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Relapse Prevention

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Why is Relapse Prevention Important?

Whether new to sobriety or sober for many years, relapsing is always possible. It is vital to understand the stages of relapse and which factors may put you at risk.

Understanding relapse prevention techniques and knowing how to help yourself is critical for a successful, long-term recovery. Creating a relapse prevention plan for alcoholism can help you maintain sobriety and avoid relapse.

The National Institute on Alcohol Abuse and Alcoholism estimates that 90 percent of people recovering from alcohol use disorder will experience at least one relapse within the first four years following treatment.

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How to Create a Relapse Prevention Plan

Whether on your own, with a rehab counselor, or through your support group, you should create an alcohol relapse prevention plan. Relapse prevention is a skills-based, cognitive-behavioral approach. It helps people learn how to avoid the triggers and situations that lead them to drink again.

While all prevention plans are unique, their main goal is to identify factors in a person’s life that increase the risk of relapse. The relapse prevention plan must also develop strategies to cope with these triggers.

These are the steps to create a relapse prevention plan:

1. Identify Triggers

Begin by creating a list of all possible relapse triggers. These can be 

You may not know all your possible triggers at the beginning, which is why it can be a list that evolves over time.

2. Learn and Practice Healthy Coping Skills and Preventative Tools

Create a list of healthy coping skills and tools you can use when cravings or thoughts of relapse occur. These coping skills can include building a healthy support system of friends and family.

Activities, such as exercising or journal writing, can also provide a distraction when triggering events occur. Another coping skill is to create a list of consequences should you relapse. Often, this is enough to redirect your thoughts and get you back on track.

3. Find and Participate In a Support Group

Support from others is a crucial part of relapse prevention. Having the ability to talk to others that understand your recovery process can help.

Finding a sponsor or counselor you can turn to in times of crisis is also beneficial. While 12 Step programs work for many people, other options are also available, such as:

  • Self-Management and Recovery Training (SMART) Recovery
  • Women for Sobriety
  • Secular Organization for Sobriety (S.O.S.)
  • LifeRing Secular Recovery
  • Holistic and Experiential Therapies

4. Create Lifestyle Changes

Recovery involves more than not drinking. For example, you must create a life where living is easier without alcohol.

Look for new activities and hobbies. Set new career goals. Meet new people and create new social circles that encourage your recovery.

5. Don’t Be Afraid to Ask for Help

Recovery is not something you have to do alone. Asking for help is not a sign of failure but rather a sign that you understand what is happening and need assistance. Self-help groups and support groups are great places to start.

6. Give Yourself Credit

Recovery isn't easy. Give yourself credit when you succeed and celebrate milestones. 

Healthy rewards such as going out to eat or buying new clothes can motivate you to continue working toward your goal. Remember, if you slip up, don’t beat yourself up. Instead, take action to correct the situation and learn from your mistakes.

What Causes a Relapse?

Addiction is a chronic brain disease that affects millions of people. A relapse occurs when someone abstaining from alcohol returns to their old ways. The following factors contribute to relapse:

Stressful situations

Situations that cause stress, like job loss, relationship problems, or financial issues, often lead to relapses. Alcohol can temporarily relieve stressful feelings, but they return once the drinker stops drinking. 

Withdrawal symptoms

Experiencing withdrawal is common after a long period of abstinence. Symptoms include:

  • Fatigue
  • Irritability
  • Anxiety
  • Depression

Going through withdrawal can lead to a relapse because the person feels miserable without alcohol.

Lack of support

Sometimes, someone trying to quit alcohol doesn’t have a strong support system. When you feel isolated, you are more likely to turn to alcohol. Support groups can help you cope with these difficult moments.

Exposure to Triggers

Triggers will affect individuals differently. Some people find that certain smells, music, or even words trigger them to think about drinking. Identifying any triggers that might make you want to drink again is essential.

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The 3 Stages of Relapse

A relapse typically doesn’t occur as a spur-of-the-moment event. In most cases, there are three main stages of relapsing. Understanding these stages and what to do when they appear can help stop a relapse before it takes effect.

The three stages of relapse include: 

1. Emotional Relapse

During an emotional relapse, a person is not consciously thinking about drinking. However, their emotions and behaviors are setting the stage for a relapse.

During this stage, denial plays a significant role. Many signs of emotional relapse are symptoms of post-acute withdrawal (PAWS).  Recognizing these symptoms can help minimize the risk of relapse.

Symptoms of PAWS include:

  • Foggy thinking/trouble remembering
  • Urges and cravings
  • Irritability or hostility
  • Sleep disturbances, such as insomnia or vivid dreams
  • Fatigue
  • Issues with fine motor coordination
  • Stress sensitivity
  • Anxiety or panic
  • Depression
  • Lack of initiative
  • Impaired ability to focus
  • Mood swings

Emotional relapse warning signs include:

  • Anxiety
  • Restlessness
  • Intolerance
  • Discontent
  • Anger and irritability
  • Defensiveness
  • Mood swings
  • Bottling up emotions
  • Isolation and not asking for help
  • Not attending support groups (or not listening and sharing)
  • Poor self-care (not eating, sleeping, or practicing good personal hygiene)

During an emotional relapse, the main goal should focus on self-care. The acronym HALT– hungry, angry, lonely, and tired–is critical to remember during this stage.

Ask yourself questions like, “are you giving yourself enough time to rest?” or “are you taking time for yourself?” If the answer to these questions is no, it might be time to take a step back and practice self-care. You might also want to share your feelings with a support group or counselor.  

2. Mental Relapse

During a mental relapse, a person is at war with their mind. They know they shouldn’t drink, but a part of them still looks for excuses to do so.

As this stage progresses, a person’s resistance to alcohol diminishes. Their need to escape through alcohol use increases. Early warning signs of mental relapse include:

  • Thinking about people, places, and things associated with past use
  • Spending time with users
  • Cravings for alcohol
  • Glamorizing past use
  • Minimizing the consequences of their past use
  • Bargaining
  • Lying
  • Thinking of ways that they could better control their alcohol use
  • Looking for opportunities to relapse
  • Planning a relapse

During this stage, seeking help is critical to prevent a relapse. You can do so by talking to non-using friends, attending a meeting, or speaking to a counselor.

You can also find something to distract yourself. It takes 15 minutes for craving urges to go away, so staying busy and using coping skills is essential.

3. Physical Relapse

Physical relapse is when alcohol use occurs. Driving to the liquor store and purchasing alcohol are also considered physical relapses.

If you can’t address the problems of emotional and mental relapse, it doesn’t take long to progress to physical relapse. For this reason, understanding and recognizing the signs of emotional and mental relapse is crucial.

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The 3 Stages of Alcohol Recovery

Research shows three main stages in the recovery process. Each stage has specific tasks that can assist in preventing alcohol relapse. However, recovery is a personal process, and the length of each stage varies from person to person. The three stages include:

1. Abstinence Stage

The abstinence stage starts immediately after alcohol cessation and can last for one to two years. During this stage, the main focus is fighting cravings and avoiding alcohol use.

Other goals of abstinence include personal self-care and development. It is also common for PAWS and relapse to occur during this stage.

Some critical tasks of this stage include:

  • Accept that you have an addiction
  • Be honest with yourself and in your life
  • Develop coping skills to address cravings
  • Become an active member of your support groups – be willing to share
  • Focus on self-care and be kind to yourself
  • Change your group of friends – stay away from friends that still use
  • Develop healthy alternatives to drinking
  • See yourself as a non-user

2. Repair Stage

The repair stage focuses on repairing the damage caused by alcohol addiction. In many cases, it can last two to three years.

During this stage, recovering alcoholics must confront the damage their addiction caused to relationships, their careers, their finances, and how they feel about themselves.

In this stage, a person works to overcome guilt and negative self-labeling to move forward. Some practical tasks during this stage include:

  • Understand that a person is not their addiction
  • Begin repairing personal relationships with family and friends
  • Work to improve self-care and make it an integral part of your daily life
  • Continue to be active in support groups
  • Continue to develop healthy alternatives to drinking

3. Growth Stage

The growth stage is about moving forward and typically begins three to five years after alcohol cessation. This stage is the start of a new lifelong path to sobriety.

Sometimes, this is the time to address and confront any underlying cause of your initial addiction. While many may want to address this sooner, people typically do not have the coping skills necessary to do so without increasing their relapse risk.

Some recommended tasks during this stage include:

  • Identify and begin to repair self-destructive patterns and negative thinking
  • Understand how familial patterns and past trauma may have contributed to your use and begin to move forward
  • Set healthy boundaries
  • Give back and try to help others
  • Take time regularly to reevaluate how you are living
  • Take care of yourself to keep moving forward
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Updated on October 31, 2022
7 sources cited
  1. Melemis, Steven. “Welcome.” 
  2. Melemis, Steven M. “Relapse Prevention and the Five Rules of Recovery.” The Yale Journal of Biology and Medicine, 2015. 
  3. Moos, RH, and Moos, BS. “Rates and Predictors of Relapse after Natural and Treated Remission from Alcohol Use Disorders.” Addiction, 2006. 
  4. “Treatment and Recovery.” National Institute on Drug Abuse.
  5. “Post-Acute Withdrawal Syndrome (PAWS).” Semel Institute for Neuroscience and Human Behavior. 
  6. “Relapse and Craving-Alcohol Alert No. 06-1989.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services.
  7. “Relapse Prevention.” UC Santa Cruz.

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