Recovering from a drug or alcohol addiction can be extremely challenging. When a person begins their recovery, they may face numerous challenges, including the possibility of experiencing a setback. A drug relapse is an instance of substance misuse after previously stopping use.

Learning about the recovery process, and the potential for setbacks, can help people set realistic expectations for addiction treatment and long-term healing.

What Is Relapse?

Many people ask, “What is relapse?” There is no standard drug relapse definition because people experience setbacks in different ways. Each person’s recovery is different, and not everyone will experience a relapse after treatment ends. Setbacks are a reality of recovery for many people because addiction is a lifelong illness that does not have a permanent cure.

A relapse can mean:

  • A person uses drugs or alcohol after abstaining from them for some time
  • A person experiences a slip-up, or uses drugs or alcohol once, and then returns to sobriety
  • Someone resumes drug or alcohol use after treatment and then returns to rehab
  • Someone experiences a full relapse and slips into old patterns and habits

A relapse does not mean:

  • That someone is a failure
  • That rehabilitation did not work or that it can’t work
  • That all the progress someone made in recovery is undone

Recovery is possible for everyone, regardless of whether they’ve faced a setback. Setbacks are common and many people can get back on track with sobriety after experiencing a setback. A healthy way to frame a relapse is that instead of viewing it as a failure, view it as a learning opportunity that teaches how to manage life in sobriety.

Signs of a Drug Relapse

There are many different physical and behavioral relapse warning signs. Becoming familiar with the signs of relapse can deter someone from using substances again. Some of the most common signs of drug addiction relapse include:

  • Drug cravings
  • Sudden mood changes
  • Depressed, anxious or destructive thoughts
  • Denial of events or behaviors
  • Secretive behavior
  • Increased irritability
  • Avoiding family members or friends
  • Making impulsive decisions
  • Returning to previous habits, routines or social groups

Developing effective coping strategies to handle cravings can help people avoid setbacks.

Infographic that lists some of the signs of drug relapse

Drug Relapse Triggers

Various relapse triggers can cause people to succumb to old habits or give in to their drug cravings. Drug addiction relapse triggers can be stress-inducing people, places or behaviors that can cause someone to misuse drugs or alcohol.

Some of the most common drug- and alcohol-related relapse triggers include:

  • Bars or clubs
  • Friends or family members who also misuse drugs or alcohol
  • Stressful environments, like hospitals
  • Interpersonal relationship issues
  • Places where substance misuse often occurs
  • Feeling bored
  • Parties where drug and alcohol use occurs
  • Stressful life situations

Whether relapse triggers are verbal, physical, behavioral or environmental in nature, the presence of triggers does not mean that someone will relapse into drug use. With healthy coping mechanisms and a firm resolve, triggers can be faced and avoided.

Infographic with a lists of drug relapse triggers

Stages of Relapse

Setbacks can be unplanned and the result of an impulse. However, there are three stages of relapse: emotional, mental and physical. To help people understand how setbacks can occur in a gradual process, this infographic from The Recovery Village explains the stages of relapse.

The 3 Stages of Relapse:

1. Emotional Relapse

Although there may be more than one definition of an emotional relapse, most emotional relapses involve someone re-experiencing emotions that they used to feel when they were actively using drugs or alcohol. During an emotional relapse, a person may not be thinking about using drugs, but they might be heading toward familiar patterns of addiction. A person who is experiencing an emotional relapse might be in denial, grow irritable, isolate themselves and avoid friends, family and support group members.

2. Mental Relapse

During the mental relapse stage, a person actively thinks about using drugs or alcohol again, and they may attempt to rationalize returning to drug use. Internal conflicts and bargaining are frequent during this stage as people feel strong urges to use drugs or alcohol but know that doing so stunts recovery.

3. Physical Relapse

The final stage is a physical relapse, or drug or alcohol use. A physical relapse can last for months for some people and may indicate the need to return to treatment. However, a physical relapse does not always indicate that someone will face addiction again or need rehab.

Relapse Statistics

Drug relapse statistics reveal the reality of addiction recovery. Close to half of people who experience drug or alcohol addiction also experience relapses in recovery. According to the National Institute on Drug Abuse’s “Principles of Drug Addiction Treatment: A Research-Based Guide” released in January of 2018, between 40 and 60 percent of people who struggle with drug addiction experience setbacks.

Although addiction relapse statistics may seem grim, not everyone who experiences addiction struggles with relapses, and many people progress in recovery despite setbacks.

What Drug Has the Highest Relapse Rate?

Anyone with an addiction to drugs or alcohol is susceptible to experiencing a relapse. However, some drug addictions may be harder to treat than others and relapse rates by drug type vary. Because setbacks are shared among all types of drug addictions, it can be difficult to tell what drug has the highest relapse rate.

Some drugs are more addictive than others and cause people to relapse at different rates. Nicotine excluded, some of the most addictive drugs that contribute to the highest relapse rates include substances like:

  • Alcohol: Some studies show that of people who are treated for alcoholism, less than 20 percent remain sober for a year.
  • Opioids: Heroin, oxycodone and hydrocodone are some of the most highly addictive opioids. According to international studies (not including data from China), the first-year relapse rate among people who abuse heroin is typically 80 to 95 percent. A study from 2010 concluded that of people treated for opiate addiction, more than 90 percent reported relapsing after treatment.

Other drugs that have high abuse potentials, thus high relapse rates, include stimulants (specifically cocaine and methamphetamine) and benzodiazepines (specifically Xanax and Valium). For people in recovery, knowing which substances have higher setback rates can be helpful in drug relapse prevention.

Preventing a Drug Relapse

The first six months of recovery is the period when a relapse is most likely to occur. However, having formed an alcohol relapse plan or a drug relapse prevention plan can be beneficial for people in recovery. During the first six months of sobriety, a strong relapse prevention plan can include:

Other components of a relapse prevention plan may include:

However, despite knowing how to prevent drug addiction relapses, setbacks can still occur. In the event of a relapse, a person shouldn’t panic or assume they’ve failed at recovery. Instead, a person can:

  • Examine what led to the relapse: Learning from a relapse can help prevent future setbacks.
  • Decide that the relapse was an isolated situation: In this case, a person can recommit to recovery and move past a relapse by seeking support in a 12-step program and from peers in recovery.
  • Consider re-enrolling in treatment: If the relapse lasted for a significant amount of time, or if the person feels that they cannot continue to maintain sobriety without help, going back into a treatment program can be beneficial.
  • Invest in professional mental health counseling: Cognitive behavioral therapy can be especially useful after a relapse. This therapy may be used in conjunction with substance abuse counseling to help people change their thinking and behavior patterns to recommit to sobriety.

Inforgraphic that lists ways to prevent drug relapse

Helping a Loved One Avoid Relapse

Friends and family members of someone in recovery can form an invaluable support network. People who are friends with or family of someone in recovery should be aware of the potential for setbacks and the many ways in which they can occur. This knowledge can help people identify when someone has resumed drug or alcohol use and how to get proper medical help.

For people who want to know how to help someone avoid relapse, good first steps include:

In the case that someone experiences a relapse, their friends and family can:

  • Reassure them that they are not a failure
  • Remind them that setbacks are common and recovery is an ongoing process
  • Help them seek treatment again, if necessary

The possibility for a relapse is a reality of recovery. However, relapses are opportunities to create a stronger foundation for the future. If you’ve experienced a relapse and want to go back to treatment, call The Recovery Village today at [phone] to talk through treatment options with a representative.


Chao Rong, et al. “Factors Associated with Relapse among Heroin Addicts: Evidence from a Two-Year Community-Based Follow-Up Study in China.” Published January 28, 2016. Accessed January 11, 2019.

National Institute on Drug Abuse. “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” Last updated January 2018. Accessed January 11, 2019.

Smyth BP., Barry J., Keenan E., Ducray K. “Lapse and relapse following inpatient treatment of opiate dependence.” Published June 2010. Accessed January 11, 2019.