The 3 Stages of Relapse and Preventative Steps You Can Take

Most people think of relapse as the physical event of returning to substance use after a period of abstinence. But the truth of the matter is that relapse is a process that begins long before the return to substance use. The stages of relapse include emotional, mental, and physical responses that may happen over the course of days, weeks, or even months. These stages all have their own characteristics and prevention strategies.

Why is it Important to Recognize These Stages?

It’s important to catch these stages as early as possible. The earlier you notice a relapse, the easier it is to implement prevention measures. If relapse reaches the physical stage, engaging in substance use, a return to sobriety will be all the more difficult. Many people feel that after a full relapse, they are back to starting from square one. However, even though a relapse is a setback, it is not the end of recovery.

With the weight of unmanaged emotional stress, an individual graduates into mental relapse. This stage is where a person begins to romanticize previous substance use and rationalize or bargain for a return to substance use. Some of these thoughts may sound like:

• “If I could stop before, I can stop again after this one time.”
• “No one will know, it’s just one drink.”
• “It doesn't count if I’m on vacation.”
• “I’ve been under a lot of stress lately and nothing else is helping.”

This isn’t to say that these thoughts won’t occur in regular recovery. In fact, it’s expected that a person in recovery will contemplate past substance use and acknowledge cravings. The difference is that these thoughts are coupled with support and healthy coping skills. An individual should be vocal about these thoughts instead of keeping them bottled up where they can snowball into physical relapse.

Preventative Steps

Since mental relapse is all about a hypothetical return to substance use, it’s time to explore. Think about not only the simple act of returning to substance use but the ramifications of that return. How did it go last time? What was your life truly like at the height of your past substance use? What was your friend group like? How was your job going? How did you feel about yourself? Play the scenario of substance use through in your head and remind yourself why you’re in recovery. This is commonly referred to in recovery as “Playing the Tape.”

• Call someone and tell them you are going to a meeting tomorrow and be sure to name a specific time. Ask them if they can come with you. Research indicates that publicly announcing your goals out loud makes you more likely to follow through on your intentions. The more specific you are, the better. Additionally, having someone attend with you keeps you accountable to follow through.
• Be transparent about your urges. Tell a friend, family member, sponsor, or someone else you feel comfortable confiding in that you’re experiencing cravings. There is no shame in these feelings and there is no shame in asking for help.
• Give it 30 minutes. Tell yourself you’re going to wait 30 minutes and set a timer. Watch a TV show, go for a walk, or start an activity. These cravings can be fleeting and pass after a period of time.

First, know that relapse is common and does not mean treatment failed or that recovery is out of reach — for many people it's part of the journey, and it's often a signal that the recovery plan needs adjusting rather than repeating. The most useful next step is usually a fresh assessment: what triggered the return to use, whether an untreated co-occurring condition (like depression or anxiety) is a factor, and whether a higher or longer level of support is needed this time. If your loved one has returned to heavy or regular use, a medically supervised detox may be the safest first step before anything else.

Why do people relapse after completing treatment?

Relapse usually happens for identifiable reasons — unmanaged stress or triggers, an untreated mental health condition, too little structure or support after the initial program, or stopping aftercare too soon. Understanding the specific reason is what lets you change the plan rather than just trying again the same way.

What can we do differently the second time?

Common adjustments include a longer or more structured continuum of care (such as an intensive outpatient program or sober living instead of returning straight home), addressing any co-occurring mental health conditions alongside the substance use, building a stronger relapse-prevention and support plan, and staying engaged with aftercare longer. Our admissions team can help reassess the situation and recommend a next step based on what happened this time.

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