High-Risk Relapse Factors: Understanding the Subtle Triggers in Recovery

Relapse from substance abuse recovery is a common occurrence. For those with substance dependence and their loved ones, that reality can be frightening. Thankfully, the risk of relapse can be managed with support and a healthy understanding of what factors, triggers and situations make relapse more likely.

While most individuals going through the recovery process work hard to avoid known and obvious high-risk situations (e.g., putting themselves in stressful situations or around their substance of choice), there are some high-risk relapse factors that are more subtle and less known. Being aware and on the lookout for these subtle but dangerous relapse risk factors can greatly aid in relapse prevention, even for individuals far along in their sobriety journey and those who have completed substance abuse treatment.

Here’s a close look at how the relapse process works, as well as some of the more subtle and high-risk relapse factors that can trip someone up as they travel along their recovery process.

Understanding the Different Stages of Relapse

There are many theories of relapse and relapse prevention. One of the more enduring theories (put forth by G.A. Marlatt and J.R. Gordon in 1985) defines relapse as a process of cause and effect, in which a high-risk situation is experienced and followed up with a poor coping response. This one-two punch results in a feeling of decreased self-confidence and self-efficacy that makes an individual in recovery more likely to relapse.

Today, regardless of whether someone is in early recovery or has been in recovery for decades, healthcare professionals and addiction relapse experts understand that relapse isn’t a single event; it’s a process. This process, or the stages of relapse, then, are easiest understood when broken down into three stages, although these stages do not need to be completely distinct for someone to experience them.

Stage 1: Emotional Relapse

In this stage, individuals in recovery from a substance use disorder (regardless of whether it’s an opioid/opiate, alcohol, or other drug addiction) usually also struggle with mental health issues and a lack of good coping skills. Before they quit using, their default was to use substances to handle pain, negative emotions or bad situations, and now that that substance is gone, any underlying pain and agitation are hard to endure.

During this first stage, the person in recovery may not even be consciously considering using again. However, because of their fraught emotional state, they may be subconsciously craving a way out of their pain and distress.

Stage 2: Mental Relapse

Following emotional relapse, if the individual doesn’t receive solid and supportive intervention, the underlying pain and agitation will become more conscious. The person in recovery will now notice and become aware of how poor they’re feeling, and their desire to use a substance or substances as a means of coping heightens. The person will feel internal conflict as they face a decision to either use or remain sober.

The person may engage in subtle and overt forms of justification with themselves in order to lay the groundwork for drug use or alcohol use. It’s also common during the mental relapse stage for people to minimize their previous substance abuse history.

Stage 3: Physical Relapse

The last stage in the process of relapse is physical relapse, and it is when the person knowingly uses again. It’s not uncommon for people in the throes of physical relapse to feel they cannot control themselves or that their efforts at sobriety are pointless.

However, this is never true. While a relapse can be very discouraging, recovery is still always on the table. That being said, avoiding the process of relapse, or interrupting it when it’s underway, should always be the goal.

The High-Risk Relapse Factors You Should Know

The statistics on substance abuse and recovery in the United States are complex. Here’s a sampling:

That’s why understanding and discussing relapse risk factors can help keep individuals in recovery on a safer and less relapse-prone path.

Stressful Life Situations

While most people understand that stress can be triggering, the stress that results from common but difficult life events is often swept under the rug as a trigger. Not only is this stress hard to manage, but oftentimes the stress of life situations means that something that could be a source of support and stress relief is instead its opposite.

Here are some examples of stressful life situations/events that can trigger relapse:

Caron's Approach

At Caron, we understand that life changes can dramatically affect the stress a person experiences. That’s why we emphasize aftercare and go beyond detoxification in treatment to help the recovering person address gaps in their support system and mental health care, while also encouraging the development of positive coping skills and self-care work.

We also offer relapse prevention programs that offer compassionate, comprehensive and personalized care.

Negative Emotional States

Everyone gets the blues now and again, but for someone in recovery, a downshift in mood can be the catalyst that leads to relapse. From full-blown depression to just feeling off, here are some emotional states that could very subtly trigger a relapse:

Caron's Approach

By employing tools like cognitive behavioral therapy (CBT) and other evidence-based treatment modalities, Caron experts help individuals with substance use disorder face difficult emotions with new skills and an open mind.

Along with support groups, where individuals in recovery and their family members can gain insight into others’ experiences with recovery, decision making post-treatment and the like, Caron’s treatment centers can also provide ongoing medication-assisted treatment (MAT) (e.g., methadone).

Social Pressure and Environments

For many people in recovery, just going back to their social circle is a high-risk relapse factor. Peer pressure from friends who still use, going out to eat at a restaurant that serves alcohol (for those who have alcohol use disorder) or working a stressful job, can all lead to a situation where relapse becomes possible.

Common types of social pressure and pressuring environments include:

Caron's Approach

For some people, attending regular Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings can help ease them when social and environmental pressure builds. For others, they may need more help. And that’s ok.

At Caron, we use evidence-based treatment that can help people detox and move out of substance use into recovery. Some of our treatment modalities include:

Overconfidence in Recovery

While it’s important for people in recovery to feel good about their efforts and recovery, and it’s important to develop self-esteem and self-confidence, recovery is a lifelong journey that has no end.

Sometimes, people in recovery assume they’ve moved beyond the need to maintain abstinence from drug or alcohol use. Such a belief is dangerous and can lead to high-risk situations where a relapse may occur.

Caron's Approach

At Caron, we impart skills, confidence, self-esteem and a healthy respect for addiction to all our clients. While it’s important to celebrate recovery, it’s also important to stay vigilant, especially in early recovery and in periods of time that are extra stressful or challenging.

We know substance use disorder is complex, which is why many of our treatment plans include provisions and care for any co-occurring issues, including treatment for medical and mental health conditions, as well as training and skill-building in handling stress and anxiety without self-medicating.

Physical Illness or Pain

A significant risk for relapse is experiencing illness or pain, especially if the illness or pain is long-lasting or difficult to resolve. It’s not unusual for people who have experienced substance use disorder to have begun self-medicating because of pain, undiagnosed mental illness, etc. It’s no wonder, then, that the illness and pain can trigger relapse.

Common types of physical illness or pain that can lead to relapse include:

Caron's Approach

At Caron, we know that a person seeking treatment or already in recovery needs to experience overall well-being, that abstinence from substance use alone does not make a happy or healthy person. That’s why our comprehensive approach to treatment and relapse prevention includes care for the whole person, and, if appropriate, that person’s closest friends and family.

From offering simultaneous mental health care and treatment to addressing underlying medical issues or other co-morbidities, we’re committed to giving each person the support, skills and care they need to be successful in their recovery.

Caron’s Comprehensive Approach To Relapse Prevention

Caron’s comprehensive approach to relapse prevention is one of the reasons people from around the country and the world choose to come here to tackle issues of drug and alcohol abuse. Unlike many treatment centers, Caron offers dedicated relapse treatment programs for both men and women on our Pennsylvania campus. These programs are designed to address the challenges individuals face when experiencing relapse, providing them with gender-focused care.

Our personalized approach includes customized treatment programs for teens, first responders, older adults, healthcare professionals, members of the LGBTQIA+ community and others who face unique obstacles to care and recovery.

We also offer ongoing support services for relapse prevention, including support groups, fellowship groups and our alumni community. Our goal in treatment is to give each one of our patients what they need to thrive in their daily lives: social connection; healthy family and other relationships; and the skills, community and mindset needed to continue on in active recovery.

How To Get Started With Caron Treatment Centers

It’s easy to get started with Caron Treatment Centers. We accept many different insurers, and other payment options abound. Some of the benefits and services you or your loved one will experience with Caron include:

Reach out today to learn more about how Caron’s evidence-based addiction treatment modalities and support can help you or a loved one on the road to recovery.