Contrary to what many people think, relapsing in addiction recovery doesn’t actually have to entail a physical return to substance use. People are considered to be in relapse when they stop making recovery their top priority and stop engaging in the activities and behaviors that are part of their defined relapse prevention plans.
For instance, even spending extended periods of time in isolation while discontinuing your involvement in sober meetings or other support services is a form of relapse. Relapse occurs in three distinct and progressive phases. Although the last of these is a physical relapse in which a person actually returns to consuming alcohol or using another substance of choice, the need for personal or professional intervention is consistently high throughout.
Another important thing to know about relapse is that it is also incredibly common. Most recovering addicts relapse at least once during their first year of sobriety. In fact, relapse is so common that it is currently recognized as a normal part of the recovery process. Thus, whether you’re in the throes of a long-running relapse event or dealing with constant, nagging temptation to use, each new day is a new opportunity to change your course.
What Are the Three Stages of Relapse
The three stages of relapse are:
- Emotional relapse
- Mental relapse
- Physical relapse
In emotional relapse, people often battle general feelings of discontent. They may find it hard to feel happy, motivated or focused, and they may struggle to connect with others around them. In emotional relapse, many recovering addicts content with persistent depression, malaise, and lack of initiative. This is a stage during which the expectations for life post-recovery aren’t always met.
Although recovering addicts can always recognize ways in which both their lives and life qualities have improved following addiction treatment, they may have had far more grandiose visions of what these improvements would ultimately be. Surprisingly, these feelings are actually connected to the chemical changes that addiction has caused. This is why emotional relapse typically occurs within just three to six months of starting recovery.
Heavy and prolonged substance abuse alters the mood-enhancing or “feel good” chemicals in the brain known as neurotransmitters. Among these, dopamine plays the most critical role in mood balance, motivation, and initiative. Although maintaining your abstinence for several months gives your brain and body ample opportunity to heal, it is not uncommon for it to take three to six months for a full dopamine rebound to occur. As such, if you’re contending with the very first symptoms of relapse, your emotional battles are a good sign that your brain is still working its way back to balanced chemistry and balanced overall functioning.
Mental relapse is the second stage of relapse. This is a time when people begin negotiating or bargaining with themselves, romanticizing their past substance abuse, and even imagining themselves actively using or making plans to acquire substances. In bargaining during the second stage of relapse, a person might promise to only use substances just one time or to limit themselves to a specific dose or amount.
Both mental and emotional relapses can also be indications of the brain and body’s gradual return to normalcy following a particularly challenging detox. For instance, after a person’s initial detox is complete and all physical withdrawal symptoms have abated, most people develop a series of post-acute withdrawal symptoms (PAWS). PAWS are largely psychological symptoms that affect how people behave, think, and feel, and they can include:
- Insomnia, hypersomnia, or other sleep troubles
- Lack of motivation
Although PAWS often dissipate within just one to three months, they can sporadically recur all throughout a person’s first year of recovery. Thus, mental and emotional relapse can be indicative of a short-term return of post-acute withdrawal symptoms for many newly recovered addicts. PAWS are a likely catalyst for relapse in alcohol and benzodiazepine recovery, and delayed dopamine rebound is a likely catalyst in opioid/opiate recovery.
The third and final stage of relapse, physical relapse, can be incredibly dangerous for certain substance types. In fact, the longer that a person has abstained from their drug of choice, the more dangerous physical relapse can become. This is because prolonged periods of abstinence result in lowered tolerance. This means that if a person returns to the same drug that they once used and at the same dose, the risk of overdose is significantly higher. With lowered levels of tolerance and virtually unchanged expectations, many people who enter into physical relapse deal with consequences such as alcohol poisoning, respiratory suppression, ataxia, and central nervous system (CNS) depression.
Although relapse is both a common and expected part of the recovery process, all recovering addicts are encouraged to have plans for preventing it. Understanding the distinct phases of relapse makes it easier for people to recognize developing issues and to reach out for support before physical relapse is reached. If you need help getting back on the path to recovery, we’re here to provide it. Call us today at 833-497-3812.