The 3 Stages of Relapse in Addiction
The stages of relapse in addiction indicate the many signs that lead to eventual substance use. Read on to learn about what these signs are and how you can prevent relapse.
Addiction relapse happens.
The 3 stages of relapse are made up of the emotional and mental struggles we face that eventually lead to physical substance use.
Spotting the signs of addiction relapse in yourself or someone you love can help to stop it from happening, and could very well save a life.
What is a relapse in addiction?
A relapse in addiction is defined as the continuation of substance use after a period of discontinuation.
It can occur at any point in time following a period of sobriety.
Many people believe that relapse begins upon substance use, but that isn’t actually the case.
Addiction researchers Dr. Steven M. Melemis and Terence Gorski first identified the various stages of relapse in addiction, which occur before actual substance use.
Relapse isn’t one single, isolated event, but rather an entire process of its own.
This is why it’s so important to know about the relapse before it happens.
The relapse before the relapse
The relapse before the relapse refers to the mental and emotional stages that occur before drug or alcohol use begins again. These stages can also apply to a person with a process addiction such as sex or gambling.
If you have been struggling with addiction, it’s often because of a mental, emotional, or spiritual void that you are perhaps trying to fill.
It could also be because of trouble with regulating emotions, or difficulties in processing a prior trauma or traumas.
There are many factors that contribute to substance use, so naturally, these factors would also contribute to a relapse.
After all, just because the substance abuse has ceased, doesn’t mean that the pain which caused the initial use has gone away as well.
By becoming aware of the emotional and mental stages of relapse that lead to physical relapse, you can become better equipped in preventing relapse.
Understanding what causes you, specifically, to relapse can also help you to learn more about your triggers and anything lurking deep within that still needs healing.
Additionally, understanding the stages of relapse can lead you towards what you need specifically out of treatment, by highlighting your own triggers. For instance, if you find that stress is what triggers the want to use, you can then focus on learning how to better manage stress.
Stages of Relapse: Stage 1 - The emotional relapse
The first stage of relapse is emotional relapse. During this stage, the person isn’t thinking about using drugs or alcohol. They are proud of their sobriety and they don’t want to use substances again.
However, they may not be working through their emotions. Experiencing an emotional buildup can later lead to physical relapse or substance use.
People who are in this stage of relapse may also experience denial since they aren’t thinking about using. Because they aren’t thinking about using, they aren’t willing to admit to themselves that they are indeed struggling emotionally.
There are many signs that indicate someone might be going through an emotional relapse.
The signs of emotional relapse are:
- isolating from others
- bottling up or suppressing emotions
- projecting (focusing on other peoples’ problems or how other peoples’ problems affect them)
- skipping meetings
- attending meetings but not being present or sharing what is going on for them
- lack of self-care
- not asking for help
- being short-tempered with others
- disordered sleeping and eating habits
Fear of judgment, ridicule, and feeling weak can cause this stage of relapse to progress into mental relapse if help isn’t sought.
Many people feel that struggling with their emotions is a bad thing, or they will be viewed as weak for admitting they are struggling.
The truth is, all of our emotions are a part of us -the good emotions and the difficult ones. We all go through them, and talking about them can help lessen their impact and sometimes, can even diffuse them.
Being willing to face your emotions will be one of your greatest strengths and assets if you allow it to be.
What to do if you’re in emotional relapse
Fortunately, there are many things you can do to get out of this stage of relapse.
Allow yourself to be honest with yourself about how you’re feeling.
Become aware of what’s really going on beneath the surface.
A great way to do this is by writing it out. Oftentimes, our thoughts can become so cluttered in our minds that trying to access emotions can feel so foggy.
Writing it out allows us to put everything in front of us on paper.
Some journal prompts to use can be:
- How do I really feel at this moment?
- Have I been gracious and kind to myself?
- How have I been factoring fun into my life?
Another wonderful option would be to talk about what’s going on with a therapist, counsellor, or trusted friend.
If you’re seeing a counsellor or therapist, share with them honestly how you've been feeling, and express your need for improved self-care. They will be able to help guide you towards the type of self-care that may be most beneficial for you.
If you aren’t seeing a counsellor or therapist, check in with yourself regarding whether you’ve been practising self-care. Self-care looks different for everyone and is based on your own needs and what makes you feel good.
For some, self-care can be as foundational as sleeping enough, eating well, and practising proper hygiene. For others, self-care is more about taking care of oneself emotionally.
Using the acronym HALT is an easy reminder to let you know if your self-care has been slipping. HALT stands for hungry, angry, lonely, and tired. Experiencing one of these is an indicator to practice self-care.
Emotional relapse toolbox:
- Practising self-care
- Talking to a friend or peer
- Making time for extra sleep
- Eating well
- Engaging in a hobby
- Exercising or staying active
- Speaking honestly with your therapist or counsellor
- Spending time in nature
- Writing in a journal
- Volunteering or giving back to others in some way
- Attending a meeting or group therapy session (in-person or virtual)
- Practising stress-reduction techniques like meditating or painting
- Watching a movie or television show you love
Stages of Relapse: Stage 2 - The mental relapse
The second stage in the stages of relapse is mental relapse. This happens when the emotions from stage one aren’t addressed or worked through, resulting in mental warfare.
At this point, a person is torn between wanting to use and refraining from use. They may feel guilty for considering using, but they keep justifying ways to use within their mind.
The farther down this mental spiral a person goes, the more their resistance to using again decreases. In conjunction with this, the more their desire for escape increases.
The signs of mental relapse are:
- craving substances again
- glamorising past use (euphoric recall)
- thinking about people, places, and things that were associated with past use
- minimising the consequences of past use
- convincing oneself that they can use it again and simply “control” it better this time
- looking for opportunities to relapse
- planning to use again
In this stage of relapse, a person is at high risk of using again. However, they may not realise they are high-risk.
Additionally, a person in this stage of relapse may also put themselves in high-risk situations, as they are looking for opportunities to relapse.
In regards to bargaining, someone in this stage of relapse may conduct an internal bargain in their mind. They may tell themselves that it’s okay to use on special holidays, or only on the weekend. Likewise, they may also end up replacing one substance for another.
It’s important to keep in mind that brief, fleeting thoughts of using are completely normal in recovery. This is different from the downward spiral of mental relapse.
What to do if you’re in mental relapse
If you’re in this stage of relapse and thinking about using, it’s so important to get help from a sponsor, a professional, or even a trusted friend.
Many people who get to the mental relapse stage experience shame for having thoughts of using, and feel like a failure in recovery and in life.
Getting to this stage of relapse and not seeking outside help is the reason people progress to the physical relapse, and start using again.
Remember that expressing the thoughts you’re having, even if you’re not proud of them, is integral to your recovery. It is not a weakness, but rather a massive strength, to be able to share what’s really going on within you.
Dropping in on a meeting, calling your treatment centre, or finding a therapist or counsellor whilst in this stage of relapse can make the difference between staying clean or falling back into the cycle of using.
Mental relapse toolbox:
- CBT therapy
- Attend a meeting and sharing
- Play the tape forwards
- Wait for 30 minutes (try doing something to distract yourself, as most urges typically last 15 - 30 minutes)
- Take your sobriety one day at a time, only focusing on the day ahead of you so you don’t feel overwhelmed
- Integrate relaxation techniques throughout your day
- Talk to a trusted friend or peer
- Lean on any healthy coping skills you’ve developed thus far
Stages of Relapse: Stage 3 - The physical relapse
The third stage of addiction relapse is physical relapse. This is when a person uses again or engages in addictive behaviour.
After reading through the previous two stages, it can be easy to see how the physical relapse becomes nearly inevitable when we aren't paying attention to our emotions and thoughts.
Some researchers divide the physical relapse stage into two different categories: the lapse and the relapse. The lapse is when the initial drug or drink is consumed. The relapse is when the behaviour becomes uncontrollable and obsessive again.
Understanding the full scope of relapse prevention means knowing that it isn’t just about saying no when presented with an opportunity to use.
Rather, it’s about being mindful of what your external triggers are, and being vigilant about your thoughts and emotions, and any shifts you may be experiencing within them.
It’s also about being vulnerable with yourself, and fully transparent about what you’re really feeling and thinking.
What to do if you’re in physical relapse
If you’ve reached this stage, it’s important to know that you can still experience recovery and you are not a failure.
Relapse happens, and it’s important to learn from it rather than beat ourselves up even more because of it.
If you’re in physical relapse, the first thing you need to do is get help.
By telling yourself it was a one-time thing or continuing to justify it in your mind, the bargaining from the previous stage will continue to run the show until life becomes out of control again.
Getting help will allow you to step outside yourself, get perspective, and cease use.
Once you’re stable and not using, you can then reflect on what happened.
What led to the relapse? Take yourself through the stages and try to understand what took place for you emotionally, and then mentally.
Understanding this will give you a deeper insight into your own triggers. It’ll give you a deeper insight into your self-care and your stress management.
Use the relapse as an opportunity to grow and gain insight. This will only benefit you as you continue along your recovery journey.
How to avoid an addiction relapse
You may now have a deeper understanding of how relapse is a process and not a single, random, isolated event.
Using substances again can be prevented by paying attention to whether you may be in one of the earlier stages of relapse, either mentally or emotionally.
Particularly, pay attention to how you are really feeling. The state of our emotions is the catalyst for our journey through the stages of relapse.
Know that you’re human, you’re not going to feel great all the time, and that is okay.
Accepting difficult emotions as they are, without placing judgment on yourself for feeling them or living in denial about having them, will serve as a huge asset in recovery and in life.
You’re not weak, wrong, or failing for experiencing emotional struggles.
When you’re in this place, be sure to use your coping skills and practise self-care.
Communicate with people who care about you, as getting things off your chest can sometimes lift the burden of bearing that weight alone.
Additionally, know that opportunities for using again will always present themselves. It’s important for you to be prepared for how you’re going to handle these moments. Play them out in your mind so you know how to handle them when you're faced with them.
A final note on the stages of addiction relapse
Relapse happens, but it doesn’t have to.
If you or someone you love is struggling please reach out to a doctor, therapist, or counsellor.
Recoverlution is always here to offer non-judgmental support, guidance, and resources. Connect with other members of our Community and share your worries. We offer a way out of relapse so that it does not have to be how your story ends.
Author - Thurga
- Preventing relapse of a mental illness https://www.heretohelp.bc.ca/infosheet/preventing-relapse-of-a-mental-illness
- Understanding and preventing relapse https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.323.310&rep=rep1&type=pdf
- Relapse prevention and the 5 rules of recovery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
- What’s the Difference Between a Slip or Lapse and a Relapse?: https://drugfree.org/article/whats-difference-slip-lapse-relapse/
- Relapse. (2022, October 1). In Wikipedia.https://en.wikipedia.org/wiki/Relapse