Like addiction itself, relapse is a highly complicated process that is experienced by almost half of all recovering addicts.

Relapse is often characterised as a process rather than a single event. Relapse may not necessarily begin with the individual using substances again, but may begin with small steps leading towards a loss of stability and abstinence.

Addiction is known as a family disease, with loved ones affected just as much (if not more) than the individual themselves. Supporting a loved one through relapse can be an intensely difficult situation.

Relapse. What does it mean?

During the recovery process, sufferers may become exposed to certain triggers and other risk factors.

Relapse refers to a return to drugs, alcohol or any other addictive behaviour after a period of abstinence.and is generally categorised into three separate stages: emotional, mental and physical.

Emotional

An emotional relapse usually experiences before a physical relapse. This can also be referred to as post-acute withdrawal, where the recovering addict experiences emotional distress, which can be a trigger for mental and physical relapse later on. It is important that an emotional relapse is addressed immediately before other stages of relapse commence.

Typical signs can be:

  • Mood swings
  • Behavioural changes
  • Problems with family, friends, work
  • Stress
  • Defensiveness
  • Ignoring continuing care plans
  • Not asking for help

Mental

Once the person enters this stage of relapse, they will begin ‘toying’ with the idea of relapsing. Throughout this stage, the person will feel temptation to use again and begin thinking thoughts of, “I’ll just do it one time.”  This stage signifies a slip back into addictive thought patterns, such as denial, minimising their problem and romanticising their ‘old days’ of using. They may not even be consciously aware that this phase is occurring.

Typical signs include:

  • Feeling nostalgic about substance use
  • Denial
  • Romanticising past use
  • Fantasising about future use
  • Socialising with people who use
  • Negotiating with self: ‘It won’t be that bad if I do it just once more.’

Physical

Ignoring emotional and mental relapse phases are likely to lead to an eventual physical relapse, where the individual returns to using substances.This phase is the hardest to recover from, and why an emphasis on an ongoing care plan is key to recovery.

Why do people relapse?

Recovering from addiction is a lifelong battle, one that requires constant effort in fighting against the chronic mental illness. It’s very important that loved ones understand that there are likely to be many ups and downs throughout the recovery process, and may require more than one treatment.

There are many triggers that can cause one to relapse, from everyday stress to large emotional events. Emotions such as depression, guilt, shame, isolation and even hunger are known as triggers, as a form of escape.

Other factors from research suggest that smoking, low self-esteem, unemployment, a family history of drug/alcohol abuse and ties to drug-related friends are major factors that influence the likelihood of relapse.

What do I do when my loved one relapses?

Friends and family may have experienced a real sense of relief and hope when their loved one entered treatment, believing that recovery could be attainable in the near future. Watching your loved one relapse can feel like a crushing defeat, and that treatment has ‘failed’. First and foremost, loved ones and the sufferer themselves need to remember that recovery from addiction is rarely linear and perfect, and mistakes do happen.  Now is the time when your loved one needs your support the most. It is likely the individual is feeling immense waves of guilt, shame, failure, self-hatred and disappointment. Whilst your support is paramount, it is also important to stay strong for your loved one and lead them back into treatment and recovery. Furthermore, Nightingale Hospital strongly recommends that those close to the recovering addict seek support as well.

Regardless of which stage of relapse, here are some of our suggestions designed to help support your loved one:

Identify changes in behaviour

Be mindful of any triggers that may have caused a change in behaviour. This could be a physical place, or a person who they connect with past substance abuse. Encourage and support your loved one to identify their feelings, and encourage open communication. Remind them to try and avoid coming into contact with this trigger. A way of doing this could be to promote meeting new people, and engaging in new hobbies. If you suspect your loved one is experiencing challenges in maintaining their sobriety, keep communication open. Ultimately, by recognising changes in behaviour, you can better help address them and prevent them from further occurring.

Encourage and motivate

Encourage your loved one to stick to their care plan. This may involve reaching out to a sponsor, attending AA/NA meetings or other support groups, or getting in touch with their specialised health professional. Encourage them by referring to how far they’ve come in their treatment, and motivate them to seek extra support now more than ever. Providing positive reinforcement is one of the best ways to support your loved one. Escorting them to peer support meetings or social events can be a positive way to support your loved one on their path to recovery.

Be firm for your loved one

It can be incredibly difficult to see someone you love suffer, however it’s important to try and stay strong and emotionally detached from the situation. It is common, but ultimately very harmful for those supporting an addict to fall into a trap of enabling or co-dependency. It is important to remind the person that they are in control of their recovery, and to also keep them accountable for their decisions. Don’t try make excuses for your loved one. Instead, motivate them to revisit steps they learnt throughout their treatment, or refer to their care plan.

Don’t blame or shame

Normal reactions watching a loved one relapsing can be anger, disbelief, hurt and exasperation. It’s very important not to berate the relapsing addict, as it’s likely they already feel incredibly guilty and hopeless. Adding to the pile of negative emotions can cause the sufferer to further retreat into using substances. Research and statistics routinely point to feelings of shame being a core factor in addiction, and a limiting factor to a healthy recovery. instead, focus on encouraging your loved one back to recovery. Instead, try and channel your varying emotions in another way.

Take care of yourself

The old saying goes, ‘you can’t pour from an empty cup.’ Addiction can be particularly draining, exhausting and emotionally crushing for the family and loved ones of the sufferer. It can lead to feelings of resentment, and a general habit of neglecting your own mental, emotional and physical health. We recommend seeking help yourself, either through a therapist or consultant psychiatrist specialising in addiction, or peer support groups.

Helpful resources