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16 Signs of Relapse

The drugs and alcohol abuse recovery process is never linear. It’s estimated that people recovering from substance abuse experience at least one addiction relapse before reaching and maintaining long-term sobriety.1

What Is Relapse?

People going through addiction recovery may at some point use their substance of choice again, whether it was planned or unplanned. This is known as a relapse.

Relapse could be something as small as having a drink while at a party or as big as binging on your drug of choice again after beginning your recovery journey.

There are typically three types of relapse:

  1. Emotional relapse: This is typically the first stage of relapse and involves negative emotional reactions toward their recovery commitment or their life in general. This could include anger, anxiety, frustration, or mood swings.
  2. Mental relapse: This is often the second stage of relapse and can affect your mental health, producing an internal struggle over whether or not you should use again.
  3. Physical relapse: This is the stage pictured when people hear the word “relapse” and involves using the substance again, whether once or completely relapsing and binging or using the drug repeatedly.

Reasons People Relapse

Alcohol or drug relapse occurs for various reasons. However, the blame shouldn’t be put on these situations, nor should they be used as an excuse by recovering addicts to explain their drug or alcohol addiction slip.

Factors contributing to relapse include:

  • Stress at work, school, or home
  • A negative environment at work or home
  • The prevailing use of drugs or alcohol at work, school, or home
  • Visiting places where drugs or alcohol are commonly used
  • Experiencing trauma or powerful negative emotions

Relapse Warning Signs

Recognizing the signs associated with relapse could help you intervene before your loved one takes it too far. The most common warning signs of relapsing are listed below.2

1. Increase in Stress

Experiencing increased stress could trigger negative emotional responses that the individual may not have learned to cope with before leaving rehab. This could significantly increase the risk of relapsing and could indicate that their environment is no longer conducive to sobriety.

2. Post-Acute Withdrawal Symptoms (PAWS)

Withdrawal symptoms don’t necessarily disappear within a few days to a week. Sometimes, specific symptoms may return even after a year and could signify that the individual is more likely to overdose. PAWS include depression, fatigue, intense cravings, and insomnia.

3. Antisocial Behavior

Spending less time with friends and family members that positively influence their sobriety could be an indicator that something is wrong. Antisocial behavior could be due to the mental effects of relapse and should be addressed as soon as possible.

4. Breakdown of Routine

Skipping school, missing days at work, or missing social events could all be a sign that your loved one may be struggling with their sobriety and needing support or help.

5. Denial

In this instance, denial doesn’t refer to not believing they have a substance use disorder but, rather, denying that they are exhibiting the signs of relapse or are at risk of using again. This behavior should be addressed in therapy or counseling and not simply ignored or made light of.

6. Cravings

Experiencing craving of any severity for the substance they previously abused is another good indicator they may currently or already have experienced a physical relapse.

7. Defensive Behavior

Defensive behavior, arguing that they don’t need help or aren’t relapsing, may also be a sign of the opposite. When questioned about their sobriety, people who get defensive may have already relapsed or be in the late stage of mental relapse.

8. Aggression or Depression

Emotional reactions to relapsing or thinking of using again may include aggressive denial or depression and guilt related to their inability to stay sober.

9. Asking for Money

Asking friends or family for money, stealing, or selling their belongings for cash could indicate they are looking for a fix and may relapse soon after.

10. Changes in Appearance

This includes changing their clothes to hide track marks or looking more disheveled, messy, or dirty than usual.

11. Impulsive Behavior

Acting impulsively or without regard for the consequences of their actions is a good indicator that something may be going wrong in your loved one’s recovery journey and that they need help.

12. Missing Therapy or Support Group Meetings

The support systems established after rehab are vital to maintaining sobriety. If your loved one stops going to their AA or NA meetings or starts missing their therapy sessions, it may be time to question them about their sobriety and their mental health.

13. Getting Back with Old Friends

Revisiting the relationships they had before entering rehab or associating with people who used to use with them is a solid indicator something has gone wrong with their recovery.

14. Poor Hygiene

Often people who are near or have already relapsed feel like giving up, not only on their recovery but on other aspects of self-care like hygiene and cleanliness. Wearing dirty clothes, not bathing or showering, or leaving their home in a mess may indicate a problem with their recovery journey.

15. Lying

Lying about where they were, what they were doing, or who they were with should raise suspicions that they may be struggling with sobriety or need professional help.

16. Worsening Health Problems Associated with Substance Abuse

A sure sign that your loved one may have relapsed is the worsening of health problems associated with their substance abuse. This may include high blood pressure, worsening liver disease, or the return of anxiety or mood swings.

How to Talk to a Loved One About Seeking Help

Talking to a loved one about them possibly returning to their alcohol or drug addiction can be difficult, but it must be done. The best way to initiate the conversation is to be honest but refrain from judging them or treating their relapse as a failure.

Often a second visit to rehab and creating a comprehensive relapse prevention plan may be what your loved one needs to stick to their recovery journey this time around.

Adelante Recovery Center offers relapse prevention skills as well as group therapy and access to treatment plans that not only address your substance use disorder but any co-occurring mental health issues that may later lead to a relapse.

If a loved one or you are struggling with addiction, contact our team at (949) 427-9099 to get access to the treatment and relapse assistance you need.


  1. https://americanaddictioncenters.org/adult-addiction-treatment-programs/signs-of-relapse
  2. https://www.verywellmind.com/warning-signs-of-an-alcohol-or-drug-relapse-67895

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