Warning Signs of Relapse in Addiction Recovery

Relapse is not a sudden event. It is a process that begins days or weeks before a person picks up a substance again. Research by Terence Gorski and others has mapped this process into identifiable stages, each with its own warning signs. Recognizing these signs early, in yourself or in someone you care about, creates an opportunity to intervene before the situation reaches crisis. Knowing what to look for is one of the most practical things anyone involved in recovery can learn.

Stage 1: Emotional Relapse

During emotional relapse, the person is not consciously thinking about using substances. They may genuinely believe they are committed to their recovery. But their emotional state and daily behaviors are quietly creating conditions for relapse. The signs are subtle and easy to rationalize:

• Withdrawing from friends, family, and recovery support networks
• Skipping therapy sessions, support group meetings, or medication
• Bottling up emotions instead of expressing them
• Irregular sleep patterns, either sleeping too much or too little
• Neglecting basic self-care like nutrition, hygiene, and exercise
• Increased irritability, defensiveness, or mood swings

At this stage, the most effective response is returning to basics. Resume the daily habits that support recovery: consistent sleep, regular meals, physical activity, honest conversations with someone you trust, and keeping commitments to therapy and support meetings. Our guide on how substance abuse treatment works explains the aftercare structure designed to catch these early shifts.

Stage 2: Mental Relapse

Mental relapse is the stage where the internal battle becomes conscious. Part of the person wants to use, and part of them wants to stay in recovery. This tug-of-war can be exhausting and confusing. Signs of mental relapse include:

• Thinking about people, places, or situations associated with past substance use
• Romanticizing or glamorizing past use while minimizing the consequences
• Bargaining, such as believing they could use just once or switch to a different substance
• Lying to therapists, sponsors, or family members about how they are feeling
• Fantasizing about using and planning how they would do it
• Looking for opportunities or excuses to be around substances

This is the critical window. Once mental relapse progresses to active planning, physical relapse becomes increasingly likely. At this stage, the person needs to tell someone what they are experiencing. Calling a sponsor, scheduling an urgent therapy session, or contacting the crisis resources line can interrupt the progression. The shame of admitting these thoughts is far less damaging than the consequences of acting on them.

Stage 3: Physical Relapse

Physical relapse is the point of using the substance. Many people think of relapse as a single event, but by the time someone physically uses, weeks of emotional and mental deterioration have typically already occurred. The actual use may happen impulsively once the emotional and mental groundwork is in place.

Physical relapse does not erase recovery progress. It is a setback that signals the treatment plan needs adjustment. People who respond to relapse by immediately re-engaging with treatment have better long-term outcomes than those who interpret relapse as total failure and abandon their recovery efforts. Understanding the stages of addiction can help individuals recognize how quickly substance use can re-escalate after a period of abstinence.

What Increases Relapse Risk

Certain circumstances raise the probability of relapse. Being aware of these risk factors helps individuals and families prepare rather than react:

• Untreated co-occurring mental health conditions, particularly depression, anxiety, and PTSD
• Chronic pain without adequate non-addictive pain management
• Major life transitions: job loss, divorce, moving, death of a loved one
• Returning to environments where substance use previously occurred
• Overconfidence in recovery leading to reduced vigilance and dropped support habits
• Social pressure or reconnecting with people who actively use substances

People with dual diagnosis conditions face elevated relapse risk because untreated mental health symptoms create ongoing pressure to self-medicate. Integrated treatment that addresses both the substance use disorder and the mental health condition simultaneously provides the strongest protection against relapse.

Building a Relapse Prevention Plan

A concrete relapse prevention plan identifies personal triggers, lists early warning signs to watch for, and outlines specific actions to take at each stage. The plan should include names and phone numbers of people to call, activities that redirect cravings, and a clear path back to intensive support if needed. Treatment programs typically develop this plan collaboratively with clients before discharge, but it should be reviewed and updated regularly as recovery evolves.

West Slope Casa builds relapse prevention into every treatment program, equipping clients with practical tools that extend well beyond the treatment period. For families supporting a loved one in recovery, knowing what not to say to someone in recovery helps create an environment that reduces rather than increases relapse risk.