What are the 3 Stages of Relapse? What Treatment Options are Available?

Last Updated: Feb 14th 2020

Reviewed by Brittany Polansky

What are the 3 Stages of Relapse? What Treatment Options are Available?

Relapse can be broken down into three stages: emotional, mental, and physical. It is commonly believed that relapse happens quickly, but in reality, it’s a gradual process that begins weeks or even months before an addict begins using again after completing a treatment program. To prevent relapse, you must understand each of the three stages of relapse. By knowing what to expect, you can prevent relapse from happening at all and keep on your path to recovery. We’ll explain each of the three stages of relapse and their warning signs, as well as how you can prevent relapse altogether.

Stage 1: Emotional Relapse

Emotional relapse is the first of the three stages of relapse. Although individuals are not actively thinking about using at this point, their negative behaviors, thoughts, and emotions may be precursors to a relapse.

Signs of emotional relapse include:

  • Isolation from family and friends 
  • Not going to support meetings such as Alcoholics Anonymous or Narcotics Anonymous
  • Bottling up emotions
  • Poor sleeping and eating habits
  • Lack of self-care
  • Mood swings
  • Not having sober fun
  • Focusing on other people’s problems instead of your own

During the emotional stage of relapse, it is not uncommon to feel angry or anxious or be in denial. It may be helpful to ask yourself questions or talk out your feelings and emotions with a therapist while going through this stage of relapse.

Some questions you can ask yourself are:

  • Are you getting caught up in life?
  • What coping skills are you using?
  • Are you starting to feel exhausted again?
  • Are you being good to yourself?
  • How are you managing stressors each day?

You can try some deep breathing techniques or meditation when you are going through these confusing feelings and emotions. These practices can help you reflect and think about the answers to each of the above questions.

If you can observe the warning signs of emotional relapse early on, it can be easier to prevent physical relapse. However, if these emotions continue to take over, they can lead to the next stage of relapse: mental relapse.

Stage 2: Mental Relapse

The mental stage of relapse is more difficult to come back from than the emotional stage. When recovering individuals begin lying, keeping secrets from loved ones, and failing to take care of themselves, their emotions can give way to ideas that are more specifically related to drug or alcohol use.

Signs of mental relapse include: 

  • Thinking about things, people, and places associated with past substance use
  • Thinking of ways to control using
  • Dishonesty and secrecy
  • Hanging out with old friends who use substances
  • Glamorizing past drug use
  • Cravings or psychological/physical urges to use
  • Experiencing symptoms of HALT (hungry, angry, lonely and tired)
  • Planning a relapse

If you are going through this stage of relapse, think hard about the consequences of using substances again. You may believe that you will be able to control your usage and dosage this time, but this is a dangerous card to play. Cognitive therapy can play an important role in curbing these emotions, and we’ll expand on this later in this article.

Stage 3: Physical Relapse

The final stage of relapse, physical relapse, is when a person uses drugs or alcohol again. The goal is to not get to this final point, which could begin a path of destruction and possibly lead to death.

When you first relapse, you may think that only taking a small amount will be fine for your body and your health. However, having a taste of what made you previously go into a spiral may induce your cravings, possibly leading to uncontrolled use.

How Can I Avoid a Relapse?

There are several mindfulness tactics you can practice to avoid a relapse.

  • Cognitive therapy: Rather than focusing on past experiences and behaviors, cognitive therapy focuses on present thinking and communication. A major key to avoiding relapse is centering your thoughts on how you feel right now versus how you felt when you were using drugs.
  • Redefine fun: Before you received treatment for your addiction, using drugs or alcohol was your way of having fun with your friends. However, when addicts are stressed, they can reminisce about their previous drug use and even romanticize it. Since becoming sober, you have been trained to evaluate fun in a different light, but conflicting emotions make this difficult. 
  • Know your triggers: Being around friends who use, as well as being in specific places and situations related to use, can lead to relapse. 

While going through the emotional stage of relapse, individuals may believe that not using substances will increase the feelings of boredom or depression that they tried to escape. At the same time, this will make them think that using again won’t be harmful, but that it will be a comfortable, pleasurable experience.

Just because you are sober and have gone through rehab doesn’t mean that cravings simply go away. Actor Philip Seymour Hoffman was sober for more than 20 years before he picked up drugs and alcohol again. In an essay for Vogue in 2017, his partner, Mimi O’Donnell, shared that reaching middle-age, the death of his longtime therapist, and falling out with friends from Alcoholics Anonymous were a few of the reasons for Hoffman’s relapse.

How Can I Recover after the Three Stages of Relapse?

If you do relapse, it is crucial to get support from friends, family, loved ones and a therapist or counselor. When you do this, make sure to admit your missteps and apologize for any hurt that you may have caused.

It is also important during this period of recovery to look at your relapse not as a failure, but as another step on your road to complete sobriety. It is not uncommon for addicts to relapse, and everybody experiences setbacks in life. You may even consider going back to treatment during this time. According to the Journal of the American Medical Association, 40-60% of people who have been treated for substance use disorders relapse within one year.

However, you also don’t want to get caught in “revolving door syndrome,” which refers to a pattern of repeated relapse and rehab. When addicts are caught in revolving door syndrome, they aren’t 100 percent committed to recovery and sobriety.

Although recovery is hard work, addiction is even tougher to deal with. Recognizing the warning signs of relapse before it happens can greatly reduce the chances of it ever occurring. 

What Relapse Treatment Options Are Available?

1st Step Behavioral Health has various treatment options available for people who have gone through the three stages of relapse. After someone goes through a life-altering event like this, they need to accept and seek help to avoid using again.

Below are a few of the treatment options that we provide:

  • Drug Detox: Our medical detox center helps addicts safely go through withdrawal symptoms with trained professionals. 
  • Addiction Therapy: Once the detox program is complete and an individual has been weaned off drugs and alcohol, they can begin addiction therapy. People who go to therapy can speak with a licensed counselor are committed to their recovery and 
  • Intensive Outpatient Program and Outpatient Rehab: Our intensive outpatient program is comprised of regularly scheduled sessions of mental health counseling and addiction treatment.
  • Inpatient Rehab: Inpatient rehab is designed for patients who need more intensive care than that provided in outpatient. 
  • Residential Treatment: In a home-like environment, patients can go through recovery with semi-private rooms and shared recreation areas. A residential setting can be beneficial for certain patients
  • Treatment for Professionals: People who work during the day can also take advantage of our programs in the event of a relapse.

Sobriety requires dedication and commitment every single day. Our staff of trained counselors and medical professionals at 1st Step Behavioral Health can help guide you through the process of weaning off drugs and alcohol.

Dual Diagnosis and Relapse

If you have a mental illness as well as an addiction, there is a much higher chance of you going through a relapse. Triggers that are associated with past drug use can very well be associated with depression, anxiety or bipolar disorder. Dual diagnosis treatment helps curb this by treating the mental illness in conjunction with a substance use disorder, such as alcoholism or drug dependence. 

It is important when having both an addiction and a mental illness that both are treated simultaneously, this way the illness is removed as an influence on your drug or alcohol dependence. After treatment is complete, there will be many temptations and possible triggers that can lead you to relapse, especially with an existing mental condition. This is why you must practice mindfulness and identify safe situations in these moments.

Get Help Now

Relapse is a difficult experience to recover from, but here at 1st Step, we are committed to helping our patients through every step of recovery. Each of the relapse stages can be avoided with the guidance and support of our trained staff. If you have relapsed or are afraid that you might, contact us today.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.