The stages of relapse are emotional relapse, mental relapse and physical relapse. In alcohol addiction, this is usually a gradual process rather than a single event, which means there are often warning signs before drinking starts again.
Perhaps you’re reading this because you or a loved one are struggling with alcohol addiction, have already relapsed, or want to understand how to prevent an alcoholic relapse. Here, we explain the stages of alcoholic relapse, the signs and symptoms to watch for, the risks and frequency of relapse, how to reduce the chance of it happening, and what to do if it does, including treatment options.
A relapse on alcohol where there has been a previous alcohol problem can be devastating for many reasons. The individual who has relapsed will often delay seeking help or being honest about their relapse as they feel a great deal of shame, guilt and an overwhelming sense of failure. These feelings can drive their alcohol use underground and escalate their drinking to a point they have never previously experienced before.
Alcoholic relapse is life threatening and something that few want to discuss openly. We want to reassure you that if you are currently experiencing an alcoholic relapse that recovery is possible, no matter how bad or how hopeless things may seem.
The Stages of Alcoholic Relapse
Alcoholic relapse is a gradual process, often described as the three stages of relapse and three distinct stages that begin before someone takes a drink. There are stages that precede the actual picking up of an alcoholic drink. Spotting the early stages of alcoholic relapse in yourself or someone you love may help you to prevent a relapse from happening.
Stage 1 of Alcoholic Relapse: Emotional Relapse
Alcohol relapse often follows three stages of relapse, and the emotional relapse stage is the earliest point in that cycle. It is also where many of the early warning signs first appear.
The individual will start to feel unable to express how they are feeling. Perhaps they start telling themselves that others will be disinterested or judge them for how they are feeling – so they stop talking. Emotionally they may feel numb, angry or frightened. Unprocessed emotions start to take over and can feel overwhelming.
An individual who is in emotional relapse is likely to withdraw from others and become dishonest around their thoughts and feelings. They are likely to feel alone and detached from life and start to wonder if recovery is worth the pain they are experiencing. Anxiety, irritability and denial can also begin to surface at this point.
Sometimes a life event triggers an emotional relapse, but not always. The break down of a relationship, poor health, financial worries or the death of a loved one are known triggers. In some cases, poor self care can also make emotional strain harder to manage.
To help someone who you see is in this stage of alcoholic relapse it is important to not be dismissive or judgemental. Encourage them to talk openly about how they are feeling. It may be that they will find counselling, therapy or a visit to their GP or mental health worker beneficial if they feel unable to cope emotionally. Good self care can also help restore emotional balance and support relapse prevention.
If the individual has achieved sobriety through a mutual aid group such as a 12 step fellowship or SMART recovery, encourage them to re-engage with what has previously worked for them. If they have attended alcohol rehab and have an aftercare package – encourage them to speak to the rehab.
An emotional relapse can last for some time and more often than not there is an underlying cause. The first step is to encourage them to talk frankly with you and to offer support in helping them access the correct help.
Stage 2 of Alcoholic Relapse: Mental Relapse
Following the emotional relapse stage and preceding picking up an alcoholic drink, comes a mental relapse. This second stage is one of the early warning signs before drinking resumes. What does a mental relapse look like?
An individual in recovery and suffering from stage 2 mental relapse will start to obsessively think about alcohol or possibly other unhealthy ways of changing the way that they feel. They are likely to revert back to dysfunctional behaviours and pull away from anything and anyone associated with their alcohol recovery. Poor self care can also show up here, including neglecting basic routines, mood swings or poor eating, even before substance use thoughts fully take over.
It is likely they will experience euphoric recall around their drinking days and start to feel resentful towards recovery. They may well blame others for the way that they feel. These are common mental relapse signs, and as cognitive resistance weakens, the risk of acting on cravings can increase. As drinking thoughts become more frequent, they start to fantasise about drinking. They may be planning a relapse, becoming secretive and distant, or minimizing consequences linked to past drinking. Their behaviour is likely to resemble their behaviour whilst in active addiction – all that is missing is the actual alcohol.
Intervention at this point becomes critical if an alcoholic relapse is to be avoided.
Stage 3 of Alcoholic Relapse: Physical Relapse
This is the second stage, or stage 2 mental relapse, where a person in recovery is pulled back towards old patterns before use becomes a full blown relapse. An individual in recovery and suffering from a mental relapse will often feel torn between wanting to stay sober and wanting to escape. Common signs include obsessive thinking, secrecy, and bargaining thoughts that make substance use seem easier to justify.
There may be euphoric recall, where they remember the positives of past use and ignore the damage it caused. This can become especially dangerous when someone starts believing drinking alcohol is acceptable on certain occasions, as this is a clear warning sign rather than harmless thinking. As they begin fantasising and planning a relapse, they may also minimise the consequences of past drinking, and their cognitive resistance starts to weaken.
Once this process continues unchecked, the individual in recovery breaks their abstinence around alcohol. Once they start to drink again they find it very difficult to stop. Often they will find that their drinking is worse than ever before as they struggle to find the courage to admit they are drinking.
Alcoholic relapse is life-threatening, even though they may appear to be able to control their drinking for a while, inevitably the alcohol consumes them once again. Professional intervention and treatment are often required once a physical relapse has happened.
The Dangers of Alcoholic Relapse
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Alcoholic relapse carries many dangers, the main one being that the individual will feel too ashamed to admit that they have fallen off the wagon to seek help. This will lead to secretive drinking and unhealthy behaviours.
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Alcoholism only ever gets progressively worse over any given period of time, never better. It has been said many times, once an alcoholic, always an alcoholic. An alcoholic brain quickly recalls what alcohol provides in terms of ease, comfort and confidence and forgets the negative consequences of previous drinking bouts.
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An individual who has previously had an active recovery life will feel isolated, detached, anxious and quickly become very depressed. This can cause them to be more reckless with their drinking and take bigger risks.
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A period of abstinence from alcohol also means that the body’s tolerance levels will have dropped dramatically. There is an enhanced risk of alcohol poisoning and damage to the body’s vital organs. Any healing that has taken place physically, mentally and emotionally is very quickly undone.
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Trust that has been rebuilt with family, friends and loved ones are also destroyed once more.
There is nothing glamorous about alcoholic relapsing. In our experience, it is extremely distressing to watch and if help is not sought can result in death.
How Common Is Alcoholic Relapse?
There is very little statistical information in the UK regarding the rates of alcoholic relapse. This is because individuals can find recovery for years before suffering a relapse, and not all who suffer a relapse re-enter treatment services. There are also those who are able to stop drinking alcohol without professional treatment and so cannot be tracked.
The most thorough investigation into understanding alcoholics and addicts in recovery was conducted by the Chestnut Health Systems, Chicago and Bloomington, Illinois, USA, who conducted an 8-year study of nearly 1200 addicts and alcoholics.
The study was able to successfully follow over 94% of participants. Their findings showed that extended abstinence from alcohol and drugs increased the chances of permanent abstinence.
The researchers, who published their findings in the National Centre for Biotechnology in 2007, found that:
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Only about a third of people who are abstinent less than 1 year will remain abstinent.
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For those who achieve 1 year of sobriety, less than 50 % will relapse.
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For those that achieve 5 years of sobriety, their chance of relapse is less than 15%
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Relapse rates are higher amongst those that do not undergo professional treatment and in those that suffer from dual diagnosis.
Relapse is common across substance use disorders, especially in early recovery, and guidance from the National Institute on Drug Abuse treats it as a sign that more support or a revised treatment plan may be needed rather than personal failure.
In a separate study, published in 2006 in the Addiction journal for the US, it was found that 62% of individuals treated for alcoholism through alcohol rehab or Alcoholics Anonymous maintained recovery after three years. This was reduced to around 43% of individuals who did not undergo any form of alcohol treatment.
Alcoholic relapse is something that can be avoided with the correct treatment and support. Permanent recovery from alcoholism is possible but it does take commitment and hard work. Sometimes alcoholic relapse happens because the individual has not accessed a treatment programme that works for them. For an individual to remain in alcohol recovery, their recovery has to be enjoyable.
For an individual that struggles to maintain abstinence from alcohol, rehab treatment is recommended. Repeated relapses are indicative of unresolved trauma, deep-rooted issues or undiagnosed mental health illness, so getting prompt help can protect long term recovery. Many people in addiction treatment experience at least one relapse in recovery, with estimates suggesting around 40-60% do so.
The Signs and Symptoms of Alcoholic Relapse
Are you worried that a loved one or family member has relapsed on alcohol? If so, there are certain signs and symptoms that are hard to ignore, especially as relapse is particularly common in early recovery:
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You smell alcohol on their breath
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They have become secretive and distant
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They are uncontactable for hours at a time
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You receive text messages that are uncharacteristic from them
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They sound slurred when talking on the phone
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They have lost interest in family, friends and things they normally enjoy
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There is a substantial change in their grooming, eating and sleeping habits
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They have withdrawn from recovery meetings and friends
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They appear angry or over emotional
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They have stopped engaging in recovery practices and become dismissive of recovery
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They appear anxious and depressed
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You find evidence that they have purchased alcohol
Some of these signs and symptoms will become apparent before an actual physical relapse on alcohol, including negative emotions and mood swings that can make someone more vulnerable to returning to previous substance use. If you have any concerns for your loved ones well being it is important to talk to them about it and support them in seeking alcohol help or treatment. A relapse should not be seen as personal failure, but as a sign that support or the treatment plan may need adjusting.
What to Do If You Have Relapsed on Alcohol: Relapse Prevention Steps
If you have relapsed on alcohol after a period of sobriety, you may well be wondering how did I end up here again? Alcoholism isn’t curable but it is treatable and relapse can be prevented by applying a recovery programme that works for you.
Perhaps you are feeling scared and worried about what people will think if you own up to your relapse. Our experience is that asking for help breaks the secrecy and denial. We appreciate that this is difficult, but in light of the fact that alcohol has the power to destroy an alcoholic, asking for help is strongly advised.
If you feel unable to talk to your family or friends as you fear being judged, then perhaps a counsellor or GP can help. We also offer inpatient alcohol detox and rehabilitation and will respect your right for confidentiality. However, we do recommend telling those that you love as they probably already suspect your relapse. Support is invaluable following on from rehab treatment.
If you cannot afford private alcohol treatment we suggest you contact Alcoholics Anonymous or your local drug and alcohol team, who will be able to help you without any judgement.
We urge you not to give yourself a hard time or assume that others will feel let down. Relapses unfortunately happen, pinpointing why you relapsed can be helpful in avoiding future relapses. The most important thing is that you seek help and tell someone of your struggles.
Many individuals that relapse and find recovery again learn a valuable lesson from their relapse. This can make their recovery stronger than ever before.
Please do contact us to find out more information about our private alcohol detox and rehab programme costs. We can facilitate an urgent admission and ensure that you receive a bespoke treatment planned aimed at healing the root causes of your alcoholism.
For tips for avoiding relapse here are our 7 top tips to avoid relapse
