Why do people with substance use disorders relapse? There is no single answer, but several factors can contribute to someone relapsing. Below we will discuss 10 common reasons people relapse, and how to address them.
REASON No. 1: The person who has relapsed was never in recovery to begin with.
Please keep in mind that in order to relapse, a person needs to have been in recovery. Some individuals may stop using a substance, but they don’t make any lifestyle changes to help sustain recovery. This is often referred to as the “dry drunk syndrome”—the person is physically sober but emotionally unhappy. People who only stop using without making any other life changes are not likely to experience much peace of mind, as they have yet to address the underlying issues that contributed to their addiction in the first place.
Recovery involves making major lifestyle changes and working on a program of recovery.
REASON No. 2: The person who has relapsed wasn’t able to be honest with themselves and others.
Alcoholics Anonymous (AA) references the idea that people who cannot be honest with themselves don’t do well in recovery. In my experience, the individuals who are honest about how things are going—good or bad—are the ones that can work through challenges encountered in recovery.
Learning to be honest is a habit that must be practiced in order to prevent relapse.
REASON No. 3: Unwillingness to do whatever it takes to stay clean.
Most people’s recovery program only consists of what they are willing to do, not what they need to do. There is a saying: “In solving any problem, it’s not our willingness to do something that makes a difference, but our willingness to do whatever it is going to take.”
Ask yourself, “What changes do I need to make to stay sober in the long run?” and then work toward becoming willing to do those things.
REASON No. 4: Overconfidence and loss of humility.
Early in recovery one believes, “I need others in this journey to help me stay sober” and “Recovery isn’t easy.” Humility was displayed during this early stage as support was embraced and utilized. Over time, a shift in attitude (such as, “I don’t think I need all this support” or “Recovery is actually pretty easy and I’m fine now”) can sabotage the recovery process.
“Humility is a necessary ingredient of sobriety. A continuous look at our assets and liabilities, and a real desire to learn and grow by this means, are necessities for us.”*
REASON No. 5: Recovery loses its priority; as a result, recovery-related activities are reduced.
As overconfidence kicks in, there is the natural tendency for those in recovery to alter behavior by reducing or letting go of recovery program aspects that are working for them and giving other activities more preference.
Some examples include:
• Attending recovery meetings regularly to attending none.
• Quitting spiritual practices such as prayer and meditation.
Imagine going on a diet and losing weight through a program of healthy eating and exercise. Would it make sense to stop the program when your goal was achieved? Of course not. The same idea applies here. As the saying goes, one needs to “Keep sobriety first to make it last.”
REASON No. 6: Problems occurring outside of one’s ability to cope.
One great reason to continue with one’s recovery plan and keep up with recovery supports is that life will sometimes throw us problems that are unexpected and outside of our coping ability. This can lead one down the path toward a relapse.
Maintaining supports, asking for help and working our plan of recovery can help during these difficult times.
REASON No. 7: Unresolved personal issues.
Often difficult issues—including family of origin issues, unresolved trauma/abuse/grief/loss, marital conflict, career decisions, etc.—serve as triggering events for relapse. Successfully facing and working through them reduces vulnerability to relapse.
These issues often require a new set of skills and/or support obtained through individual therapy, couples counseling, family counseling or trauma-based therapy.
REASON No. 8: Untreated mental health issues.
Many recovering individuals have untreated mental health issues outside of their substance use disorder which make recovery more challenging. Unresolved personal issues cause stress to build. Often, these mental health issues were self-medicated by the substance use.
Individual therapy and potentially medication-assisted treatment (MAT) are options to consider for addressing these concerns.
REASON No. 9: Cross addictions and other addictive behaviors.
When people enter recovery, they often find new ways to cope with life’s challenges. However, not all these new coping mechanisms are healthy. As individuals distance themselves from substance use, they may develop similar problematic behaviors, such as preoccupation, loss of control, and continued engagement despite negative consequences.
It’s important to stay vigilant about potential issues with overeating, pornography, gaming, internet use, overworking, shopping, and gambling.
REASON No. 10: Being prescribed an addictive medication.
When you have a history of addiction, there’s always a risk of becoming addicted to another substance, even if it’s prescribed. Many addictions begin with a seemingly “harmless” prescription.
It’s crucial to communicate your addiction history with your doctors to prevent potential issues.
Experts consider relapse a process with identifiable warning signs that indicate someone is becoming dysfunctional in their recovery and, as a result, is at an increased risk for using. Relapse can be preventable if we keep in mind the above factors and are willing to take the necessary steps to address them.
*Alcoholics Anonymous, 12 Steps and 12 Traditions
