Relapse Risk Factors

Learn about some common triggers that raise the risk of relapse and how they can be avoided.

One of the biggest risks during drug recovery is that someone who is recovering from using a substance will relapse and begin taking that substance again. To avoid relapse, it is important to understand the risk factors and causes that typically lead to relapse. Understanding these risk factors will help you to avoid the potential risk of relapse during or following recovery.

Often, relapse will be preceded by a trigger that causes someone to start thinking about relapsing or creates a craving for a substance that was previously used. These triggers can be difficult to recognize and can completely disrupt a recovery if they lead to relapse. Recognition and avoidance of potential triggers will be a key part of any recovery process.

Types of Addiction Relapse Triggers

There are two main types of triggers that can start someone towards the path of relapse. These include both external triggers and internal triggers.

• External Triggers: External triggers for substance abuse are triggers that come from your environment, including things, people or places that you come in contact with.  Once recognized, external triggers are easier to control.
• Internal Triggers: Internal triggers for substance abuse relapse are triggers that come from within, typically from your emotional state or thought process. When these triggers are recognized, it can take more work to avoid them. These triggers can also be more likely to occur subconsciously, making them vital to recognize and avoid.

Both types of triggers present unique challenges that can derail a recovery process. Understanding how these triggers affect you is vital to avoid potential relapse.

Common External Relapse Triggers

Our brain stores memories by associating them with other memories. Often a place may trigger a memory of an event, or smelling something, such as a particular cologne, may trigger your memory of a loved relative. The way that the brain links memories is a powerful tool that is used to help you recall important information, but that may also affect your recovery process.

Your brain associates the act of using a substance with places where you used that substance, people you used with or bought from and different objects related to substance use. When you are exposed to these things or people, it triggers your brain to think about the substance that you used to use and can create cravings for the substance.

Beyond cravings, this can also lead to a longing for the environment or lifestyle that you left and does not provide the same recall for the reasons that you initially sought recovery.

While everyone’s external triggers will be unique to them, some common relapse triggers include:

• Former Drug Dealers – Some of the biggest drug addiction relapse triggers include people and relationships. Talking to, or spending time with, former drug dealers is a sure way of triggering your brain to start thinking about your substance use. Avoiding toxic relationships in recovery is vital for avoiding relapse.
• Friends & Family that Use Drugs – Managing your relationships in recovery is important. While avoiding former drug dealers may seem obvious, it is also important to avoid spending time with, or communicating with, people you know who use drugs. This can not only trigger a relapse but can also create negative peer pressure.
• Returning to Locations Where Drugs or Alcohol were Used – A common drug or alcohol relapse trigger includes locations where drugs or alcohol were used. Avoiding these locations may even include moving out of your residence temporarily or moving to a new location. Bars and nightclubs may also be relapse triggers for alcoholics or others who misuse substances.
• Finding Drug Paraphernalia – Common substance abuse relapse triggers include finding drug paraphernalia such as needles, bongs or other items that were associated with drug use. Eliminating this trigger may involve cleaning every piece of drug paraphernalia from your house or even getting rid of everyday items that were once part of using drugs.
• Empty Pill Bottles – For those who were previously addicted to an opiate, relapse triggers may include pill bottles that are reminders of the bottles that opioids come in. Someone who finds that this is a trigger may benefit from placing their prescription medications in a weekly medication planner instead of taking them from traditional medicine bottles.

Avoid external triggers whenever possible, and get rid of any item that may lead to a trigger. Avoiding external triggers may involve ending some past friendships. Recognize that these friendships are harmful to you and be sure to cut the friendship off completely; a half-way ending to a bad friendship will be much less likely to succeed.

Common Internal Relapse Triggers

Internal triggers for relapse are typically related to emotions or thought processes that may trigger a craving for drugs or alcohol. These triggers can be harder to avoid, as they are often subconscious. Successfully addressing these triggers will involve understanding what type of triggers to watch for and being aware of your emotions and thoughts. Some common internal relapse triggers include:

• Negative Emotions – Negative emotions, such as guilt and shame in recovery, can lead to an increased risk of relapse. This is because substance use can provide some degree of comfort and detachment that allows escape from these emotions. Dealing with emotional relapse triggers will require developing new coping strategies that do not involve substance use.
• Fear or Anxiety – Fear and anxiety can lead to increased stress. Stress in recovery is especially common, due to the physical and emotional changes that occur. Anxiety in early recovery is normal, but this increased stress may lead to a desire to relapse. Finding new ways of coping with fear or anxiety is very important during recovery and is one of the reasons that professional help during recovery is so necessary.
• Exhaustion or Other Sleeping Problems – During recovery, insomnia is a common effect of withdrawal. Being exhausted can be not only an internal trigger for relapse, but can also make it more difficult to resist cravings and urges. If you are having problems sleeping consider practicing good sleep hygiene and asking your recovery specialist about non-addictive sleeping medications.
• Boredom – There is a strong connection between boredom and relapse. Try to find a job, volunteer for community service or start a new hobby.  Avoiding boredom during recovery is very important, and if you find that you have significant amounts of free time, you should try to find something to occupy that time.

Everyone will have different internal triggers, but by recognizing some of the common ones you will be better equipped to avoid or address your internal triggers.

Recognizing Relapse Triggers to Avoid Risky Situations

If you are starting to consider relapse, you may find that you are exposing yourself to possible triggers, even subconsciously. If you find yourself in high risk situations that could trigger a relapse, you should immediately reach out to someone that you can trust and who is supportive of your recovery. Talking through the trigger and enlisting someone else’s help can provide you with the motivation and assistance needed to overcome the trigger and stay sober.

When you are exposed to a potential trigger, the cravings will pass within a few hours if you resist the urge to relapse. Having a plan to get through times when your cravings are triggered will be very helpful in avoiding a relapse.

If you or a loved one has experienced a relapse, or are just considering treatment options, we are here to help you. The Recovery Village has a strong record of helping people with substance use disorders to achieve recovery. Reach out to one of our understanding team members today to learn how you can start on your path to recovery.

Editor – Daron Christopher

Daron Christopher is an experienced speechwriter, copywriter and communications consultant based in Washington, DC. Read more

Medically Reviewed By – Benjamin Caleb Williams, RN

Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more