Recovery from substance use disorder or behavioral addiction involves significant changes in habits, thinking, and lifestyle. A primary concern during this journey is the possibility of returning to former patterns of use, known as relapse. Relapse is often misunderstood as a sudden failure rather than a complex process that unfolds over time. Understanding what constitutes a relapse—and the factors that lead to it—is paramount for maintaining long-term recovery.
The Precursors to Relapse: Emotional and Mental Stages
Relapse is understood as a gradual process with distinct internal stages that begin long before any substance is consumed. The first stage is emotional relapse, where the individual neglects self-care practices that support recovery, even if they are not actively thinking about using.
In this emotional stage, a person might exhibit poor sleeping and eating habits, experience mood swings, or isolate from their support system. They may bottle up difficult feelings instead of processing them through healthy coping mechanisms. This sustained internal discomfort and poor self-management creates a vulnerability, setting the stage for the next phase.
The second stage is mental relapse, characterized by an internal conflict between the desire to stay sober and the urge to use. Signs include the return of cravings, which become increasingly difficult to resist. The individual may fantasize about past use, minimizing negative consequences or “glamorizing” their former lifestyle.
During the mental stage, the person may bargain with themselves, rationalizing that they can control their use or only engage in it once. They might actively seek out people, places, or things associated with past substance use or start planning how to obtain the substance. This signals that the focus has shifted from actively pursuing recovery to contemplating a return to old behaviors.
Distinguishing a Lapse from a Full Relapse
The term “physical relapse” refers to the actual use of a substance after a period of abstinence. This stage includes an important distinction: the difference between a lapse and a full relapse. A lapse, often called a “slip,” is a single, isolated incident of substance use immediately followed by a recommitment to recovery.
A person who experiences a lapse recognizes their mistake quickly and immediately takes action to get back on track, such as calling their sponsor or increasing their engagement with support groups. This quick response prevents the single incident from escalating into a sustained return to compulsive behavior. Lapses are often viewed as learning opportunities, providing data about a person’s specific triggers that need to be addressed in their plan.
In contrast, a full relapse is a sustained return to previous patterns of compulsive use and a loss of control over the substance. The individual has resumed regular use, often at or near pre-recovery levels. The differentiating factor is the duration and the loss of control, signifying a complete departure from the recovery plan and a re-establishment of the addictive cycle.
A lapse can become a full relapse if the individual experiences intense feelings of shame, guilt, or failure, which they then use to justify further use. This reaction can trigger the “abstinence violation effect,” where the person concludes that since they have already used, all progress is lost, leading to a downward spiral into active addiction. Understanding this distinction informs the immediate course of action and prevents a temporary setback from becoming a long-term one.
Formal Definition of a Relapse Event
Clinically, a relapse event is defined as the recurrence of behavioral or substantive indicators of active disease following a period of remission. The National Institute on Drug Abuse (NIDA) considers addiction a chronic disease, and a return of symptoms is a recognized part of the disease process. Relapse rates for substance use disorders are estimated to be between 40 and 60 percent.
The formal criteria focus on the return to compulsive use, which is the hallmark of the addiction cycle. A person experiencing a full relapse has lost the ability to control the amount or frequency of substance use, despite negative consequences. The event represents a return to the maladaptive thought patterns, behaviors, and environment that characterized their life before sobriety.
For treatment professionals, a relapse is a pattern indicating the individual has abandoned recovery efforts and returned to their pre-treatment state. The definition is a clinical indicator that a more intensive intervention may be required. Formal definitions help guide the adjustment of treatment plans, potentially requiring a return to a higher level of care to regain stability.
Strategies for Responding to Relapse
A relapse or lapse does not erase all progress made in recovery; it is an interruption. The most immediate step is to seek medical attention if there is concern about overdose, as tolerance is significantly lower after abstinence. Following this, the individual should immediately re-engage with their established support system.
This re-engagement means contacting a sponsor, therapist, or other trusted support person and being honest about the event. Increased attendance at mutual support groups, such as 12-step meetings, can provide a non-judgmental environment and reinforce the connection that helps counter isolation. The goal is to break the cycle of secrecy and shame, which can fuel further use.
Practicing self-compassion is an important part of the response, reframing the event as a learning experience rather than a personal failure. The experience provides valuable information about specific triggers, such as stress or emotional states, that led to the event. An individual should work with a professional to adjust their recovery plan, incorporating new coping skills or increasing frequency of therapy to address the vulnerabilities exposed by the relapse.