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Relapse can happen in recovery and does not necessarily mean you have failed. Rather than being discouraged, you can learn from it and know what to do if you relapse in the future. If given the proper attention, it can also strengthen your recovery and move forward.1,2
What Is a Relapse?
A lapse and a relapse are two different concepts:3,4
- A lapse is defined as a deterioration of your condition (in this case, your recovery) after you’ve had a period of improvement and is an isolated event.
- A relapse is defined as the continued deterioration of your condition or something more prolonged and severe than a lapse. A relapse occurs multiple times and is a process that typically requires a higher level of intervention.
What Happens if You Relapse While in Transitional Living?
Experiencing a relapse can be very frustrating. If you’ve made progress in your recovery and in transitional living, such as at a sober home or in a therapeutic community, it’s vital not to let a relapse hinder you from re-engaging and renewing your commitment to your recovery program.
When Do You Need to Disclose a Relapse to Your Program?
Research shows that transitional living, such as sober living homes, aids in your recovery process. Having a supportive, drug- and alcohol-free home environment is beneficial. So, maintaining a healthy relationship with the transitional living where you reside is important. You can do this by being honest about your relapse.5
Keeping things like a relapse a secret from transitional living staff, your professional team, and loved ones can lead to more relapses or be a barrier to re-engaging in successful, sustained recovery.5,6
It is best practice to disclose relapse to a program that you’re involved in as soon as possible so you can receive the help and guidance you need. Also, being honest is consistent with recovery-related behavior. Usually, a relapse is predicated by behaviors that are not consistent with recovery.
Some behaviors that can be signs of potential risk of relapse include:7, 8
- Spending time with people who were part of your substance use
- Going back to old neighborhoods and bars where you used substances or consumed alcohol
- Filling life up too quickly after completing primary treatment or in early recovery
- Not prioritizing maintenance of your recovery
- Going to work late routinely
- Stopping practicing daily routines such as attending support meetings or talking with your sober network
- Discontinuing any structures that you have put in place for yourself (e.g., sleep routine)
- Regressing to behaviors that you were doing prior to recovery
By “telling on yourself” and letting your transitional living home know about your relapse, you can ensure that a lapse does not become a relapse and that a relapse does not worsen. You can adjust and re-engage in recovery-related behaviors and discontinue those that are not supportive of recovery.5,7
What Should You Expect After Disclosure?
Most transitional living facilities are aware of the relapse rate—which can be as high as 60%—and have a supportive staff that also holds you accountable.1,2
Some transitional living facilities have a zero-tolerance policy on illicit substances and alcohol on their property, and they may search your room for substances. This is not to belittle or shame you; it’s to create safety for you and the other residents at the facility.9
Research shows that success rates for recovery increase when you have an alcohol- and drug-free living environment, especially in early recovery. Given this, they may ask you to take a drug screen/urinalysis for a time, along with a check of your belongings and your room to ensure there are no illicit substances and/or alcohol on the property. This is to lower any physical triggers for you and the others who live there.9
How Could Relapse Affect Housing?
Some transitional living facilities with a zero-relapse policy may ask you to leave for a period and gain a certain length of sobriety before you are allowed back in. You may not be allowed back at some houses with strict no-use policies, though they may be able to refer you to another community. Sometimes the facility will have a professional relationship with a sister facility and assist in your transfer.9
If your transitional living home allows you to stay, they may also require you to meet additional goals for a specified period of time. For example, you may need to enter an outpatient form of addiction treatment or attend peer support meetings once a week.
How Do You Know If You Need to Reenter Treatment?
Depending on the severity of your relapse, you may choose to reenter formal addiction treatment. If you experienced a lapse that did not progress to relapse (i.e., an isolated incident that was not followed by additional substance misuse), you may have enough support in your existing recovery program. However, if the relapse was a longer series of events and a progression into old patterns and behaviors that you are struggling to discontinue, you may want to consider reentering treatment.4
A significant indication to reenter treatment is if you try to return to your current program of recovery after a relapse and continue to struggle.4
How Does Relapse Affect Treatment?
There are a variety of options for reentering treatment after relapse.
Relapse Prevention Program
A dedicated relapse prevention program typically entails meeting one time per week for 1-3 hours, either one-on-one with a credentialed counselor or professional or in a group setting with others who have relapsed or need this level of care in an outpatient setting.6
Private Counseling
One-on-one counseling can be done with a credentialed professional for substance and alcohol misuse or a mental health professional, depending on your needs. For example, if the trigger to the relapse was financial struggles, you may choose to work with a career counselor. If the trigger was a relationship, you might want to see a counselor specializing in relationships, such as a licensed marriage and family therapist (LMFT).
You create a treatment plan, including an addiction treatment plan, with your counselor in terms of how often and for how long you will work with them and take advantage of other resources.3, 7
Additional Aftercare
Aftercare is part of formal addiction therapy. If you recently completed a treatment plan, you may still be receiving aftercare services. After a relapse, you may return to ask your treatment team for additional aftercare referrals, services, or recommendations. This type of care typically can include meeting one time per week for 30, 60, or 90 days, 6 months, or up to 1 year in a group setting.6
How Do You Decide Which Treatment to Seek After Relapse?
If you’ve successfully completed a primary treatment program such as inpatient, residential, or intensive outpatient treatment, you can contact them and share that you have relapsed. You can schedule an intake assessment with a credentialed professional, and they can make recommendations. Together, you will formulate a treatment plan, decide on the best course of action and determine the appropriate level of care.4,6
Whatever level of treatment you re-engage in, you will typically create a relapse prevention plan or a relapse recovery plan, sometimes referred to as an addiction recovery plan. This includes a section where you list triggers, things, and actions that are consistent with recovery behaviors, what helped you get and stay sober, the supportive people you can call if you feel you are close to relapsing, and any national emergency hotlines.8
Once you create an addiction recovery plan, it is important to keep it somewhere accessible. You may also choose to make photocopies of it and provide the copies to people in your support system.7,8
What Are the Potential Impacts of Relapse on Your Access to Services?
Your relapse may increase access to services, given that a relapse could indicate needing a higher level of care. However, it could also decrease your access to services if the programs you are enrolled in have a zero-tolerance policy. It is helpful to remember that this is temporary and can usually be regained after a certain length of time, as outlined by the program.9
Some transitional living facilities may require you to do community service or reenter treatment to remain there. They may also increase the required number of meetings, such as 12-step, SMART Recovery, or another type of equivalent program, and have you ask the chairperson to sign an attendance slip.9
The purpose behind this is to provide external queues and accountability along with the structure to quickly re-engage and bolster your existing program of recovery.
What Does Social Support Look Like After A Relapse?
Admitting and taking responsibility for your relapse is a vital step to recovering from it. Not taking ownership or being inconsistent with your words about what happened tends to prolong relapse and isn’t the most useful strategy when it comes to receiving the help that you need. It can also burn bridges with your support team, whether this is includes loved ones, coworkers, friends, family, counselors, sponsors, and sober peers, especially others who live in the transitional living facility with you.7
These structures can serve as additional protection and guideposts for you temporarily. Once you regain your grasp on your program of recovery, transitional living facilities have a path to loosening the requirements such that you may have more flexibility again.9
Rely on your existing social support, such as your:
Twelve-step sponsor
Mentor
Substance abuse counselor
House manager
Therapist
Addiction program team
Friends
Family members
Talk to them and to the people in your inner circle who would be supportive, yet hold you accountable as well.
This could actually strengthen your relationship with them if done in an honest manner with a willingness to own your part in the relapse and to re-engage. Some may not take it as well. In this case, it is best to focus on the people who remain supportive and address the other relationships as part of your relapse recovery plan.7
Without beating yourself up, emphasize to the people closest to you that your relapse doesn’t mean you aren’t committed or have lost your motivation in recovery, just that you may need different or new resources to make progress.
Contact a treatment specialist at 800-963-1579 (Who Answers?) if you or a loved one feels treatment after a relapse is a right fit.
Resources
- National Institute on Drug Abuse. (n.d.). Drugs, Brains, and Behavior: The Science of Addiction Treatment and Recovery.
- National Institute on Drug Abuse. (2018, Jan). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), How effective is drug addiction treatment?
- Menon, J., & Kandasamy, A. (2018). Relapse Prevention. Indian Journal of Psychiatry, 60(Suppl 4): S473–S478.
- Mee-Lee, David. (2016, November 3). How to Deal with Relapse, Continued Use and Continued Problems: Working Together to Promote Recovery.
- Substance Abuse and Mental Health Services Administration. (2016, April 19). Recovery Homes Help People in Early Recovery.
- NCBI. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Chapter 3. Intensive Outpatient Treatment and the Continuum of Care.
- U.S. Department of Veterans Affairs. (2014). Reducing Relapse Risk.
- Melemis, S.M. (2015). Relapse Prevention and the Five Rules of Recovery. Yale Journal Biological Medicine, 88(3), 325–332.
- Substance Abuse and Mental Health Services Administration. (2018). Recovery Housing: Best Practices and Suggested Guidelines.