Once your loved one has gone through a treatment program, it is not the end of recovery. It’s just the beginning. Whether it’s alcohol or another substance, recovery is an ongoing process. It’s restarted every day, in the moment and is a fluid element of life. Some days are good and others, not so much. But how can one know if they are just having a bad day or a relapse episode? Relapse prevention is possible; however, the problem is that relapses are so common that 90 percent of individuals who have undergone some sort of recovery program will have at least one relapse, usually in the first year after rehab. These are some of the relapse warning signs to watch for.
General Drug or Alcohol Relapse Warning Signs
If you have a loved one who has been through treatment and is currently showing behaviors similar to when active drug or alcohol abuse was going on, you might be asking yourself, “Is my loved one relapsing?” Relapses can occur for alcohol, cocaine and other drugs, similar to what can happen with other chronic diseases such as asthma, diabetes and hypertension. Like these diseases, addiction is chronic in nature and can be recurring. A relapse is not a single event but rather a process, broken down into three stages.
Relapse Stage 1
The first stage is the emotional stage. This is where the individual has not yet thought of drinking or using drugs, but is setting themselves up for it. Some of the symptoms include anxiety, intolerance, anger, defensiveness, mood swings, isolation, failing to attend recovery meetings, poor sleeping patterns, and unhealthy eating habits. This stage is often associated with Post-Acute Withdrawal Syndrome (PAWS), during which the individual experiences emotional and psychological withdrawals rather than the physical ones. The actual withdrawal process during initial treatment usually lasts for a few weeks, but PAWS withdrawal can last up to two years and is episodic, with each episode lasting a few days.
Relapse Stage 2
Mental struggles come about in the second stage of relapse. This is the battle of the mind, where part of the person wants to go back and drink alcohol or do drugs, but the other part wants to stay in recovery. The individual will start reminiscing about drinking or doing drugs and all the fun that was had, glamorizing it. Sometimes, thoughts about spending time with people from the past (other addicts) will take place. This stage is sometimes harder to recognize as most of it is an internal tug-of-war. At this stage, the individual needs to talk to someone such as a sponsor or counselor, because thoughts of abstaining forever can be overwhelming and depressing. They need to be gently reminded that today is what matters, this minute, and making it through this minute, this day.
Relapse Stage 3
The last stage is the physical stage of relapse, when the person actually goes back to active drinking or using drugs. If you or your loved one has come to this point, the realization of what has happened may guide towards a refocus on recovery or this relapse could remain for months, or longer. This is the hardest stage for family and friends of the user, but also a time for patience and understanding. Knowing that family and other support systems are there provides for a beacon of hope, as a resurgence of guilt and shame within now exists because of the relapse.
Alcohol and Opioid Relapse Warning Signs
Should your loved one show any of these progressive signs of a relapse, it may be time to talk to them about renewing focus on their treatment. A relapse is not considered a failure of the treatment but a learning experience.
Review these relapse warning signs:
- Change in Attitude – If going to their counselor or group meeting doesn’t seem as important as before, or they don’t feel right but can’t quite put their finger on it.
- Rising Stress Levels – If they overreact to situations or feel overwhelmed, helpless, or out of control, they may go back to old habits. Severe mood swings are a sign of a major relapse.
- Denial – When denial about life stress is causing problems and they stop sharing their feelings with you.
- Return of Withdrawal Symptoms – Shaking, anxiety, depression and sleeplessness, all symptoms of withdrawal, can reappear when the individual is stressed. Feeling the need to self-medicate with alcohol or drugs can occur.
- Routine Changes – If the healthy routines learned during rehab are set aside for the former negative habits: bad meal choices or not eating, lack of personal hygiene or changing sleep patterns.
- Social Breakdown – Feeling uncomfortable around others or making excuses not to socialize, go to therapy or meetings, overwhelmed with negative emotions or depression.
- Loss of Judgement or Control – Making irrational choices and unable to change them, actively cutting off the people who could help, feeling they can control drinking or drug use. They may lose hope or confidence in themselves.
An opioid relapse (heroin or pain pills) may be dangerous because after detox, the body has become accustomed to functioning normally, now that the drugs are no longer in their system. They may have been using larger doses before treatment because of a higher tolerance for the drugs. When relapse occurs, they often overestimate the amount needed to get the desired euphoric or numb feeling. This lowered tolerance also increases the risk of overdose and death during relapse.
Cocaine Relapse Warning Signs
These symptoms are similar to the others with a few differences, as cocaine affects the body differently. Strong cravings for cocaine and drug seeking behaviors are the biggest warning signs.
If you see these signs, you may want to intercede.
- No Aftercare – Bailing on counseling, support group, or 12-step program.
- Overly Stressed and Ignoring It – Not dealing with life stressors effectively or forgetting to use healthy coping skills learned in treatment.
- Increased Drug Cravings
- Engaging in Compulsive Behaviors – Gambling, overeating, overworking or over-exercising.
- Revisiting Places and People from Former Drug Use
- Feeling Hopeless – Feelings of lack of support or staying away from family and friends. A return to addictive thinking and negative thoughts.
- Isolation – Bottling up emotions and hiding from others.
- Poor Self-Care – Not eating healthy, disturbed sleep or insomnia, or ignoring personal hygiene.
- Glamorizing Past Use, Delusions about Consequences
- Lying and Other Secretive Behaviors
The risk of relapse increases, the longer your loved one has used cocaine.
Benzodiazepines (Benzos) Relapse Signs
After rehab from prescription benzodiazepine dependency (Valium, Xanax and more), the possibility of a relapse is strongest because these drugs work on the brain by enhancing the effects of the chemical GABA (Gamma Aminobutyric Acid) a tranquilizing neurotransmitter. Benzos stay in the system a long time and individuals build a tolerance. After rehab, the possibility of a relapse is, by far, the most serious consequence of the addiction.
The easiest way to understand when a relapse occurred is by the symptoms of use.
- Lack of interest in activities person used to enjoy
- Neglecting family members and friends
- Doctor shopping
- Plastic bags and empty bottles left behind
- Shallow breathing
Everything can go well for a while, but all of a sudden, severe discomfort and urges for use will pull them back in to popping pills. This is a benzodiazepine relapse. There are no real warning signs. The worst thing with benzos is that long term use compromises the central nervous system and body functions whereby the habit becomes a disease.
Accepting Treatment and Recovery as a Personal Quest
A treatment program is never a guarantee for addiction recovery but an open door to get there. Like a way station on the road of life, it’s a signpost signaling the beginning of vigilance and the need for more love, compassion and understanding towards your loved one in recovery and yourself. Relapse warning signs work only if they are heeded, but as long as they are willing, a relapse is never a failure but a learning bump on the right track. Remedy Recovery can help your loved one and the family prepare for the challenges of addiction recovery and the warning signs along the way.