It can be helpful to be aware of the early warning signs that could indicate a person is headed toward a potential relapse.
Maybe you are trying to stay sober, or perhaps you are concerned about a loved one who is working to maintain sobriety. In either case, it’s important to recognize when someone is veering off track.
Relapse does not happen suddenly. It’s a subtle shift that often begins long before a person picks up a drink or drug – sometimes weeks or even months in advance.
The good news? If this shift is noticed early, and steps are taken to course-correct, relapse may be avoided. However, if you wait until you are already pouring a drink, it becomes much harder to stop the train.
The Relapse Prevention Workbook
The difference between abstinence and recovery
To understand relapse warning signs, it’s also helpful to understand what successful recovery looks like.
Recovery involves more than simply abstaining from drinking or using drugs. It includes engaging in “recovery behavior,” which may include:
- Showing up and being on time for important obligations
- Being more present with family and friends
- Being responsible and reliable
- Engaging in a 12-step program or therapy
- Being even-tempered and less reactive
- Improving problem-solving and communication skills
- Being more honest and open
The role of “change talk”
Another way a person may demonstrate recovery behavior is through “change talk.” This refers to comments that reflect a new, healthy, and positive way of thinking about situations, as well as introspective insights into their past substance use.
9 early signs of relapse
Warning sign #1: Decreased engagement in recovery activities
One of the first signs of potential relapse is a reduction in recovery-oriented behaviors. This might include:
- Skipping AA or other support group meetings
- Avoiding communication with their sponsor
- Becoming more irritable with family and friends
- Showing up late for work or missing obligations
- Becoming increasingly reactive to situations
- Isolating themselves more frequently
Warning sign #2: Lack of recovery behavior and the “dry drunk”
A person in early recovery who never starts to develop or demonstrate recovery behavior is at an increased risk for relapse.
Someone who gets sober but does not make any changes in how they think or conduct themselves is sometimes referred to in 12-step programs as a “dry drunk.” This term describes individuals who are “white-knuckling” their way through sobriety without addressing the underlying behaviors that contributed to their addiction.
Addiction rewires the brain and alters neurochemistry. A sober person who does not make the necessary changes to sustain their recovery is at high risk for returning to old behaviors. In this case, an early warning sign of relapse is the lack of recovery behavior.
Warning sign #3: Neglecting self-care
Self-care is a crucial part of maintaining sobriety.
If a person stops engaging in self-care activities, it could indicate they are at risk for relapse. This might include:
- Ceasing exercise or healthy eating habits
- Having difficulty falling asleep, sleeping too much, or experiencing disrupted sleep patterns
- Neglecting medical or mental health needs
Warning sign #4: Romanticizing the “good old days”
Another early warning sign is when a person starts talking or thinking fondly about the times when they were drinking or using.
They may begin:
- Recalling or sharing memories of excitement from their past substance use
- Comparing how dull their current sober life seems in contrast
- Editing out the negative consequences of their past behavior
Boredom or a decreased interest in their new sober life also puts them at risk for relapse.
Warning sign #5: Complacency and dangerous rationalizations
A very common and dangerous warning sign is complacency.
A person in early recovery may decide that now that they have some sobriety under their belt, they are “strong” or “smart” enough to drink in moderation. For many people with substance use disorders, moderation is not sustainable and quickly leads to excess.
Other risky rationalizations include:
- Believing it’s okay to use marijuana or other drugs as long as they don’t drink
- Thinking that occasional or social use is manageable
- Bargaining with themselves: “I’ll let myself have a couple of drinks tonight since it’s been a rough week, and then I’ll get back on track.”
For many individuals in recovery, using any substance can be a slippery slope that leads back to their addiction.
Warning sign #6: Neglecting personal appearance and hygiene
A decline in personal appearance can also indicate relapse. Signs include:
- Poor hygiene or lack of grooming
- Wearing unclean or inappropriate attire
Additional warning signs may involve:
- Becoming increasingly secretive
- Experiencing financial difficulties
- Reconnecting with people, places, or things associated with their past substance use
Warning sign #7: Mood swings and increased anxiety
Changes in mood can also serve as a warning sign for relapse. A person at risk may:
- Experience frequent mood swings
- Become more anxious or irritable
- Seem withdrawn or emotionally unstable
Warning sign #8: Bargaining and dreams about relapsing
A person at risk for relapse may start bargaining with themselves about drinking or using again. They might say things like:
- “Just one drink won’t hurt.”
- “I can handle it this time.”
- “It’s just for special occasions.”
Dreaming about drinking or using drugs can also be a relapse warning sign. While these dreams are common in recovery, frequent or vivid dreams about substance use may indicate that a person is struggling with cravings or unresolved emotional triggers.
Warning sign #9: Post-Acute Withdrawal Syndrome (PAWS)
PAWS, or Post-Acute Withdrawal Syndrome, refers to symptoms that mimic acute withdrawal but occur days, weeks, or even months after detox.
Symptoms of PAWS include:
- Fatigue
- Mood swings
- Irritability
- Cravings
PAWS can leave a person vulnerable to relapse, making it an important warning sign to monitor.
Preventing relapse: What to do next
When a person starts to demonstrate early warning signs of relapse, the best plan is to step up involvement in their recovery program and mental health care.
If they are not already engaged in these resources, now is the time to get connected.
Some key relapse prevention strategies include:
- Increasing participation in AA, therapy, or other support groups
- Strengthening their support system – reaching out to friends, family, or sponsors
- Developing a solid relapse prevention plan
- Prioritizing physical activity, yoga, meditation, and healthy eating
- Developing new hobbies and interests to fill time productively
- Avoiding high-risk people, places, and situations
- Using accountability tools, such as BACtrack View, to stay motivated and on track
Being vigilant and addressing relapse warning signs early can help a person maintain long-term sobriety and prevent a return to substance use.
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