What to Do When You Relapse? Is It Necessary to Go Through Rehabilitation Again?

Substance abuse disorder (SUD) is not just a bad habit; it’s a chronic and progressive disease. Unfortunately, a lot of people don’t understand the nature of SUD and believe that one course of rehabilitation is always enough to cure a person with addiction. In fact, for some, it could be enough to stay sober for a long time, but those people are more like exceptions to the rule. Usually, the battle with addiction is a series of ups and downs, where relapses are part of the recovery process. Sometimes you can handle it on your own, but in some cases, returning to rehab is necessary. In this article, you discover this difference and what to do if a relapse after rehab has happened.

Understanding the Nature of Relapse

What Counts As a Relapse? Laps vs. Relapse

How common is relapse after rehab? Scientific researchers report that 40 to 60 % of all rehab residences experience a relapse at least once. But do we classify any substance use as a relapse?

Relapse is a well-known term when it comes to addiction and recovery, and means using drugs or alcohol after a period of sobriety. However, therapists and recovery specialists distinguish another term — lapse. It has a different determination.

• Lapse is a situation when a person uses a short amount of substance and goes back to sobriety after that. This episode doesn’t provoke the next cycle of addiction. Accidental use can also be classified as a lapse. For example, when a person was sure that his or her drink was non-alcoholic but there was some amount of alcohol there.
• Full relapse means that a person goes back to full-blown substance use. He or she could decide to return to sobriety at some point, but it could take weeks or even months of use.

Lapse and Relapse Signs Comparing

Why Do People Relapse? Common Relapse Triggers

The most important technique in relapse prevention is identifying your triggers. Each person has his or her own triggers, but some are common to almost everyone.

• Stress. Job determination, death, illness of an important person, financial issues, or any sudden change in life circumstances can affect you both physically and mentally and become a trigger to your substance dependency.
• Exposure to old environments or people. One of the most powerful triggers is finding yourself surrounding people with whom you were using in a place connected with using. The best option for a person in recovery is to avoid the old environment and create an escape strategy if it does happen.
• Lack of support or aftercare. A strong support network is the basis of your recovery after rehab. Making new sober social connections and extending the communication circle help to resist cravings and prevent boredom. A person in social isolation or surrounded by those who don’t believe in and don’t respect sober life choices is almost always at risk of relapse.
• Social pressure. Most likely, during the active phase of addiction, you were surrounded by people who tolerated alcohol or drug use. If you go back to your social circle after finishing rehab, they may provoke you to start using again. So it’s another important point in your recovery plan.
• HALT (Hungry, Angry, Lonely, Tired). This acronym describes physical and mental conditions that make you unstable and vulnerable to relapse if not taken care of. Each time you feel craving, ask yourself, “Am I hungry, angry, lonely, or tired?” If the answer is “yes,” take care of yourself, and most likely cravings will weaken.

Relapse Warning Signs

Relapse is rather a process than an event. It starts in subtle ways and progressively gets worse. Typically, relapse occurs in three stages: emotional, mental, and physical. Understanding those stages is important as it helps to nip relapse in the bud.

1. Emotional. This stage is the trickiest, as at that point, a person most likely doesn’t even think about drug or alcohol use. However, negative emotions could trigger past harmful habits. It’s hard to recognize that you are in the first stage of relapse but at the same time, it’s the easiest time to stop it by just changing your behavior.

Here are some warning signs of emotional relapse:

• Stop sharing in meetings, bottling up emotions
• Stop attending recovery support groups
• Stop asking for help
• Bad sleeping and nutrition
• Anxiety
• Anger
• Victim position
• Deliberate social isolation
• Mood swings

2. Mental. At this stage, a person has already experienced strong craving and dialogue with himself or herself. Negative emotions during emotional relapse provoke thoughts about substance use. It could be fantasizing, thoughts about where to get substance, or rationalization of cravings like “I can control myself” or “I will do it just once.” A person could restore the connection with people who drink alcohol, use drugs, or romanticize substance use.
3. Physical. It’s the final stage when a person is actually using drugs or alcohol. It is very important to ask for help now, as waiting could lead to active addiction. Only one portion of a substance can be a trigger to a powerful craving (scientists call it the “phenomena of craving“), even if you were sure that you would do it “just once.” It explains why do addicts relapse when things are good.

What to Do After a Relapse?

If you relapsed, it means that your prevention plan doesn’t work well, and you have to do a great job to replan it. But that will come later; now you have to think about your physical and emotional safety.

Immediate Steps To Take

1. Keep safety measures. If you were using substances in a public place or a company, remove yourself from there to prevent further seduction. If it happened when you were on your own, then get rid of alcohol or drug products. Take care of your and other’s safety and don’t drive a car or operate heavy machinery.
2. Reach out for help. Call or talk personally to a sober, trusted friend, relative, therapist, etc. There is nothing wrong with admitting you are having problems. Much worse is staying one by one with your destructive thoughts and cravings. This person can quickly remind you about your goals and values to return on a recovery path or provide you with some physical assistance. For example, get you out of a party where a relapse had happened.
3. Make necessary medical considerations. People in recovery lose their tolerance for substances, and it can cause long-term effects on the body. In case you feel bad or have symptoms of overdose, call 911 immediately.

Engage Your Support Systems

Do you lose everything after a relapse? It is largely determined by the attitude of people who surround you. A strong support system plays a key role in a person’s aftercare treatment, decreasing chances of relapse after rehab and dealing with relapse if it happens. Being able to face up to it right after a relapse happens helps greatly, whether you take steps to get back to sobriety or not. It could be your family members and sober friends, support groups, or you can ask for professional help from a therapist. Any kind of support is needed for you during this difficult period.

Drug treatment research has shown that people who find support during the aftercare period much more often get back to recovery compared with those who were in social isolation. Usually, such people decide not to continue their treatment program.

If You Relapse Do You Start Over? Going Back to Rehab Or Not?

After a relapse, it’s not always easy to determine if you should go back to rehab. Often people feel guilty, disappointed, and ashamed if there is such a necessity; they consider it a lack of success. But the truth is that there is nothing wrong with going to rehabilitation more than once. How many times in rehab before it works? Everything is very individual, but each next visit will give you the skills and knowledge that will help you to cope with addiction. There are some questions to ask yourself to understand if you really have to going back to rehab:

1. Was it a one-time slip or a regular use? Usually, people with a strong supportive system and good motivation can handle short-term laps without professional opioid treatment. But if you have multiple “slips,” it’s a reason to consider rehab.
2. Do you need detox? If, after relapse, your addiction was out of control and you were abusing for a long period, you may experience withdrawal symptoms when finally you decide to stop. Trying to detox on your own could be unsuccessful and even dangerous.
3. Can you regain control with aftercare or support? Can you do things you need to do to get back to sobriety? Are you able to stop drinking or using drugs without physical isolation in a safe, substance-free environment? If you are unsure or want to but still can’t, rehab is an option.
4. Can you afford rehab or can your insurance cover it? Inpatient treatment programs are not cheap and if you can’t pay for them now, you can consider other alternative treatment options like outpatient treatment programs or more intense therapy sessions.

Decision-Making Flowchart: “Sure I Return to Rehab?”

When Rehab May Be Necessary

There are situations when professional treatment is demanded and returning to rehab is the best option:

• Multiple relapses despite outpatient support.
• Loss of control or dangerous behavior patterns. You could be dangerous for yourself and the people around you.
• Serious withdrawal symptoms. Trying to manage it without medical monitoring is extremely hard and even dangerous.
• Mental health deterioration alongside substance use. This factor increases the likelihood of relapse and makes it much harder to get back to recovery. Especially if the disorder was not adequately addressed during your stay in rehab.

What Happens If You Relapse and Return to Treatment?

If you decide to go back to rehab after a relapse, it’s important to be informed that your treatment plan has to be modified. You may consult the treatment team about what improvements to make and what things didn’t work. If you don’t feel that all of these changes would be enough, you may try another rehabilitation center with a different approach and philosophy.

Cognitive-behavioral therapy (CBT) is a method of psychotherapy that is very popular in addiction treatment. It helps identify addiction triggers and develop handling strategies. During your next time in rehab, think about how you can react differently to triggers that cause relapse.

Various medication-assisted treatments (MAT) can be used to deal with withdrawal symptoms and cravings. Depending on clinic policy and your addiction history, methadone, suboxone, buprenorphine, etc. could be used. The right medication can have a great positive effect on long-term sobriety.

You may need to learn how to cope in the future with negative emotions that provoke opioid or alcohol relapse. Meditation, relaxation techniques, yoga, and breathing practices can help you reduce stress and manage your triggering emotions when rehabilitation is over.

Alternatives to Rehab

Of course, you can decide not to return to rehab. Or you may want to do this but certain cases avoid it, like financial issues or personal problems. In that case, you can add additional points to your aftercare plan to work through relapse triggers, increase your motivation, and improve your recovery strategy. Those steps are:

• Counseling or therapy sessions.
• Joining a peer support group like a 12-step program, Alcoholics Anonymous, or Narcotics Anonymous.
• Increasing the frequency of aftercare meetings.

Steps to Prevent Future Relapses

Relapse is often an indicator that rehabilitation and aftercare treatment have to be reviewed. First, build a strong aftercare plan—the main tool that helps you to come back to a normal sober life after rehab. Work on your mistakes and add new strategies on how to deal with relapse triggers. Ask yourself, “How can I act differently in this situation to avoid relapse?”

Don’t forget to include counseling and group therapy in your aftercare plan. Make journaling an everyday habit and write down everything that happened during the day and your feelings and emotions caused by these events. Journaling helps you detect alarm signs that you could probably miss without writing down.

Addressing Triggers and Stressors

Returning to Rehab Is Not a Failure

Maintaining long-term sobriety is not just a temporary measure. It’s more of a lifestyle that involves constant work on yourself. We are all different, and there is no on-feet-all approach to recovery. Some people can stay sober and motivated by one rehabilitation program, while others need to go there several times, and it’s normal as they have different recovery journeys. The most important is not how many people relapse after rehab, but how many of them keep working to return to sobriety. If you are struggling with potential or real relapse, contact a rehab center near you to discuss available treatment options.