Alcohol Relapse

Alcoholism is a disease associated with high rates of relapse. Several things can cause a relapse, and it’s common for people recovering from alcohol addiction to relapse multiple times before achieving long-term sobriety. It’s important to understand that relapse is normal and can be overcome.
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An alcoholic relapse or relapse into alcoholism is a return to the compulsive pursuit and consumption of alcohol after a period of sustained sobriety. Relapse is characterized by a return to the unhealthy behaviors and negative consequences that characterize addiction. It usually involves disengagement from recovery activities.

A single episode of drinking isn’t always considered a relapse. It’s often referred to as a slip. It’s possible to slip without relapsing. To avoid relapse after a slip, many people attend support group meetings or therapy sessions.

“We know relapse has a lot to do with experiencing negative emotions and interpersonal conflict,” Dr. Kenneth Leonard, director of the Research Institute on Addictions, told “Sometimes it can be associated with positive emotions, such as feeling really good and feeling like you want to celebrate. Sometimes the cues of where and how you drank in the past can be a trigger.

“It’s important to identify what those triggers might be and to have a strategy to deal with them if they come up. And also recognize that sometimes things will come up that you’re not ready for.”

Relapse can occur at any stage of the recovery process. People in recovery from alcohol addiction are at the highest risk of relapse during the early alcoholic recovery stages, in the immediate moments after a traumatic event or during times of transition. Most people in recovery must actively take steps to avoid relapse for the rest of their lives.

Alcohol Relapse Warning Signs

Friends and family see the noticeable benefits of quitting alcohol when their loved one stops drinking and chooses to pursue a healthy life. They often say that the person seems like his or her old self.

But when people start to relapse, the decline is obvious. They stop sounding happy and optimistic. They may stop taking care of themselves or start making excuses for their problems.

Other noticeable warning signs for alcoholic relapse include:

  • Talking about missing alcohol
  • Behaving secretively
  • Becoming more isolated
  • Eating an unhealthy diet
  • Hanging out with others who drink
  • Appearing anxious or depressed
  • Missing meetings or therapy appointments

These warning signs don’t mean relapse is inevitable. Relapse can be averted if friends or family members intervene and convince the person to go to recovery meetings or alcohol counseling. The person may also recognize the risk for relapse and reach out for help.

Slips are the biggest warning signs for relapse. Some people who slip realize their mistake and seek help. It’s sometimes the last obstacle to overcome on the path to alcohol recovery. But many people who slip lose progress. They either relapse or seek further therapy to prevent future slips.

Stages and Symptoms of Alcohol Relapse

Relapse is usually a gradual process. For people who have established a sustained period of sobriety, relapse doesn’t occur overnight. In a 2015 article published in the Yale Journal of Biology and Medicine, Dr. Steven Melemis described three stages that occur during relapse.

The first two stages represent a progression away from recovery and toward a full relapse. The third stage is a complete relapse into alcoholism.

Stages of alcoholic relapse:

Emotional relapse
is characterized by suppressing emotions, becoming more isolated, missing meetings, blaming others and developing poor recovery habits.
Mental relapse
is associated with experiencing cravings, thinking about triggers, glamorizing alcohol, lying and planning for relapse.
Physical relapse
involves slipping and relapsing into an obsession with alcohol and compulsive desires to drink.

Slips can occur at any stage of the relapse process. Slips can cause a transition from an emotional relapse to a mental relapse or from a mental relapse to a physical relapse. When someone in recovery slips by consuming any amount of alcohol, the brain can revert back to how it functioned when the person was abusing alcohol.

When physical relapse happens, people in recovery from liver damage risk a recurrence of alcohol-related liver disease. And if they have cirrhosis, relapse can even lead to death.

What Causes an Alcohol Relapse?

Every alcoholic possesses genetic traits that helped cause alcoholism to develop in the first place. Each time that these people drink, their brains adapt to the presence of alcohol. The adaptations make the brain crave alcohol, which makes it harder to quit drinking. All alcohol relapses are linked to these vulnerabilities in the brain.

Relapse is usually triggered by a person, place or thing that reminds a person of alcohol. When the brain processes the memory, it causes cravings for the substance.

Common relapse triggers include:

  • Smelling alcohol
  • Feeling stressed
  • Having financial problems
  • Seeing alcoholic beverages
  • Interacting with people who drink
  • Experiencing the loss of a loved one
  • Going to a place where alcohol is served
  • Experiencing emotional or physical abuse

Several factors can increase the risk of relapse. People who become overconfident in their ability to stay sober may put themselves at risk by decreasing recovery meeting attendance, exposing themselves to triggers or trying to control how much they drink instead of abstaining.

A dry drunk, a slang term for someone who is sober but still displays risky behaviors associated with alcoholism, also has a heightened risk of relapse.

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Alcohol Relapse Statistics

Alcoholism is a chronic disease that takes months or years of treatment and support to recover from. It takes years to conduct studies on people recovering from alcoholism. That’s why 2017 and 2018 alcohol relapse statistics aren’t available yet. However, studies published in recent years provide a picture of current relapse rates.

In a national three-year study that surveyed people trying to recover from alcoholism, 38 percent of individuals with minor alcohol problems and 30 percent of people with moderate or severe alcohol problems were able to quit drinking. People who had severe addictions to alcohol or co-occurring disorders were less likely to successfully quit. The study was published in 2014 in the journal Drug and Alcohol Dependence.

In a separate 2014 study published in Drug and Alcohol Dependence, researchers reported relapse rates of 506 people who had maintained recovery from alcohol use disorder for one year.

During the next 20 years:

  • 5.6 percent relapsed after five years
  • 9.1 percent relapsed after 10 years
  • 12 percent relapsed after 20 years

A 2006 study published in the journal Addiction found that 62 percent of people treated for alcoholism through alcohol rehab or Alcoholics Anonymous maintained recovery after three years. About 43 percent of people who did not receive any form of treatment maintained sobriety.

Relapse into alcoholism is less likely if you attend rehab, dedicate yourself to a recovery plan and avoid becoming overconfident in your ability to prevent relapse. If you do relapse, know that it isn’t the end of the world. With further treatment and dedication, you can maintain sobriety.

Chris Elkins, MA
Senior Content Writer,
Chris Elkins worked as a journalist for three years and was published by multiple newspapers and online publications. Since 2015, he’s written about health-related topics, interviewed addiction experts and authored stories of recovery. Chris has a master’s degree in strategic communication and a graduate certificate in health communication.
Medical Reviewer
Ashraf Ali
Psychiatrist, Los Angeles County Department of Mental Health

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