are both common and dangerous. Many people are actually nervous about going to treatment because they fear relapsing. While it is a concern, it should never stand in the way of someone going to rehab or trying to get clean.

Relapses happen often, but that does not mean they happen to everyone. Knowing as much about it as possible is the best way to be prepared. This is true for the recovering addict as well as for their family.

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What is a Relapse?

A relapse is an act of backsliding or worsening after a period of improvement according to the Merriam Webster Dictionary. The definition also mentions a recurrence of symptoms, which someone who relapses with drugs or alcohol experiences.

For someone who is a former alcoholic or drug addict, it means going back to substance abuse after a period of sobriety. It can and often does happen very quickly. But there are also times when people can relapse years after committing to a life of staying clean.

There is a common misconception about relapsing, and that is that it means that the former addict has failed. This is not the case at all. Addiction is defined as a “relapsing disease” according to The American Society of Addiction Medicine. That means that it is extremely common, and often a part of the healing process.

In other words, a relapse is using again, not using forever. Someone who has relapsed simply needs more help.

Of course, the best approach to recovering is to never go through a relapse at all. There are ways to avoid it and prevent it, as we will discuss below.

What is it that makes relapsing so common for recovering alcoholics and drug addicts? The answer lies in knowing that addiction is a disease, as we mentioned earlier. Because it is a disease, it needs consistent treatment, based on the person’s individual needs.

Drug and alcohol addiction share many of the characteristics of other types of diseases. Some examples include:

  • Physically changing some part of the body (addiction drastically changes the brain).
  • Being inescapable – Being a reality rather than a choice.
  • Carrying the possibility of a relapse, even when responding well to treatment.
  • Causing pain, dysfunction, social problems or even death.
  • Inflicting mental pain and anguish.

In many ways, addiction is similar to other diseases. Take cancer, for instance. When someone has cancer, there is always a risk of relapsing; regardless of how successful treatment is. It is in the very nature of the disease. The same is true for addiction. In fact, there are more people in the United States who suffer from addiction than from heart disease, diabetes or cancer.

The reality is that the world views other types of diseases differently than it views addictions. It seems as though because so many more Americans are impacted by substance abuse, public opinion should be more treatment-minded. Relapse is a possibility with all diseases, and they all need proper treatment to reduce the risks.  

The Odds of Relapsing After Sobriety

What are Relapse Triggers?

relapse trigger is something that brings about the urge to use drugs or alcohol. It typically refers to anything that is associated with the substance abuse pattern for that particular individual. There are many triggers that are considered to be common, and some that may only apply to certain people.

Understanding what triggers a relapse is the very first step in preventing it. That is why this is such an important part of the recovery process. Avoiding them at all costs is vital to maintaining sobriety; at least until enough time has gone by. And the amount of time it may take before triggers become a worry of the past will vary from person to person.

There are several triggers that are generally quite common for most people. They are:

  • Stress – One of the reasons so many people use drugs or alcohol is because it helps them to cope with stress. Once they have recovered, returning to their daily lives undoubtedly brings about more stress. That, in turn, causes them to consider using, and many people relapse at that point.
  • People Connected to the Substance Abuse – There are some people who only use with a certain group of friends. For them, being around those individuals could serve as a trigger.
  • Places Connected to the Substance Abuse – For others, there are various places that are connected to their substance abuse activities. Some people only use at a friend’s house, or they may even only use in their bedrooms. Avoiding these places – at least for a little while – is highly recommended to avoid a relapse.
  • Difficult Emotions – Daily life is full of negative emotions. For so many people, alcohol and/or drugs is how they cope with them. It is important for people to find new coping strategies to deal with this trigger effectively.
  • Sensing or Seeing the Object of the Addiction – This happens frequently, and it is what causes many recovering addicts to go back to using. We see it most often when people have stopped smoking, drinking alcohol and smoking marijuana. Any type of exposure to the substance at all brings back all kinds of memories of when the individual was a user.
  • Happy Times or Celebrations – It might be surprising to learn that celebrations can also be a trigger. In general, people tend to feel good when they attend these events. They feel in control, and some may even give in and use because of that feeling. What they do not realize is that they put themselves at risk for a relapse.

Having a co-occurring disorder also puts people at risk for being triggered into a relapse. This term refers to a mental health condition that often causes an addiction. People will use as a way to cope with their symptoms; and many do so without realizing it.

Getting treated for a co-occurring disorder is very important, and this should be done via dual diagnosis treatment. Otherwise, that particular trigger will remain, and it will almost always end in a relapse.

Drug and Alcohol Relapse Facts and Statistics in the U.S.

It is surprising to see the statistics surrounding relapses in the United States. Research shows that:

  • 27 million Americans over the age of 12 used illicit drugs in 2014.
  • During that same year, 16.3 million Americans were considered to be heavy alcohol users.
  • Only one-third of people who have been abstinent from drugs or alcohol for less than a year will not relapse.
  • Among people who have been abstinent for at least one year, half of them will relapse.
  • Among people who have been abstinent for at least five years, 15% will relapse.
  • When people complete treatment programs that are shorter than 90 days, only 31% of people successfully reach one year of sobriety.

The longer someone avoids a relapse, the better their chance is of continuing to abstain. This is great news, but it should drive us to find recovery solutions to give people better chances of success.

The chances of someone relapsing after having gotten sober are very high. The National Institute on Drug Abuse reports that between 40-60% of addicts will relapse at some point after recovering. This statistic is often very discouraging, and it makes people wonder what the point of recovering really is. They may think, Why should I get sober if I will just go back to using again and again? It is a great question, but please understand this – sobriety is worth it.

Relapsing does not mean that the person has failed, and it does not mean that treatment is not working. Remember, an addiction is a disease, and relapses are a part of the recovery process, in many cases.

The relapse rates for asthma and hypertension are between 50-70%, which is significantly higher. But those relapse rates do nothing to keep people from seeking the treatment they need. Also, relapsing does not mean that the treatment is not working. It is, but it may need to be changes, resumed or reevaluated.

Just like with hypertension and asthma, the effects of an addiction are much worse than the risk of relapsing. The right treatment can cause symptoms to decrease in intensity and frequency.

What Causes People to Relapse?

We have already mentioned triggers, but there is something else that often causes a relapse to occur. It can happen when withdrawal symptoms have become too much to bear.

Withdrawal symptoms are caused because of the body’s dependence upon a drug or alcohol. The individual becomes used to the presence of the substance. When it is taken away, the body begins to go through the detoxification process, and it can act as though it is in a state of shock. There is so much that can happen, depending on the severity of that dependence.

Common Withdrawal Symptoms

Some of the more common symptoms of withdrawal that people experience include:

  • Intense cravings
  • Flu-like symptoms, such as body aches or a runny nose
  • Headaches
  • Symptoms of anxiety
  • Symptoms of depression
  • Mood swings
  • Anger and irritability
  • Seizures
  • Insomnia
  • Bouts of fatigue
  • Mental confusion
  • Hallucinations or delusions

Of course, withdrawal symptoms can vary, depending on the type of drug being used. But many of the ones on this list apply to almost every substance.

Is Relapsing Dangerous?

It can be very dangerous to relapse back to drug or alcohol use after a period of sobriety. There are actually two main dangers – the risk of starting an addiction cycle, and the increased risk of an overdose. Both of them are unhealthy outcomes, and they can have severe negative consequences. In some cases, that can even include death.

When people first become addicted to a substance – be it drugs or alcohol – their bodies learn to depend on it. This refers to the physical and psychological dependence on the drug that leads to withdrawal when it is stopped.

Once the recovery process begins, the body starts to learn how to live without the substance. This can take quite some time. When someone relapses, they are hindering that process. The relapse itself tells the body that it does need the drug in order to function.

In time, the individual may decide to quit again, but relapsing is only that much easier the next time. The more times the body and brain go through this pattern, the harder it is to get clean. It is not uncommon for people with a long history of relapses to require additional time in treatment for this reason.

This is the cycle of addiction. It is extremely dangerous, and anyone who relapses is at risk for falling into it.

Once an individual first gets addicted to a substance, their body slowly builds a tolerance to it. That means it is getting more and more used to the drug or alcohol. As a result, it needs a larger amount in order to feel the effects.

Getting clean or sober causes the body to go through the detoxification process. Once it does, it is no longer used to the drug. That presents a serious problem when someone relapses.

In most cases, when people relapse, they typically go back to using the same amount they used previously. They are feeling desperate to get high or drunk, and they do not take into consideration that their tolerance has changed. This is exactly how so many people overdose.

An overdose occurs when someone takes excessive or dangerous amounts of a particular drug. This can leave that person either hospitalized or dead.

According to the National Council on Alcoholism and Drug Dependence, Inc., there are many overdose signs. These are particularly important for family members and friends to be aware of. They include:

  • Shallow breathing or no breathing
  • Gurgling sounds, which could mean a partially blocked airway
  • Lips or fingertips that have taken on a bluish tint
  • Becoming unresponsive
  • Becoming disoriented
  • Falling unconscious
  • Losing control of arms and/or legs
  • Seizures
  • Chest pain
  • Bouts of confusion
  • Paranoia with hallucinations and/or delusions
  • Headaches
  • A high body temperature
  • A high blood pressure
  • A high pulse rate

These symptoms will vary, based on the drug the person was taking. If an overdose is suspected, the paramedics need to be called right away. Dial 911. They can often give the victim life-saving treatment right there at the scene. Demi Lovato is an excellent example, and we will discuss her in more detail in a moment. Her life was saved because of the drug, Naloxone, which reversed her opioid overdose.

Steps to Take After a Relapse

Nothing is as disheartening as relapsing after a period of sobriety. People often do not know what to do. Many will return to using because they start to feel as though they just cannot recover. This can be an extremely depressing situation, and it is one that frequently keeps people in chains because of their addictions.

The good news is that there is something that can be done. Taking the right steps after a relapse can change everything about the person’s life. It may also help to keep them from relapsing again in the future.

One of the mistakes people often make is that they keep their relapses to themselves. They may live their lives in fear of being judged if they let others know that they went back to using. That fear has the power to keep them trapped for years.

The fact is that secrecy is often the fuel beneath the fire of drug or alcohol addiction. Not telling anyone will only allow the substance abuse problem to continue. If it is allowed to continue, it will only get worse as time goes on.

One of the best things a recovering addict can do is confide in someone they trust. Talking with a trusted friend or family member and letting them know what happened can be so beneficial. It can help the addict to regain any lost motivation and continue the fight for sobriety long-term.

There are a lot of ways to get help for an addiction. But not all of them are beneficial or even appropriate for everyone. Seeking out the right kind of help can make such a difference in the life of someone who has been through a relapse.

Every situation is different. But in most cases, this involves going through some form of addiction treatment. Depending on the person’s needs, they may need to go through a period of detox in order to help them stop using safely. Afterwards, they should continue on with a high quality alcohol and drug rehabilitation program.

It is not always necessary to start back at square one. For example, everyone who relapses may not need to re-do their time in inpatient treatment. But they do need to talk with a professional to determine what type of help they should be seeking. It may just be that they need to get back into therapy, or that they need to start attending a 12-Step group. As we have said before, every situation and every addiction is different.

Addicted Celebrities and Relapse

Hollywood could be described by some as a Mecca of drug and alcohol relapse. So many celebrities are or have been addicts in recovery. Likewise, many of them have relapsed; some have even done so many times on the path to healing.

As might be expected, there are many success stories. But there are also many tragic stories.

Demi Lovato is a recording artist who has always been open with her fans about her struggle with addiction. She even released a single with the title, “Sober,” and in that song, she revealed that she had relapsed. Approximately one month later, she came close to suffering an overdose that almost took her life.

In addition to battling cocaine addiction, Demi also had dealt with an eating disorder and bipolar disorder. Some sources indicate that her overdose was because of heroin or another opioid drug. But there are no specifics as to what drug it was that she actually overdosed on.

Demi’s recovery was a long and arduous one. She remained in the hospital for a little over a week, and then she was to move on to rehab afterwards. The singer had had six years of sobriety under her belt, which goes to show it can happen to anyone.

Famed actress, Jamie Lee Curtis, held on to a secret addiction to opioid painkillers for years. The star took the drugs for 10 years, and they were only prescribed for her after a minor plastic surgery. She was so addicted that she even stole them from family and friends. They had no idea that she was an addict until 1998; 10 years after the surgery.

Fortunately, once she began attending recovery meetings, Curtis put that life behind her. Since that time, she has never looked back. But her story is certainly a cautionary one.

Jamie Lee Curtis (and anyone else with a similar story) has several risk factors for relapsing. The first one being the fact that she has already been secretive about her addiction. It would be easy to do so again. Second, she was addicted for a very long time.

It appears that great things are happening for her. Curtis reprised her role as Laurie Strode in the latest Halloween movie. She has also become an author, and has the support of her family and friends.

Kelly Osbourne had gone to rehab three times by the time she was 24 years old. She battled an addiction to opioid painkillers. She suffered through many drug relapses, and for a number of different reasons.

The first reason was that the rehab she attended in Malibu, California did not provide her with the right kind of treatment. She was quoted as calling it, “a vacation without a bar.” It was too comfortable, and it felt more like a luxury trip than rehab.

The second occurred because she moved back to Los Angeles, which she believed triggered her relapse. She mentioned using drugs to help her sleep during the day. She also states that she used to throw herself down the stairs in an attempt to injure herself and get prescribed painkillers.

Kelly says she spent a lot of years living a life of darkness. She gave up on everything; even herself. Today, she is finally at peace and she is now beginning to understand what real happiness is.

Country star, Keith Urban actually stopped using because his wife, Nicole Kidman, staged an intervention for him. That was in 2006. He had been in drug rehab twice before that, only to relapse both times.

Prior to meeting her, Keith had gone through some very difficult times. He constantly battled dark thoughts in his mind. He recalls telling himself that he probably was not going to make it until the next day. He did not care, and even said that he would just take an Ambien and then at some point, he would pass.

His new marriage was failing, and that was when his wife stepped in. With her help, and with the right treatment, he was finally able to recover and stay sober.

In an effort to highlight his journey, Eminem named two of his albums, “Relapse” and “Recovery.” The rap artist has been very forthcoming about his battle with substance abuse. He was very honest about his thoughts on rehab. He stated that it was not really for him only because everyone focused on him and not on themselves.

Still, he went, and afterwards he overdosed on drugs and ended up in the hospital. He was sober for two weeks, and then had a second relapse. It was not until he almost overdosed a third time that he got his wakeup call.

At that point, Eminem realized that he needed to take serious steps to get clean. He did, and it has been quite some time since his last use. He learned the hard truth about addiction being a disease. Up until he got sober, he never believed that to be the case. But now, he does.

In 1984, Michael Jackson suffered third-degree burns on his scalp as he was filming a commercial for Pepsi. That day was the day he was began taking opioid painkillers in attempt to control the pain. He would frequently take Percocet, Darvocet and even Demerol. His addictive tendencies and behaviors carried on for years; with even harder drugs being prescribed.

The doctor that had been prescribing Michael his medications had given him a deadly cocktail the night he passed. It included the drug Propofol, which is a surgical anesthetic. It was medication that he frequently used to help him get to sleep.

The loss of Michael Jackson was one that no one will forget. Unlike other celebrities, he lost his life due to a drug overdose. His death does provide us with an important lesson. It is possible to overdose even when not relapsing when too much of a drug has been taken.

How to Avoid a Relapse

The truth is that it is not always possible to avoid a relapse. In some cases, it may be something that is out of the person’s control. For example, genetics can play a role in someone’s susceptibility to relapsing.

But most of the time, a relapse can be avoided. There are several different steps that can be taken to achieve that goal.

The best way to avoid relapsing is to go to alcohol and drug rehab to get help. There are so many people who believe that this is not a necessary step at all. They believe that they have enough willpower to stop using on their own. They may attempt to use a drug detox kit, vitamins, supplements or holistic methods to quit. A large percentage of people will try to quit cold turkey.

What so many celebrities and recovered addicts have learned is that recovering requires support. People need to get help from experts in the field. Their guidance and expertise can make such a difference in the life of someone who wants to avoid relapsing.

During treatment, staff members should work with the addict to come up with a relapse prevention plan. Essentially, this is a very important document in the life of someone in recovery.

A relapse prevention plan outlines all of the potential triggers that could possibly lead to a relapse. Then it details the plan if and when those triggers are encountered. This can be so helpful because it gets addicts to think ahead, which is something they might not necessarily do. Many people have been saved from relapsing and even overdosing because they had a good plan in place.

Contrary to popular belief, addiction treatment is not meant to be a short-term thing. While there are many forms of rehab that do not last a long time, people still need to continue to get support.

This idea is scary for some people because they assume that it means they will be in rehab forever. In most cases, that is not true at all. While there are some people who definitely need long-term treatment, that is not the case for everyone.

A lot of people can benefit from a step-down approach to addiction recovery. For example, they may begin by going to an inpatient treatment program. Once that is finished, they move on to an intensive outpatient program. After that, they will be ready for 12 Step meetings and outpatient therapy.

It may seem tedious, but there is so much to learn in regards to addiction recovery. It is impossible to learn it all in a month or less. Aside from that, the friendships that can be formed in recovery are irreplaceable, and often needed to help people avoid relapsing.

Just as Jamie Lee Curtis stated, keeping an addiction a secret can certainly be done; even if it is challenging. Recovering addicts need to have their own personal support system to rely on. This might mean one or two individuals they can trust to be open and honest with about their substance abuse.

Addicts are often not aware of how loved they are. Most have loved ones who would be more than happy to offer them support. This is frequently an essential part of the recovery process, and it helps people to avoid relapsing.

Types of Drug and Alcohol Treatment

There are several different types of alcohol and drug treatment. As we mentioned earlier, the best way to avoid a relapse is to get professional help. That can be done through a variety of methods.

The first step for most people is to go through drug and alcohol detox. This should be done on an inpatient basis only. There are many programs that offer outpatient detoxification services, but they could possibly be dangerous. It is best to be in an inpatient facility where staff members can closely monitor patients for any potential emergencies.

There are some drugs that actually require detox. Among them are:

Most of the best detox programs will actually combine medical detox with holistic treatments. This tends to produce the best results.

12-Step programs actually are not considered to be professional treatment. They can be offered as a part of many rehab programs, but they are typically led by other addicts in recovery.

Alcoholics Anonymous and Narcotics Anonymous are two of the most well known 12-Step programs. They are held on an outpatient basis and they usually involve weekly meetings. There are some that may meet more often than that.

Usually, these meetings are best reserved for those who have some other type of additional support. For instance, members may also go to outpatient rehab, or they may be working with a therapist. When utilized correctly, they can be extremely effective.

Inpatient treatment is considered among many to be the “gold standard” of care in the addiction treatment industry. There are many people who need this higher level of care, but it is not the right choice for everyone. There may be some who cannot commit to this type of program because of its inflexibility.

Going to an inpatient program requires a 28-day stay that usually also involves detox services. Patients experience many different types of therapy during that time. They meet with a therapist regularly for personal sessions, and they also have group therapy and family therapy.

Inpatient rehab is an excellent way to recover from an addiction. In many cases, it is the right option.

Outpatient rehab is also available, but again, this might not be right for everyone. In fact, unless someone has been through some other form of treatment, they should not choose an OP program.

Usually, most outpatient rehabs only involve regular therapy sessions. Some may offer support group meetings, but they are typically in the minority. This is a form of treatment that is usually saved for people who have first had a higher level of care. For them, it can be very effective.

Intensive outpatient programs, or IOPs, can be extremely effective at treating all kinds of addictions. Participants usually have to go through detox first. But afterwards, they can get the therapy and support they need through the IOP.

There is research to support the notion that IOPs are just as effective as inpatient programs. People appreciate their availability because they are much more flexible, and allow them to live at home.

Finally, residential, or long-term treatment is also available for those with a history of relapsing. These facilities are often called sober living homes because they allow people to stay for quite some time.

While residents are there, they need to comply with the rules, which often include obtaining their own treatment programs.

Northpoint Evergreen Bellevue

The Right Drug and Alcohol Treatment Lowers the Risk of Relapse

A drug or alcohol relapse can be a very scary situation, and it can even become fatal. So many people are unaware of the risks involved when they go back to using. At The Evergreen at Northpoint, we hope that we have done a good job with explaining those risks.

Our goal is to help as many people as we can. That is why our IOP program is among the best in the region. A relapse does not have to happen to everyone who stops using. With the right kind of treatment and support, that risk can be drastically reduced.

Do you still have questions about relapse and recovery? Please contact us.

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