3 Stages of Relapse: How to Spot Early Warning Signs

April 20, 2022

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Understanding that relapse happens gradually in three distinct stages allows for prevention planning at each stage. Research shows that identifying early warning signs and coping with negative thinking patterns is essential to recovery and success.

What Does Relapse Mean and How Does It Happen?

Opiates are among the most addictive substances posing significant public health problems due to the biopsychosocial impact on individuals.[3]

Relapse happens when a person returns to old ways of thinking and behaving. Contrary to what most people believe, this doesn't happen overnight. The process of recovering from opioid dependence takes time and effort. 

Though relapse is often unplanned and impulsive, certain warning signs indicate the danger of a potential opioid relapse. Although this "relapse" experience may seem unexpected and abrupt, actual relapse occurs in multiple stages and begins long before the physical use resumes.  

The 3 Stages of Relapse Explained

We can think of relapse in three stages: emotional, mental, and physical, according to an article published by the National Center for Biotechnology Information (NCBI).[1]

Emotional Relapse

Most people are not thinking about using opioids during an emotional relapse. They remember their last use and do not want to repeat it, but emotions and behaviors may be setting you up for a potential relapse.[1]

The individual may start to neglect the newfound coping techniques that have helped the individual maintain sobriety thus far. 

A common denominator of emotional relapse is poor self-care. The key in this stage is to recognize that you are in the emotional relapse stage.

Warning Signs of Emotional Relapse

  • Isolation
  • Anger
  • Anxiety
  • Keeping your feelings to yourself
  • Not participating in treatment or support groups
  • Poor eating and sleeping habits

How to Overcome Emotional Relapse

Practicing self-care is essential. This involves getting enough sleep, maintaining a healthy diet, exercising regularly, and taking care of your mind. 

Further, it is essential to recognize relapse triggers, attend meetings or support groups and prepare for significant changes in life or routine. 

Mental Relapse

The mental relapse stage is characterized as a battle of the mind. As the individual goes deeper into mental relapse, their cognitive resistance to relapse and the need for escape increase.[1,2,3]

Warning Signs of Mental Relapse

  • Glamorizing past use
  • Memories about people you were with in the past
  • Places where you used to use and things that remind you of when you used
  • Lying to yourself and loved ones
  • Thinking that you can use just once
  • Planning a relapse

How to Overcome Mental Relapse

Learn to cope with opioid cravings and find a reliable sober support system. More than likely, someone in your support system has been in your shoes and will have valuable feedback on managing cravings and thoughts about using.

Physical Relapse

Physical relapse is the final stage of relapse. When a physical relapse occurs, the person succumbs to their opioid use disorder and engages in substance abuse again. 

The negative emotions that the individual is feeling have become overwhelming. A lack of coping skills has led to unhealthy thoughts that justify opioid use. Finally, the individual has sought out and used the substance.[1,2]

How to Overcome Physical Relapse

Ask for help before picking up and using again. Talk to a professional, such as a counselor, doctor, or peer in recovery. The individual must communicate with people they trust about having the urge to use again. 

Relapse Doesn't Mean Failure! 

Be honest about relapse and open to learning new ways to cope. Never be afraid to ask for help. Remember that relapse is most preventable when you are in the earliest stage of relapse: the emotional stage.

When you start noticing warning signs of emotional relapse, speak up and get the help you need. 

Cognitive-behavioral therapy (CBT) is one of the most effective tools for managing warning signs and negative thinking patterns. It aims to help individuals recognize the early warning signs that may lead to relapse and develop coping skills that can help prevent it.

CBT seeks to help patients recognize, avoid, and cope with the situations they are most likely to use drugs. The key to recovery is making a life that makes it easier not to use. 

Worried About Relapsing on Opioids? 

Bicycle Health uses Suboxone as a primary medication for dealing with opioid dependence. 

Schedule an enrollment call or give us a call today at (844) 943-2514 to learn more about relapse rates for those on Suboxone treatment.

Photo by Tima Miroshnichenko from Pexels

Yerelin Checo

Yerelin Checo is a Licensed Mental Health Counselor in the state of Florida with an Education Specialist degree in Mental Health Counseling from Florida Atlantic University. She obtained her master’s degree in School Psychology from Barry University and earned her bachelor’s degree in Psychology at Florida Atlantic University.

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1. Melemis S. M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale journal of biology and medicine, 88(3), 325–332.https://www.researchgate.net/publication/281513257_Relapse_Prevention_and_the_Five_Rules_of_Recovery

2. The Stages of Relapse. Published: January 3, 2020. Updated: December 1, 2021. Accessed December 10, 2021. https://www.fortbehavioral.com/addiction-recovery-blog/the-stages-of-relapse/

3. Drugs, Brains, and Behavior: The Science of Addiction - Treatment and Recovery Accessed December 10, 2021. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

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