Going Back to Rehab After Relapse 

 Addiction is a brain disease that is chronic and remitting.¹ Therefore, relapse can be part of the recovery process. When a person relapses, they may need additional treatment to return to the path of recovery. Understanding what a relapse is and when you may need to return to treatment can be important for achieving long term recovery.  

Why Does Relapse Happen in Recovery?

Relapse is the use of a substance after sobriety. A slip, or lapse, is the first use of a substance after a period of sobriety.² A relapse is the continued use after the initial lapse.² 

Various reasons exist as to why relapse can occur. These include psychological risk factors such as experiencing depression, cravings, or having a lack of adaptive coping skills.² Other internal risk factors include boredom or untreated physical or mental health conditions.² External, or environmental, risk factors for relapse include those such as living in an area with high substance use activity or the presence of substances in a person’s social circle.² 

If a person relapses after a period of sobriety, the first and most important thing is that they know it does not mean they are a failure. Rather, relapse can be part of recovery because addiction is a remitting disease.¹ Second, returning to rehab is often an important step in returning to sobriety.² Third, relapse doesn’t occur abruptly but rather, in stages; recognizing the stage can help a person identify what they need to get back to recovery.³ 

Going Back to Rehab After a Relapse

Returning to rehab after a period of sobriety is common for most people who remain in long-term recovery. They go through more than one cycle of lapse-relapse-treatment-sobriety-sustained recovery.² That is why returning to rehab should be viewed as part of the recovery process. What’s more, multiple rehabs can lead to sustained recovery because the different treatment courses can build on each other.² 

Rehab after a relapse can be a bit different from the first rehab in a few ways. Firstly, it provides the opportunity to explore the relapse and identify warning signs and circumstances around it that are unique for the person.² These insights allow for the development of an even more specific relapse prevention plan moving forward.² Secondly, the level of treatment the person engages in may be different from their initial rehab experience. For instance, if someone had outpatient rehab before the relapse, then after the relapse, they may be recommended for inpatient treatment.² Treatment plans are tailored to specific needs, and recovery can also be facilitated by transitioning from a higher to a lower level of care to help the patient adjust back to independent living.² 

Stages of a Drug or Alcohol Relapse

Drug or alcohol relapse is not just an event but rather, a process that occurs gradually and in stages.³ The stages can be categorized into three main ones: emotional relapse, mental relapse, and physical relapse.³ 

During an emotional relapse, the person is not thinking about using; they may even recall their last relapse and not want to repeat it.³ At the same time, the emotional experience during this stage can lead the person to progress further to the subsequent stages. 

Signs of emotional relapse include:³ 

• Poor self-care. 
• Focusing on others’ problems. 
• Bottling up emotions. 
• Withdrawing from others. 
• Lack of attending, or sharing in, support group meetings. 

Recognizing the signs of emotional relapse can help the person to use coping skills that help prevent progressing through the relapse process.³ The sooner the signs are noticed, and action is taken, the greater the chances of success.³ 

Mental relapse involves an internal conflict for the person where a part of them wants to use and the other part does not.³ Over time, the part that wants to use can take the lead.³ 

Signs of mental relapse include:³ 

• Craving substances. 
• Thinking of ways to better control using. 
• Thinking about people, places, or things associated with substances and past use. 
• Minimizing consequences of, or glamorizing, past use. 
• Bargaining, or thinking about situations in which it’d be acceptable to use. 
• Lying to self or others. 
• Looking for relapse opportunities. 
• Planning a relapse. 

While in recovery, occasional thoughts of using are not uncommon and do not necessarily mean that the person is failing at recovery or will relapse.³ Utilizing adaptive coping strategies can help them to let go of their thoughts.³ 

Lastly, physical relapse is the stage where the person uses substances again.³ This stage includes lapsing or using a substance once and a return to a pattern of uncontrolled use.³ A lapse, or consuming one drink or using a substance once, can be a slippery slope toward uncontrolled use.³ 

The good news, however, is that most physical relapses are a result of encountering an opportunity to use.³ Therefore, being aware of the types of opportunities that can arise can help the person to avoid them. 

Relapse Prevention

Relapse prevention consists of specific relapse prevention tools as well as establishing a foundation of recovery across various aspects of life.² Tools unique to the person can help them be most meaningful and effective. 

Some general relapse prevention tools include:² 

• Taking it one day at a time. Imagining lifelong abstinence can feel daunting, so people are encouraged to make a decision not to use in the next 24 hours or even in the next one hour. It also helps to remember that cravings pass on their own. 
• Reaching out to support network: Making a list of names and numbers can allow the person to have it handy when feeling distressed. The person needs to call someone who is supportive of their recovery, not someone with whom they used. 
• Thinking through the scenario: While having the urge to use, it can be helpful for the person to think through the consequences of using (e.g., personal, financial, legal, social, etc.) 
• Recognizing HALT: It is often the case that being hungry, angry, lonely, or tired can lead to the desire to use. Thus, it can be helpful for a person to ask themselves during a craving if they are sensing any of those four states. Addressing them—like eating when hungry or relaxing when tired—can often help the craving to pass. 
• Carrying a personalized relapse prevention plan: Carrying a wallet card that has important reminders about why the person is in recovery can also help to forestall a lapse. Important elements on the card may include the person’s top three reasons for not using, a list of names and numbers of those supportive of their recovery, and any strategies they find helpful in particular. 

Building a recovery foundation, on the other hand, goes beyond tips to structuring a life supportive of recovery.² This can involve significant changes that the person may not be accustomed to. However, the foundation can be laid down gradually with the guidance of therapy in rehab. 

Examples of parts of the recovery foundation are:² 

• Avoiding people, places, and things associated with substance use. 
• Engaging in self-care such as a healthy diet, enough rest, exercise, attending to mental and physical health concerns, and helpful coping strategies to deal with stressors. 
• Building a social network that is supportive of the person’s recovery, like spiritual involvement or a 12-Step peer support group. 

Relapse prevention strategies are helpful not only in avoiding relapse but also in having a foundation to return to in dealing with a relapse. 

Start the Recovery Journey

It is never too late to seek help and start your recovery journey. American Addiction Centers is here to answer questions and provide support. Whether you are seeking treatment for the first time or after a relapse, our websites are a helpful resource. You can use our treatment directory on Rehabs.com to search for programs across the country. 

You can also call us at and connect with a person who can help locate suitable rehab programs and verify your insurance benefits. 

Recovery is possible. Please call us today. We are here 24/7 and happy to help.