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Most Common Reasons for Addiction Relapse

Medically Reviewed by: Charley Allen

Table of Contents


Addiction relapse is when someone returns to using substances, such as drugs or alcohol, after stopping or reducing their use. It’s a serious issue that many people in recovery face. According to the National Institute on Drug Abuse, about 40 to 60% of people in recovery from substance use disorders will experience a relapse. This makes understanding the reasons for addiction relapse crucial in preventing it and helping people continue their recovery journey.

Emotional, Mental, and Physical Stages of Relapse


Addiction relapse is not just a single event but often a process that includes emotional, mental, and physical stages. It’s also essential to distinguish between a relapse and a lapse. A lapse is a one-time or short-term return to substance use, while a relapse is a full return to the previous level of substance use.

Understanding the different stages of relapse is an important part of relapse prevention. It’s a process that happens over time, not all at once. Recognizing these stages can help people struggling with substance abuse and their support teams intervene before a full relapse occurs. The stages include emotional, mental, and physical relapse.

Emotional Relapse

In the emotional relapse stage, individuals aren’t necessarily thinking about using substances again. However, they may start to experience negative emotions that could set the stage for future relapse. Examples of these negative emotions could be anxiety, anger, and loneliness. Other indicators of this stage could include:

  • Poor self-care: Not getting enough sleep or eating poorly.
  • Withdrawal symptoms: These could include hot and cold sweats, irritability, and fatigue.
  • Not seeking or engaging in social support: The person might isolate themselves from their support system, such as mutual support groups, family therapy sessions, or treatment teams from addiction treatment programs.

During this stage, the individual needs to remember self-care practices, seek help from a professional at substance abuse treatment centers and reinforce their relapse prevention plan.

Mental Relapse

In the mental relapse stage, the battle between using and not using substances again becomes more intense. The individual might start glamorizing their past use, downplaying the negative consequences they experienced due to drug or alcohol abuse. Other signs of mental relapse could be:

  • Thinking about people, places, and things associated with substance abuse: They might start thinking about old friends who still use drugs or favorite places to drink alcohol.
  • Planning a relapse: The person may start to plan how they could use again without getting caught.
  • Lying: They may start to lie to their family members or treatment team about their feelings or thoughts.

In this stage, it’s important for the person to seek help from their support network, engage in outpatient programs or other forms of addiction treatment, and continue practicing the coping mechanisms they learned during treatment.

Physical Relapse

Physical relapse is the final stage and occurs when the person starts using substances again. This could involve drinking alcohol, drug use, or returning to other harmful behaviors associated with their addiction. It’s the most dangerous stage because it could lead to chronic illnesses, mental health issues, and negative consequences like losing a job or damaging relationships.

However, entering treatment again after a physical relapse occurs is crucial for continued recovery. Addiction recovery isn’t a linear process, and relapse rates are high. But many people have managed to regain and sustain recovery even after relapses. The National Institute on Drug Abuse highlights that treatment programs that adapt to the individual’s needs, like behavioral therapies or medical treatments, can effectively help avoid withdrawal symptoms and reduce the risk of future relapses.

Remember, early recovery is a learning process and each stage of relapse comes with its own set of challenges. By understanding these stages and recognizing the signs, individuals can be better prepared to face these challenges and stay committed to their recovery journey. In all stages, a solid relapse prevention plan is a valuable tool, helping individuals stay sober and manage any intense cravings or emotional turbulence they may experience.


Internal Factors

Psychological Triggers

Psychological triggers are often thoughts or feelings that can lead to drug abuse. This can include memories associated with substance use, such as:

  • Recalling the sensation or euphoria of using the drug.
  • Remembering locations, people, or events connected with previous drug use.
  • Recollecting the relief or escape from distress that substance use provided.

These triggers can pose a significant risk factor in the relapse process, as they can lead to intense cravings and eventual substance addiction.

Emotional Instability

Unstable emotions can significantly increase the risk of relapse. Emotions such as sadness, anger, or stress can make an individual more vulnerable to relapse. For instance:

  • Increased stress levels can make individuals seek substances as a form of self-medication.
  • Feelings of anger or frustration may lead to impulsive decisions, including drug use.
  • Persistent feelings of sadness or loneliness can push individuals towards substance use as a means of escape.
  • Understanding and managing emotional health is a critical part of the recovery process.

Co-occurring Mental Health Disorders

Co-occurring mental health disorders, such as depression or anxiety, can increase the risk of relapse. This is because these conditions can exacerbate feelings of distress and discomfort, making the recovery process more challenging. Conditions that may influence relapse include:

  • Depression, which can cause feelings of hopelessness and despondency.
  • Anxiety disorders, which can lead to constant worry and stress.
  • Post-traumatic stress disorder (PTSD), which can cause flashbacks and intense distress.

Such conditions often require a comprehensive treatment plan that addresses both substance abuse and co-occurring mental health disorders.

External Factors

Social Environment and Peer Pressure

The social environment and associated peer pressure can significantly contribute to relapse. Being around people who use substances or experiencing pressure to use can lead to relapse. This could involve:

  • Spending time with old friends who still use drugs or alcohol.
  • Attending social events where substance use is common.
  • Facing direct or indirect pressure from peers to engage in substance use.

Engaging in alcohol research and education about the dangers of substance abuse can help resist this pressure.

Lack of Support System

Without a robust support network, individuals in recovery may find it more challenging to stay sober. A strong support system can provide encouragement, empathy, and practical assistance during the recovery journey. A lack of this system can lead to feelings of isolation and loneliness, which may increase the risk of relapse.

Stressful Life Events

Major life stressors can push individuals towards substance use as a maladaptive coping mechanism. Such stressors can include:

  • Job loss or financial problems.
  • Relationship difficulties or breakup.
  • Death of a loved one or other personal loss.

These events can significantly disrupt an individual’s life, causing distress that may lead to relapse if not properly managed.

Exposure to Addictive Substances or Cues

Exposure to addictive substances or associated cues can trigger intense cravings, leading to a potential relapse. This could involve:

  • Seeing drug paraphernalia or substances, such as alcohol or other drugs.
  • Visiting places where the individual used to use substances.
  • Encountering people with whom they used to engage in substance use.

Psychological Reasons for Addiction Relapse


Cravings and Triggers

One of the primary psychological reasons for relapse is the experience of triggers and cravings. Triggers, which are conditioned cues from the environment, can stimulate intense desires or cravings for a substance. For instance:

  • Seeing a favorite bar or liquor store can stimulate cravings in those with alcohol dependence.
  • Encountering a group of friends who still use substances can rekindle the desire to use.
  • Even specific times of the day or emotional states can act as triggers, leading to cravings.

Cravings are not just psychological phenomena; they are deeply intertwined with neurological changes in the brain caused by repeated substance use. Years of drug or alcohol use can alter brain functioning, which results in a persistent and powerful urge to use even after long periods of abstinence. These changes in the brain can lead to addictive behavior, making it crucial to consider these aspects when individuals enter treatment for substance use disorders.

Coping Mechanisms and Self-Medication

Another psychological reason for addiction relapse is the tendency to turn to substances as a form of self-medication. Individuals in recovery may resort to substance use as a means to escape from emotional pain or stress, particularly when they lack healthy coping strategies. This form of self-medication can be a significant risk factor for relapse, particularly in the following scenarios:

  • When faced with high levels of stress, an individual may turn to substances as a way to numb their emotional response or temporarily forget their problems.
  • In the event of emotional pain, such as grief or heartbreak, substances may be used as a temporary relief from the intense emotions.
  • In moments of anxiety or panic, substances can be seen as a quick solution to reduce the feelings of fear and discomfort.

The lack of healthy coping mechanisms makes it harder for individuals in recovery to deal with these difficult emotions and situations. Ideally, healthier coping strategies should be instilled during treatment, like relaxation techniques or positive reinforcement strategies. These can include:

  • Engaging in regular physical exercise, which can help reduce stress and improve mood.
  • Practicing mindfulness or meditation, which can help manage anxiety and negative emotions.
  • Developing hobbies or interests, which can provide a positive distraction and a sense of achievement.
  • Building strong, supportive social connections, which can offer emotional support and encouragement during difficult times.

By understanding and addressing these psychological reasons for relapse, treatment programs can be better designed to support individuals with alcohol use disorder or other substance use disorders in their recovery journey. This could involve providing therapies to manage cravings and triggers, teaching healthier coping strategies, and offering ongoing support to help individuals navigate the challenges of recovery.

Emotional and Mental Health Factors

Emotional and Mental Health Factors Design for Recovery

Understanding the interplay between emotional and mental health factors and addiction can enhance the quality and effectiveness of addiction recovery plans. These factors can often act as potent triggers for relapse if left unaddressed.

Underlying Trauma

Numerous individuals suffering from substance use disorders carry the burden of unresolved trauma. This trauma, which could originate from experiences such as physical or emotional abuse, can have profound and lasting effects on an individual’s emotional and mental health. Unresolved emotional wounds from these traumatic experiences can trigger the urge to use substances as a way to numb the pain or escape the troubling memories. Some examples of these experiences include:

  • Physical or sexual abuse during childhood or adulthood.
  • Emotional or psychological abuse, including neglect or manipulation.
  • Experiences of extreme violence, such as war or domestic violence.
  • Significant loss, such as the death of a loved one or the end of a significant relationship.

Without proper treatment and resolution, trauma can become a significant risk factor for relapse. Hence, trauma-informed care should be a cornerstone of treatment plans for those battling substance use disorders. This approach can help patients process their trauma safely and develop healthier coping mechanisms, thereby reducing the risk of relapse.

Co-occurring Mental Health Disorders

A significant number of individuals with substance use disorders also struggle with co-occurring mental health disorders, a condition known as dual diagnosis. Common mental health conditions that co-exist with substance use disorders include depression, anxiety disorders, bipolar disorder, and schizophrenia, among others.

This duality complicates the recovery process for the following reasons:

  • Symptoms of mental health disorders like depression or anxiety can increase the urge to self-medicate with substances, thereby increasing the risk of relapse.
  • Withdrawal symptoms from substance abuse can mimic or exacerbate mental health symptoms, making them harder to manage.
  • The stigma associated with both mental health and substance use disorders can lead to feelings of shame and isolation, which can in turn increase the risk of relapse.

To effectively manage a dual diagnosis, integrated treatment is required. This approach simultaneously addresses both the substance use disorder and the mental health condition. Some components of an integrated treatment plan may include:

  • Psychotherapy, including cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or trauma-focused therapies, to help patients understand and manage their thoughts, emotions, and behaviors.
  • Medication management, to treat symptoms of mental health disorders and/or manage withdrawal symptoms from substances.
  • Support groups, to provide a community of individuals facing similar struggles, reducing feelings of isolation.
  • Wellness strategies, such as stress management, exercise, and nutrition, to support overall health and wellbeing.

Recognizing and addressing emotional and mental health factors in the context of substance use disorders can significantly improve the quality of care and recovery outcomes. Ultimately, a comprehensive and holistic approach to treatment can lead to more sustainable recovery and reduced relapse rates.

Social and Environmental Influences

Social and Environmental Influences Design for Recovery

Understanding the interplay between social and environmental influences and substance use disorders can significantly enhance the quality of care and effectiveness of addiction treatment and relapse prevention strategies. These influences can often act as triggers for relapse if left unaddressed.

Social Environment

The social environment in which an individual operates can have profound influences on their journey toward addiction recovery. Particularly, peer pressure and the individual’s social circle can sway the odds of relapse. If a person continually finds themselves in the company of those who actively use substances, the challenges to maintain sobriety can be significantly compounded. Examples of such social scenarios include:

  • Regular gatherings where substance use is prevalent.
  • Maintaining relationships with individuals who were a part of one’s substance use past.
  • Engaging in activities where substance use is a common practice.

Lack of Support System

An absence of a robust support network can derail recovery efforts. Family, friends, and support groups such as Alcoholics Anonymous or Narcotics Anonymous can provide the much-needed resilience to sustain recovery. Without these networks, isolation can fuel feelings of loneliness and despair, amplifying the risk of relapse.

Stressful Life Events

Stressful life events like job loss, relationship breakdowns, financial instability, or bereavement can trigger a relapse. The overwhelming emotional burden that such events bring can push individuals towards seeking relief through substance use.

Exposure to Addictive Substances or Cues

Environmental triggers, including being around substances or places associated with previous substance use, can ignite cravings and increase the risk of relapse. Identifying these environmental cues and establishing strategies to manage their impact is crucial.

Treatment and Relapse Prevention Strategies

Treatment and Relapse Prevention Strategies Design for Recovery

Organizations such as addiction treatment centers emphasize the paramount importance of relapse prevention as a component of comprehensive addiction treatment programs. Below are a few strategies that can aid in relapse prevention:

Identifying High-Risk Situations: Self-awareness plays a critical role in relapse prevention. Identifying personal triggers and situations that make one vulnerable to substance use is the first step in this process. These could include:

  • Certain individuals or groups.
  • Specific locations associated with past substance use.
  • Specific times or days that were previously associated with substance use.
  • Emotional states that have led to substance use in the past.

Building Coping Skills: Learning and implementing coping strategies like stress management techniques, exercise, and self-care practices can help manage cravings and avoid relapse. These can range from breathing exercises to mindful meditation, from regular physical activity to engaging in hobbies and recreational activities.

Seeking Professional Help: Addiction is a complex disease that often requires professional assistance to overcome. Therapy and counseling, medication-assisted treatment, and medically supervised detoxification are crucial to a comprehensive treatment plan. Different types of therapies that may be employed include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and family therapy.

Engaging in Support Groups: Support groups provide a sense of community, empathy, and understanding, all of which can be highly beneficial for sustained recovery. These groups can offer an environment where individuals can share experiences, gain insights, and provide mutual support.

Lifestyle Changes: Maintaining a healthy routine, which may include regular physical activity, balanced nutrition, adequate sleep, and proper hydration, can enhance both physical health and mental well-being. Such lifestyle changes can provide the energy and emotional stability required to deal with cravings and avoid relapse.

In sum, effective relapse prevention requires a holistic approach that addresses social and environmental influences, cultivates positive coping skills, and encourages professional treatment and support networks. By incorporating these strategies into their daily lives, individuals in recovery can significantly reduce the risk of relapse and sustain their journey toward long-term sobriety.


Understanding the most common reasons for addiction relapse is crucial in preventing it and supporting individuals on their path to recovery. It’s important to remember that relapse is not a failure but a signal that the treatment plan needs adjustment. With the right relapse prevention strategies and support, individuals in recovery can continue their journey toward long-term sobriety. Never lose hope because recovery is always possible.

Begin Your Personal Journey Towards Sobriety with Design for Recovery


Your road to long-term recovery and freedom from addiction starts here. Design for Recovery is committed to providing personalized, comprehensive addiction treatment and relapse prevention strategies tailored to your unique needs. Contact us today and take the first step on your journey to a healthier, substance-free life.

Frequently Asked Questions

Peer support groups like Alcoholics Anonymous or Narcotics Anonymous provide an empathetic community for individuals in recovery. Members share their experiences and offer mutual support, which can greatly assist in managing cravings and understanding that they are not alone in their journey concerning sobriety.

A comprehensive treatment program typically involves multiple elements, such as medical detoxification under medical supervision, individual and group counseling sessions, learning coping strategies, and aftercare planning. This integrated approach addresses the multiple needs of the individual, not just his or her substance use disorder.

Medical detox is the first step in most treatment programs and serves to cleanse the body of harmful substances. It is conducted under medical supervision, ensuring the safety and comfort of the individual during withdrawal. The process may involve medication to manage withdrawal symptoms and should always be followed by further treatment to address the underlying issues related to addiction.

Learning coping strategies is a key part of recovery as it empowers individuals to deal with stressors and triggers without turning to substance use. These may include techniques like mindfulness, exercise, and other self-care practices that can manage negative emotions and reduce the risk of relapse.

Rehab facilities like Design for Recovery manage risk factors associated with relapse through comprehensive, individualized treatment plans. These plans often involve identifying personal triggers, building coping skills, engaging in peer support groups, and creating aftercare plans to sustain recovery long after the initial treatment program has ended.

NIDA. “Treatment and Recovery.” National Institute on Drug Abuse, 9 Mar. 2023, Accessed 13 Jul. 2023.


Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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