Relapse Signs and Symptoms – How to Spot if Your Loved One is in Danger and Ways to Help
When it comes to substance abuse recovery, relapse is a word nobody wants to hear, but the reality is that addiction is a chronic illness and, like other chronic illnesses (think hypertension, asthma, etc.), relapse happens. Studies published by the National Institute of Health, put the chance of drug or alcohol relapse at 40% to 60%, with a median of around two recovery attempts per individual. This does not mean all people grappling with substance abuse will relapse, but for many it is an unfortunate part of the journey. If your loved one is heading toward relapse, they are in danger and they need help. Knowing the signs and symptoms and having some tools ready can be lifesaving.
Overdose – A Real Relapse Danger
When people relapse – especially if they are in recovery for heroin or opioids – they are in danger of accidental overdose if they use the same quantity of the substance they were using before entering treatment. Because their systems are no longer accustomed to processing such a high volume of the substance, the overdose risk can be greater than before they entered treatment. Relapse overdoses also sometimes occur when people switch to different substances than the ones they originally sought treatment for.
Research suggests that early recovery (within the first three to six months) is the time when an individual is most in danger of relapse, although it is important to remember that recovery is a lifelong process and relapse can occur at any point – even years after recovery is established.
Signs and Symptoms of Relapse
Substance abuse recovery requires much more than willpower and desire. Psychological, relational, emotional and physical components can all contribute to an individual’s initial addiction and subsequent success in recovery. In order to remain sober, most addicts need to make big lifestyle changes, commit to therapeutic assistance, and participate in recovery programs, such as the 12-steps.
Relapse is generally not something that happens overnight. Rather, it is a process that happens in stages. An individual in danger of relapse will pass through an emotional, mental and finally a physical stage which involves the seeking out and using of the substance.
The Emotional Phase of Relapse
This phase represents the first steps on the road to relapse, and it is a tricky period because the individual in recovery isn’t typically thinking or fantasizing about using. Rather, they are engaging in poor self-care, which can eventually lead to using later on. If you notice your loved one not eating right, skipping their 12-step meetings and/or therapy appointments, isolating from friends and family, etc., they may be headed toward building up the feelings of restlessness, low self-esteem, irritability and desire for an escape that trigger substance use.
What You Can Do
Talk to your loved one. Tell them that you’ve noticed their behavior changing and ask if you can help. Share your concerns with them and let them know you love them and are there to support them. Encourage them not to isolate and to engage in self-care – good food, quality sleep, proper hygiene, exercise, therapy, etc. Offer to take them to appointments and meetings if you can, and try to stay connected.
The Mental Phase of Relapse
After a period of low self-care, the next phase of relapse is mental – and this is where the cravings return. In this phase, an addict in recovery is engaged in a battle of back and forth; their resistance begins to wear down and they start to look for excuses and opportunities to revert back to their addictive behaviors. They may purposefully enter high risk situations, engage in bargaining or begin to use an alternative substance.
What You Can Do
If you get a call from a friend in danger of relapse, be available if you can – they may be trying to distract themselves from a craving.
There are helpful and unhelpful ways to engage with someone in danger of relapse. Offering practical support and hope has been shown to be more effective than hostility. If you have a history of hostile confrontation and negativity with the person in danger of relapse, it might be better to refrain from engaging with them. Research indicates that helpful confrontations are ones that are perceived as legitimate, come from trusted and respected individuals and are offered by people who do not have an air of moral superiority.
The Physical Phase of Relapse
This is the phase of relapse where the actual obtaining and using of the substance occurs. At this point, it is imperative that the individual get help in order to curb the behavior before it becomes lethal. Signs of possible relapse include falling back into old lifestyle patterns and associating again with the people they hung around with pre-recovery. Other signs include lying, positive reminiscing over “the good old days” of using, and frequenting places like bars or nightclubs where others consume drugs and/or alcohol.
What You Can Do
If your loved one has relapsed, it’s important that you don’t judge or shame them. They have a disease and the disease has returned. It may be time to encourage them to reenter detox and then either an inpatient or intensive outpatient program. Communicating with empathy and understanding is important, but so are boundaries. You can express how sad it makes you that your loved one has relapsed, but you can also be firm in the type of help you are willing (and not willing) to give.
At this point, self-care for you is critical. The stress, worry, frustration and feelings of hopelessness that come with watching a loved one struggle with addiction can take a serious toll on your well-being. Al Anon and Nar Anon meetings can help you find support through this difficult time. Seeking out therapy beyond group options may also be helpful. Addiction is difficult for everyone involved. Even though you might be the reliable one, the responsible one, the “rock” of your family, dealing with a loved one who is relapsing is hard, it’s stressful, and it’s painful. It’s ok to acknowledge the toll it’s taking on you.
Mare’s House Provides Transitional Living for Young Women in Recovery
The first months after rehab can be some of the toughest to get through. That’s why transitional living facilities exist. Group living arrangements, like those found at Mare’s House, provide the stability, support and accountability that many people in recovery need to transition into full independent living. Programs like ours provide six months to a year of living away from the old friends, places and lifestyles that trigger addictive behavior. We provide job skills training, therapy and instruction in self-care to help our residents develop the coping skills necessary for success.
