Warning Signs of an Alcohol or Drug Relapse

Published On: November 17, 2023

Relapse refers to when an individual who has become sober after developing an addiction slips back into substance use.

After rehab has been completed, they will have returned home and found themselves unable to resist the urge to use their substance of choice again.

According to research, there are thought to be several stages of relapse [1]:

  • Emotional relapse – While not consciously considering relapse, an individual’s feelings and behaviours are slowly pushing them towards a point where it is more likely.
  • Mental relapse – An individual becomes conflicted, wanting to relapse but also knowing that it would mean giving up on the progress they have achieved.
  • Physical relapse – An individual succumbs to their cravings and begins using a substance again.

Although it can be perceived as a failure for recovering individuals, relapse is very common. It does not mark the end of their addiction recovery journey, and many individuals can continue to make positive progress if warning signs are identified or if support is found.

What are the Signs that an Individual is About to Relapse?


Thankfully, relapse is an event which is preceded by common warning signs. Individuals will exhibit different signs, and they will likely show a combination before succumbing to their cravings. Looking out for them is important for preventing relapse.

1. Changes in behaviour and attitudes

Before relapsing, individuals will likely exhibit behaviours which indicate what is about to happen. Often, they will begin slipping back into the habits and routines they showed during their addiction, demonstrating recklessness, emotional instability, and impulsiveness.

Additionally, their attitudes will begin moving away from the rational, forward-thinking ways they have been taught to see the world during rehab. Alongside being more impulsive, they will generally become more accommodating to their feelings and snap judgements.

2. The disappearance of social life

Those leaving rehab require social and emotional support. After weeks of having therapists and fellow recovering individuals to rely on, individuals need to stay connected with their loved ones and live a balanced, socially active lifestyle.

An indication that relapse is on the horizon, therefore, is an individual’s total social withdrawal. Spending more time alone, making excuses for not seeing people, pretending to be unwell – these show that an individual has cut themselves off from those around them.


3. Showing signs of withdrawal

When cravings return and begin taking their toll on an individual’s mind, withdrawal symptoms might come back as well. Of course, these won’t be physical as an individual won’t yet have become physically dependent again, but psychological symptoms can return.

Withdrawal can look different for every person, but some of the most common symptoms include increased anxiety, bouts of depression, and insomnia.

4. Shorter fuse or heightened stress

The internal conflict of mental relapse pushes individuals to the edge, and this can result in them exhibiting negative emotions, such as considerably high levels of stress.

This stress can manifest in several obvious ways. Individuals might be quick to anger, have irrational fears and beliefs, or struggle to manage their work-life balance effectively. The presence of stress is an important sign to spot as it will hasten physical relapse.

5. Being in denial

Denial is very common among those who suffer from substance abuse [2]. Refusing to acknowledge the presence of a problem is a fundamental behaviour for many, but rehab spends a lot of time helping individuals shed this attitude and acknowledge the problem.

Returning to denial indicates that an individual is in danger of relapse. If they indicate that substance use is normal, or they justify their old behaviour, it shows that their perception of addiction has once again become skewed and that their behaviour will soon follow.


6. Routine dismantlement

As well as overcoming their urge to abuse a substance, rehab helps individuals construct a lifestyle that is balanced and serves their health in different yet equally important ways. One of the more obvious signs that an individual is struggling is if this routine collapses.

When they are losing control inside, it will be mirrored in their lack of control over the world around them. Skipping meals, being absent at work, and not studying for school – these behaviours highlight an individual’s progress towards relapse.

7. Loss of sound judgement and control

Decision-making is the pillar of an individual’s mental health. Whether they can make logical judgements and decide things is a great way to tell if they are of sound mind or are struggling with something psychologically.

When relapse is approaching, a warning sign is if an individual begins making wayward choices or relies on their impulses to get by. One bad decision – such as pretending to be ill to stay off work – leads them to the next, which has every chance of being a physical relapse.

What Increases the Risk of Relapse?

A man turning away

As for what puts people at risk of experiencing a relapse, there are a variety of factors which can play a part.

Some of the most common ones to look out for and can be tackled include some of the following.

1. Mental health

Mental health conditions play a huge role in the initial development of substance use disorders, and it is really important to acknowledge during treatment, so it makes sense that they are a huge factor in the chances of a relapse occurring.

If an individual struggles to cope with their anxiety, depression, or trauma after rehab has ended, they will be more likely to perceive relapse as a viable option for coping.

2. Unhealthy influences

Within rehab, an individual is protected. They are most obviously guarded against the threats of physical and mental harm during detox and therapy, but in a wider sense, they are protected from the influences of the outside world which might threaten their progress.

After rehab has ended, this protection slips away. This means that the friends, family, and situations which prompted their addiction in the first place can resume exerting their negative influence. If an individual struggles to manage this, relapse is more likely.

3. Relationship breakdown

Our relationships ground us and offer us support, and those who leave rehab are dependent on them for so much. As a result, when a relationship breaks down or becomes fractured, it can have disastrous results.

Whether it’s a breakup or a family member dies or becomes distant, an individual loses a vital source of support. The stress or upset resulting from this breakdown can also push them into a depressive state, meaning relapse becomes much more appealing to them.

4. Overconfidence

It might seem like a strange thing to be cautious of – since confidence is an absolute necessity if an individual is to overcome their addiction in the first place – but there is a degree to which they must also remain realistic and wary.

The reason for this is that life after rehab is incredibly difficult. Everything can seem well in hand when treatment finishes and an individual is enjoying the comforts of assessing their progress within a facility, but they must also be prepared to endure more challenges.

One who is overconfident is likely to misjudge the challenges of everyday life after rehab. They are at risk of being overwhelmed by the strength of cravings, and they might equally be vulnerable to panic when things do start to go wrong.

Is it Possible to Prevent Relapse?

Two women hugging

Drug and alcohol rehab is designed to maximise an individual’s chances of attaining sobriety and keeping it in the long term. This means that, in addition to providing physical detox and addiction therapy, most programmes will provide a relapse prevention plan.

Relapse prevention is not a guaranteed method of stopping an individual from relapsing. Instead, it is a stage of addiction treatment which employs techniques to minimise the odds of relapse, while also boosting an individual’s ability to avoid one in the future.

The techniques employed in relapse prevention will be chosen on account of their suitability for the situation, but below are some of the most commonly turned-to options.


Cravings are inevitable following rehab, but individuals need to be able to recognise what is a craving and what is a natural bodily need. Keeping on top of physical health is more important now than ever, so individuals must know what’s what.

To help make this easier, HALT prompts individuals to scrutinise what they believe to be cravings. They are taught to ask whether they are hungry, angry, lonely, or tired, allowing themselves the opportunity to avoid relapse if all they need is food or a good sleep.

2. Trigger management

During drug or alcohol addiction therapy, an individual is supported in identifying the triggers responsible for their consistently unhealthy behaviour. When it comes to relapse prevention, these same triggers can be worked with and prepared for.

Before leaving rehab, an individual can plan for how to minimise the impact their triggers will have on them in the coming weeks and months. This might involve them planning for how they can avoid triggers, lessen their presence, or mitigate their negative impact.

3. Social networking

Rehab is so effective because it surrounds recovering individuals with people they can rely on for support and advice. Leaving treatment can be so difficult because it often means that they lose a lot of their support network.

Relapse prevention can therefore focus on bolstering an individual’s support network. This might involve them speaking with family and friends to ensure they know what kind of support is needed, or instead arranging sessions with a therapist.

4. Emergency plans

A relapse prevention plan might not always be about pre-empting the warning signs of relapse and treating them early. They can also be about preparing for what might be done in the face of relapse, and what an individual can do when they are on the brink of succumbing to cravings.

For these last-minute situations, an individual might arrange with family and friends to be put under constant supervision, or a deal might be made with a local rehab centre for them to be re-admitted for the duration of their intense cravings.

Relapse has Happened – What Next?

Two people talking

It is important to stress that relapse is not a point of failure. It is very common for those recovering from addiction to experience some form of setback along the way, and this often comes in the form of relapse.

But what happens when relapse does happen?

For those who relapse, it is essential to remember that a lapse in judgement and/or endurance does not necessarily mean that a complete reversion to addictive behaviours is necessary. A relapse can quickly be reversed with the right support.

In the event of a relapse, an individual should get in touch with their GP, or they should call the rehab facility which they completed their rehab with.

Once this is done, arrangements can be made for an individual to re-enter a facility, or for an addiction expert to meet with them to offer guidance as to how the recovery process can resume.

How Rehab 4 Alcoholism Can Help

Women talking 1-1

Relapse can be a scary thing to think about, but working to understand it is the best way to limit the chances of it happening. Even if relapse has occurred, knowing how to get back on track is essential, and by no means are individuals destined to fail.

At Rehab 4 Alcoholism, our team are available to offer you the information and guidance to help you prevent or bounce back from relapse.

If you need us to ensure your long-term recovery, give us a call at 0800 111 4108.


[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/

[2] http://pure-oai.bham.ac.uk/ws/files/25519189/DENIAL_PICKARD_M_L_FINAL_PRE_PROOF.pdf

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