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Signs of Relapse

picture of Joe Gilmore
Medically Reviewed By: Diana Vo, LMFT

November 4, 2021 (Originally Published)

November 28, 2022 (Last Updated)

Table of Contents

With rates of relapse for addiction similar to rates of other physical illnesses, recognizing the signs of relapse is invaluable, whether in yourself or in a loved one.

Data shows that between 40% and 60% of those in recovery will relapse at least once during the first year of sobriety.

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Addiction is a chronic and relapsing condition, meaning relapse always remains a possibility for anyone in recovery.

While relapse can feel like the end of the world, take a step back and consider the broader canvas. Recovery is a process and not an isolated event like detox or relapse. The process might not always go smoothly, but what counts is how you react to a relapse.

Ideally, you should immediately re-engage with treatment after relapsing, whether in a residential rehab or an outpatient facility.

There are many common warning signs of relapse, though, so the more awareness you have of these pitfalls, the less likely you are to slip up.

Signs and Symptoms of Relapse

Research shows that the following are the most common predictors for relapse of alcohol abuse and substance abuse:

Many factors can cause an increase in your stress levels, from external events and major changes through to an accumulation of small things causing you to feel stressed.



For many people in the early phase of recovery, shifting from the cocooned environment of residential rehab back into the harsh reality of daily living can prompt stress levels to soar.



Stress is an inevitable part of life, so while you can do your best to minimize it, there is no practical way to avoid stress completely. What counts is how you deal with stress, especially if you tend to overreact to stressors. If you find you are experiencing dramatic mood swings, or if you have overly positive or negative feelings, this could be a sign of imminent relapse, so keep your guard up.

If you notice yourself or a loved one in recovery starting to place less importance on the recovery process, this is an early sign of relapse potentially looming on the horizon.

Another classic indicator of possible relapse is someone abandoning the schedule and structure developed during the initial phase of sobriety.

From sleeping into skipping meals and a dip in personal hygiene, when structure starts collapsing, you are inviting the chaos of active addiction back into your life.

If you notice this happening, take decisive action and get back on track before relapsing.

Insomnia, memory loss, depression, and anxiety are all post-acute withdrawal symptoms.

These symptoms can return during stressful periods, so avoid any temptation to self-medicate with drink or drugs.

Any pronounced behavioral changes can indicate the possibility of relapse. Be on the lookout for this, whether in yourself or a loved one in recovery.

Are you feeling overwhelmed or confused for no particular reason?

Do you find your head feels cloudy and you are struggling to make healthy decisions?

If your judgment appears suspect, stay strong as relapse could be lurking ready to pounce.

Many people in the early stage of relapse find themselves withdrawing socially.

From making excuses not to meet friends to cutting back on the number of support meetings you attend, isolation is not a good sign.

Denial often accompanies active addiction, but in recovery many people find themselves in denial of the stress they are undergoing.

If this manifests in the form of denial of any problems in recovery in the face of obvious evidence to the contrary, relapse is a threat you should look out for.

A surefire sign of relapse is when someone starts limiting their options, typically with adverse outcomes.

Failure to attend meetings, discontinuing medication-assisted treatment, or refusing to attend 12-step meetings can indicate relapse is looming.

When you find yourself making irrational decisions such as cutting off those who are helping you, you may start feeling hopeless, while at the same time losing confidence in your recovery.

Alcoholic Relapse Warning Signs

Relapse is a process that can start weeks or months before physically picking up a bottle.

Research shows there are three distinct stages of relapse:

  • Emotional stage of relapse
  • Mental stage of relapse
  • Physical stage of relapse

Emotional Stage of Relapse

While you may not be thinking about drinking during emotional relapse, your behaviors and your emotions are making this a possibility.

Common red flags of emotional relapse are as follows:

  • Poor sleep habits
  • Poor eating habits
  • Not attending support meetings
  • Not asking for help
  • Isolation
  • Mood swings
  • Anger
  • Anxiety
  • Intolerance
  • Defensiveness

This is the easiest stage of relapse to pull back from.

Mental Stage of Relapse

During the mental stage of relapse, part of you may feel like drinking, while part of you remains committed to sobriety.

When this phase begins, you may only idly and occasionally think about drinking, but during the latter part of the mental stage of relapse, you are frequently and pointedly thinking about drinking.

The most common signs of mental relapse include:

  • Think about relapsing
  • Fantasizing about drinking
  • Thinking about people, places, and things you associate with drinking
  • Hanging out with drinking friends
  • Glamorizing your past drinking habits
  • Lying and deceitfulness

With the pull of addiction becoming stronger, making the right choices becomes harder. Making the wrong choices, on the other hand, can lead to the physical stage of alcohol relapse.

Physical Stage of Relapse

If you find yourself thinking about relapse and you fail to take action, you could find yourself rapidly entering physical relapse, and at this point you will need to re-engage with recovery.

Heroin Relapse Warning Signs

Heroin addiction brings about changes to the structure and function of the brain just like alcohol addiction. As such, heroin relapse follows the same three stages as those outlined above for alcohol relapse.

Beyond this, you may notice physical warning signs such as the reappearance of drug paraphernalia or track marks on the arms of a loved one from someone dealing with heroin relapse.

As with alcohol relapse, you should take immediate action if you find yourself thinking of using heroin during your recovery. Reach out to your support group or social support network and stay strong!

Overcome a Relapse at Renaissance Recovery

Being aware of the most common signs of relapse is the best chance of preventing relapse from happening.

That said, with relapse rates for addiction mirroring relapse rates for other chronic conditions, it is a common occurrence, and it’s also considered a part of the recovery process.

Relapse does not mean that treatment has been a failure, but it sometimes means your treatment plan might need tweaking. We’ll help you with that here at Renaissance.

We can also help you to pinpoint the reasons underpinning your relapse, and we’ll help you to create a new relapse prevention strategy with the help of a therapist.

Whether you need to re-engage with treatment here at Renaissance or you want to take advantage of our outpatient treatment services for the first time, getting started is easy. Call admissions today at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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