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3 Relapse Warning Signs You Can’t Afford to Ignore

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relapse warning signs risks ahead

People in recovery know that it requires consistent effort to maintain their sobriety, even if it’s been years since they last took a drug or drink. However, just as life has its ups and downs, so too does recovery. The important thing is to acknowledge the relapse warning signs you can’t afford to ignore and safeguard your well-earned recovery.

What is a Relapse?

Unfortunately, in some recovery groups, relapse is stigmatized, leaving members feeling like they weren’t working hard enough at their recovery or like they’ve let others down. The reality, however, is very different once you consider that addiction is a well-established medical condition (substance use disorder), not a moral failing.

As mentioned, relapse occurs with many chronic health conditions, and substance use disorder falls into this category. In fact, the National Institute on Drug Abuse defines addiction as a “chronic, relapsing disorder.” That’s because substance use disorder can make functional changes to the brain responsible for reward, stress, and self-control that continue long after the person has stopped taking drugs.

Bottom line: Even if you are in recovery, you are still at risk of relapse due to the long-term changes in brain function. But there are relapse warning signs you can be on the lookout for and prepare to address.

How Common is Relapse?

While not everyone in recovery relapses, there are certain groups who are at a higher risk, such as those in the early stages of recovery. Rates of relapse differ depending on the substance, too. Research shows that, for people who have completed alcohol addiction treatment, rates of returning to use are as high as 90 percent. Whereas those in substance use recovery are at a 50 percent risk of returning to use within the first 12 weeks of their recovery.

Approximately 40-60 percent of people with substance use disorders relapse, which is comparable to other chronic health conditions. For example, rates of relapse among people with asthma or hypertension are between 50 to 70 percent.

Now that we’ve explained the medical part of addiction, we can explore the life events and emotions that tend to contribute to relapse.

Relapse Warning Signs That Demand Attention

While any of life’s stressors can be a trigger for relapse, the warning signs we’re talking about are big red flags. In other words: a sign that your recovery could be in imminent danger. Below you’ll find three major stressors/red flags that can lead to relapse.

#1 Grief and loss

We often associate grief and loss with the death of a loved one. But grief and loss can apply to other events too, like losing your job, breaking up a romantic relationship, the loss of your home, or a family pet. These are all valid losses that can stir up the same sense of emotions that can be difficult to handle and could make you vulnerable to relapse.

Loss, even if it is expected, causes extreme emotional turmoil. If you have lost a family member, you may struggle to comprehend the gravity of their departure and deal with the waves of grief, sadness, anger, and depression that follow. The stress of dealing with that loss in your life may also mean the stress and burden of funeral arrangements, telling others of your loss, taking time off work, settling estates, and maybe increased responsibilities. Or perhaps losing your job means you may lose your home and be unable to support your family, causing distress, worry, fearfulness, insomnia, social isolation, and more.

At three years sober, Sarah lost her mom suddenly. “I felt like a rock had been slammed into my chest. I couldn’t breathe,” she explained. The enormity of her grief and sense of loss was so overwhelming that Sarah felt like she was on an emotional rollercoaster that she couldn’t wait to get off.

“As soon as I woke up in the morning, I realized my mom wasn’t there and I’d feel this searing pain and it came in huge waves all day, even when I was trying to sleep. I tried talking to friends and going to a meeting, but nothing helped. I’d have given anything to take away the pain.”

Unfortunately for Sarah, her brain remembered that she used to cope with her trauma by using, and that’s when the using thoughts started. “I just wanted one hit of heroin to give me a night off of the pain,” she said. She so desperately wanted to escape her reality that it frightened her, and she reached out to friends in recovery, who came to be by her side for a couple of weeks for support.

Sarah was lucky to have built a solid foundation of recovery so that she knew what to do to maintain her recovery even during her pain. Not everyone is that lucky.

#2 Thinking you can return to drinking normally

Perhaps you’ve been in recovery for a while and see your friends drinking, and maybe thinking to yourself that maybe enough time has passed since your addiction that you could drink normally if you gave it another chance. Or maybe you reflect on your past drinking and accept that drinking was a problem, but question other drugs, like marijuana, that you could return to and use normally.

In Reece’s case, his distorted memory caused a trail of destruction. “I had been sober for ten years and often wondered if I was just exaggerating my drug use. I mean, didn’t all teens take drugs all the time?” he explained. Unfortunately for Reece, his denial led him to picking up a drink again and before long, cocaine. “I thought I was fine drinking. I had a few and went home at a reasonable hour. I was able to do this for a month, until my friend brought out the cocaine, then all bets were off.” Before he knew it, Reece was sourcing his own cocaine and a few drinks with friends on the weekends, which eventually led to cocaine use every day.

“I ended up on this three-month bender, where I had to go back to treatment. It was so bad,” he explained.

#3 Withdrawing from recovery

When you stop attending meetings or therapy, stop answering your phone to friends in recovery, and let the demands of life take over, you may find yourself getting further and further away from the things that kept you sober. We’re not talking about missing one or two meetings or sessions with your therapist; we mean stopping for several weeks or months and maybe even feeling like they’re no longer necessary.

Dave was 18 months sober and a relatively active member of Alcoholics Anonymous (AA). He attended meetings three nights a week, worked through step work with his sponsor once a week, and hung out with his recovery buddies at the weekend. Dave was starting to feel pretty good about life, he took on a new job that made it difficult to attend meetings, and he was in a new relationship.

“I was feeling really stable in recovery. My girlfriend drank but she didn’t have a problem and it wasn’t triggering to me. Given my relationship, and my demanding job, it seemed like I had less time for AA, but I was OK with that because using was the last thing on my mind.”

“Life was awesome. I had fallen in love with my girlfriend, Michelle, and things were going well in my new job,” he explained. As life got busier, Dave had less time for AA.

Dave stopped attending meetings, stopped answering the phone to his recovery buddies, and spent all his time and effort at work and in his new relationship. We’re not saying this is wrong, per se. Rather, Dave was less connected to his reasons to stay sober and his support network for when life happens.

At two years sober, Dave went out for dinner with his girlfriend, but on the way home he was involved in a collision with another car that ran a red light. “I remember hearing a loud bang, but the next thing I knew I woke up in the hospital in agony,” he explained. The doctor explained to Dave that he’d broken his leg and would need surgery. To deal with the pain, he was given Vicodin (an opioid painkiller).

“It felt like a warmth washed over me and all the pain went away,” said Dave. Unfortunately, Dave needed more and more of the medication as his tolerance increased. However, even weeks after surgery, when the pain should’ve reduced, Dave found himself developing a problem. “I would go to the doctor telling them that my prescription ran out, but I had taken more than prescribed,” he explained. Unfortunately, it didn’t take long for Dave to end up back in AA, feeling like he’d gone full circle. Had he been in closer contact with his recovery friends, someone might have been able to point out his problematic use of painkillers, before it felt out of control.

Other impending relapse warning signs include, social isolation, feelings of discontentment, mental health problems, compulsive behaviors, loss of judgment, developing other process addictions (like gambling), behaving irrationally, and a sense of restlessness and discontent.

Safeguard Recovery By Recognizing Relapse Warning Signs

The good news is that you can safeguard the recovery you worked so hard for by being prepared to address any relapse warning signs when the occur. Some of the ways we can prevent relapse include:

  • Developing a relapse prevention plan, in which you look at major triggers and life stressors and develop potential solutions, so you know what to do in times of emergency, like sickness, death, grief, job loss, ending of a relationship, natural disaster, a pandemic.
  • Stick to your recovery routines. We’re not saying you still need to attend weekly therapy, or five meetings a week when you’re in longer-term recovery, rather be mindful of any major changes and be sure to check in with your support network about any potential changes.
  • Maintain mental and physical health. Working out regularly, eating nutritious foods, getting adequate sleep, and drinking enough water are great ways to maintain your health.
  • Manage stress levels. That could mean meditating, working out, talk therapy, playing with your dogs, getting outside in nature, taking regular breaks from work, pushing back on extra demands, and reaching out for support.
  • Be mindful of old thought patterns. Don’t forget that the brain changes in addiction, taking a long time to recover. In times of stress, it is only natural for the brain to remember that we used to cope with stress by taking substances. You don’t have to act on that thought and the more you do something more supportive, the closer you are to rewiring your brain to support recovery decisions.
  • Stay away from using buddies and environments. Chances are that the only thing you had in common was getting high. That’s why it’s important to avoid those situations in recovery. Otherwise, you may find yourself feeling comfortable about the prospect of using again, throwing away your hard-earned recovery.
  • Be adventurous while maintaining recovery. Believe it or not, boredom is a risk of relapse. That might mean doing the same thing day-in-day-out or feeling like life is mundane and lacking pleasure. While it’s important to maintain recovery routines, it’s equally important to plan adventures and have new experiences. After all, the point of recovery is to enjoy life!

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