Recovering from a dependence on alcohol or another drug is a process that can take time.1 A relapse (or multiple relapses) is one part of the recovery process from alcohol and other drug dependence, and can often be a feature of the recovery.2
A relapse happens when a person stops maintaining his or her goal of reducing or avoiding use of alcohol or other drugs and returns to previous levels of use.3,4
This is different to a lapse, which is a temporary departure from a person's alcohol and other drug goals followed by a return to their original goals. For example, a person who has set a goal of not drinking alcohol may end up having a glass of wine at a party, only to return to their alcohol goal the following day.4
The degree of substance use can vary within a lapse, but what makes a lapse different from a relapse is that a lapse is a brief period of return to substance use followed by a clear return to the person's recovery goals.
Many things could lead a person to relapse. There is a strong connection between dependent alcohol or other drug use and personal challenges, problems at work, ongoing emotional and psychological issues, and social or economic problems such as financial hardship, rejection by social support networks and challenges in personal relationships.5
Much like dependent drug behaviours themselves, the process of recovery – and the reasons for relapse – can be highly personal. A relapse is not a sign that the person is 'weak' or a 'failure' – it is merely a continuation of old coping patterns that need to be replaced with new ones.2
Causes of relapse
There are a range of circumstances that may promote relapse. These include:
It may take several attempts to get the right management strategies to maintain an alcohol and other drug goal in the long term.5
Managing relapse is part of the long-term strategy of alcohol and other drug recovery. This means that the solutions are both immediate and focused on long-term behavioural changes.
What to do straightaway
What to do in the short to medium term
Overdose risk during relapse
When a person uses a drug regularly, they develop tolerance to it, which means they need to use more to get the same effect. If a person then doesn't use it for a while, their tolerance to the drug may drop, so when they take their usual amount after a break from using, it could be too much for the body to cope with and lead to an overdose.
Overdose due to changed tolerance is a specific risk for people who return to using a drug after a period of non-use, at times such as post-release from prison, during detoxification and/or rehabilitation. Someone on naltrexone, for example, can be at risk if they use soon after stopping oral medication, or skipping a dose, or when the effects of a naltrexone implant have ceased.8
If an overdose is suspected, seek medical assistance immediately.
Long-term solutions for managing relapse are really about preventing relapse as much as possible. The following strategies have been proven effective for people who are dependent on alcohol or another drug in helping to reduce the risks of relapse on the road to recovery:
If a person has ongoing emotional, physical and/or mental health issues, they may need to use specific strategies in addition to those listed above to help them recover and prevent relapse. These include:
Every Australian state and territory has a range of services to support people who are experiencing problems from drug use. More information and details are available on our Help and Support page, or contact DrugInfo on 1300 85 85 84.
1. Best D & Lubman D (2012) The recovery paradigm: a model of hope and change for alcohol and drug addiction. Australian Family Physician 41(8) 593-597.
2. Sack D (2012) Why relapse isn't a sign of failure. Psychology Today.
3. Stephens RS, Curtin L, Simpson EE & Roffman RA (1994) Testing the Abstinence Violation Effect construct with marijuana cessation. Addictive Behaviours 19(1) 23-32.
4. Department of Health (2004) Relapse prevention and management. From Working with young people on AOD issues: learner's workbook. Canberra: Australian Government Department of Health.
5. Queensland Government (2013) Induction Module 6: Relapse Prevention and Management. Brisbane: InSight Alcohol and Other Drug Unit.
6. Brady KT & Sonne SC (1996) The role of stress in alcohol use, alcoholism treatment and relapse. Alcohol Research and Health 23(4) 263-271.
7. Penington Institute (n.d.) Overdose Awareness Day: overdose basics. Victoria: Penington Institute.
8. Davis KE & O'Neill SJ (2005) Special report on relapse prevention: a focus group analysis of relapse strategies for persons with substance use and mental disorders. Psychiatric Services 56(10) 1288-91.
9. Ivanovski B and Malhi GS (2007) The psychological and neurophysiological concomitants of mindfulness forms of meditation. Acta Neuropsychiatrica 19(2) 76-91.
10. NPS MedicineWise (2015) Chronic pain: limited evidence for opioids. New South Wales: NPS MedicineWise.
11. Marsh A, Dale A & Willis L (2007) A counsellor's guide to working with alcohol and drug users. Western Australia: Alcohol and Drug Office.
Last updated: 9 June 2016