Unfortunately relapse rates for individuals who enter recovery from a drug or alcohol addiction are quite high. Studies reflect that about 40-60% of individuals relapse within 30 days of leaving an inpatient drug and alcohol treatment center, and up to 85% relapse within the first year. It is important for individuals who struggle with an alcohol dependence or other substance dependence to acknowledge the high risk for relapse, have an awareness of what their own personal triggers are, and learn to cope with their triggers and emotions in a healthy way. Through an understanding of common risks for addiction relapse, individuals can be better equipped and better able to maintain their recovery. Here are a list of 10 common triggers that contribute to addiction relapse.
Many individuals relapse within the first week of stopping their substance use in order to avoid withdrawal symptoms, or thereafter due to post-acute withdrawal symptoms which can last for up to 6 to 18 months. Individuals with an alcohol or drug addiction will experience varying degrees of withdrawal symptoms when they stop using their substance of choice. Depending on the type of substance used, the quantity of use, the frequency of use, the duration of use, and other factors, withdrawal symptoms will be different on a case by case basis. Some common physiological withdrawal symptoms may include nausea, hot and cold sweats, restlessness, vomiting, diarrhea, insomnia, and muscle aches to name a few. Withdrawal from substances such as alcohol and benzodiazepines (Xanax, Ativan, Klonopin, Etizolam, etc.) can even be deadly and/or cause seizures. As such, it is highly recommended that individuals who stop using drugs or alcohol seek out a medical detox where they can safely and more comfortably get off of the substances they were using under medical supervision and using medically assisted treatments such as Suboxone or Valium.
2. Mental Health
Alcoholism and drug addiction are a problem in and of itself, but there is also a problem underlying the substance dependence. Without addressing the underlying issues and simply stopping substance use, it is like putting a band aid on severed limb. Oftentimes there are unaddressed or hidden mental health concerns such as anxiety, depression, mania, personality disorders, or post-traumatic stress. If an individual receives proper alcohol and drug addiction treatment, therapists, psychiatrists and other addiction specialists will work with the patient to address underlying mental health issues. As with alcohol and drug addiction, mental health issues often require long-term attention to sustain recovery. If mental health issues go unaddressed, or if an individual does not know how to properly cope, they can trigger an alcohol or drug relapse. Individuals with alcohol or drug addiction are not used to experiencing psychological issues such as depression or anxiety without using alcohol or drugs as their primary coping mechanism. With proper guidance from a mental health professional, and in some cases with the aid of prescribed psychotropic medications, individuals can live a thriving life with a mental health diagnosis.
Individuals with an alcohol or drug addiction often surround themselves with likeminded individuals who also enjoy drinking or drugging. Being around the same people who are engaging in substance use while you are in recovery can trigger a relapse. Part of the recovery process is setting healthy boundaries with friends, family or colleagues who do not respect your sobriety enough to stay sober while they are around you. Ideally you want to reach a point in your recovery where you can enjoy social gatherings where other individuals are drinking alcohol and not be triggered to relapse, but this often takes time and effort. One should not surround themselves intentionally with other people who are using alcohol or drugs unless they have a stable foundation in their own recovery. It is also helpful to have a plan in place when surrounding oneself with people who are using alcohol or drugs, and bring a sober support and accountability partner with them when possible.
Bars, liquor stores, wineries, strip clubs, casinos, and parties are some obvious places that individuals in recovery from alcohol or drug addiction may want to avoid, but there are many others. The place will be dependent on the individual. Any place that you may have associated with your alcohol or drug use is a place you would ideally want to stay away from. The impacts of addiction on the human brain are so far-reaching that miniscule things may trigger an individual in recovery that may not even enter their conscious minds. This is important for individuals in recovery to be aware of, and if they do feel triggered in a “random” situation they may want to take inventory of their surroundings and ask themselves why they are feeling triggered. If an addicted individual was frequently using alcohol or drugs in their own home or apartment, their own residence in and of itself may be triggering for them. For obvious reasons their own home may not be a place they can simply avoid (although, this is why Sober Homes are very helpful in early recovery). In such cases, it may be helpful to get new furniture or rearrange furniture to allow for a new space that they can correlate with their newfound life in sobriety rather than with their substance use.
People, places and things, oh my. Yes, we could not have this list without listing things. What exactly are things anyway? Well, first let’s remember how addiction impacts the brain as noted above, and how miniscule things can trigger a relapse, ones that may not even enter our conscious mind. For example, glasses clinking, bottles popping, or cans opening may trigger an alcoholic to think of alcohol. Credit cards or straws may trigger a cocaine addict or other drug addict to think of their drug of choice, as might a pill bottle or syringe. Anything that you associate with your drinking or using is a thing to be mindful of. Obviously we live in a world where these things are nearly impossible to avoid. In any given situation, with awareness and mindfulness, you can understand why you might be experiencing cravings, understand why you are feeling the way you are, and then properly cope without the use of alcohol or drugs.
6. Poor Self-Care
Self-care is an important part of addiction recovery. Proper self-care will make you feel better about yourself, and will be sending a message to yourself that you care about your wellbeing. Conversely, poor self-care sends messages to yourself that you don’t care about your wellbeing and can trigger a relapse. For example, eating a diet that is unhealthy, low in nutrients, and/or high in sugar may result in poor physiological and neurological health that can lead to low mood and cause alcohol or drug cravings. Weight gain can lead to individuals feeling depressed, and trigger thoughts that their substance use might help them lose the weight they have put on. Poor sleep-hygiene can leave individuals feeling irritable, stressed, anxious, and experience low mood, which can also trigger a relapse. It is important for individuals in recovery to eat well, exercise, meditate, have proper sleep-hygiene, and engage in other such self-care behaviors that support their mental wellness and addiction recovery.
7. Relationships and Intimacy
If an individual is not in an intimate relationship when they enter recovery, it is often encouraged to stay out of one for several months or even a year, until they are more stable in their recovery. This is because individuals who are newly sober may try to fill their void with an intimate partner. There are many other reasons it is encouraged not to date in sobriety. For example, dating and intimacy often involves alcohol, and a newly sober individual may not know how to navigate the dating scene without alcohol or drug use. Additionally, relationships (even long-term relationships that existed prior to recovery) can trigger unpleasant and unwanted emotions that a newly sober individual may not know how to cope with. Furhtermore, individuals who are newly sober may never have had sober sex, and therefore sexual experiences in recovery can be very triggering. Due to arguments, uncomfortability, or insecurity that relationships can cause, this is an area that needs to be taken with caution by a newly sober individual.
8. Pride and Overconfidence
Sometimes individuals who are new to sobriety experience a pink cloud, or have notions that they will never use alcohol or drugs ever again no matter what. They have such bad memories of their substance use, and are enjoying their recovery journey. Sure, it is a great feeling when you are confident in your recovery, but keep in mind that everyone is eligible for relapse. All it takes is a millisecond, being in the wrong place at the wrong time, or just one bad thought that leads to one bad decision. Do not be so confident in your recovery that you are willing to put yourself in risky situations or seek them out to prove to yourself that you can be sober at a party, for example. Do not become complacent, cocky, or have the belief that you are “cured.” No matter how confident you feel, it is encouraged to follow treatment recommendations and engage in recovery related behaviors and activities, and stay away from people, places and things that are not aligned with your sobriety.
9. Boredom and Isolation
Boredom and isolation could easily be listed as the number one reason for relapse by many individuals in early recovery. Any and all down time prior to recovery was usually used getting their substance, using their substance, and recovering from their substance. As such, individuals new to sobriety often find lots of time on their hands. When one is bored or feeling isolated, they are left with themselves, and as they say, an addict alone is in bad company. When one is bored or isolated they are left with their own thoughts and emotions, which often do not want to be heard or felt. While one should also be cautious to not fill their days with activity after appointment after activity as a means to escape reality and avoid their thoughts and emotions, it is also not healthy to be bored and isolated in early recovery. Spend down time engaged in recovery related behaviors such as exercising (join a fitness or running club), cooking nutritious meals with loved ones, going to recovery related therapy or support groups, or trying new activities and picking up new hobbies.
10. Uncomfortable Emotions
In active addiction, when you were tired you used alcohol or drugs. When you were angry you used alcohol or drugs. When you were sad you used alcohol or drugs. When you were lonely you used alcohol or drugs. When you were stressed you used alcohol or drugs. Etcetera. Nobody wants to experience uncomfortable emotions, but they are a natural and normal part of the human experience. What is not healthy is avoiding such emotions, or even worse, using alcohol or drugs to cover them up and sweep them under the rug. The more we accept uncomfortable emotions and acknowledge that they are trying to teach us something important about our current situation, the better able we are to handle them and cope with them. An important part of the addiction recovery process is learning to be aware of emotions, accept emotions, feel emotions, and cope with emotions.
The longer one is able to maintain their sobriety, the better chance they have at long-term recovery. As noted, up to 85% of individuals relapse within their first year of sobriety. The good news is that the longer one is able to maintain their recovery, the better chance they have at sustaining long-term sobriety. Once an individual is able to maintain sobriety for their first year, their chances of maintaining their sobriety exponentially grows. Do not think that just because you attended a 28 day inpatient treatment program you are cured. It is highly recommended to seek out outpatient drug and alcohol treatment and have additional support such as a sober coach and/or sober companion. Engage in holistic recovery related behaviors and surround yourself with likeminded individuals who care about your wellbeing.
For more information on addiction treatment, therapy and mental health, sober coaching, sober companions, or to inquire about our private concierge therapy services and/or our teletherapy services (online therapy/virtual therapy) in New York City please contact our undisclosed therapy office location in the Upper East Side of NYC today at (929) 220-2912.