Arielle Cruz
Alcoholism, or alcohol use disorder, is a chronic condition that can be challenging to overcome. Recovering from alcohol dependence is a process that takes time and often involves setbacks and relapses. Relapse rates vary, but studies suggest that around 40-60% of individuals with alcohol use disorders relapse within a year, and two-thirds of those treated for AUD will relapse within the first six months. The longer an alcoholic stays sober, the better their chances for long-term sobriety; among people sober for five years, the chances of relapsing are less than 15%. Relapses can be triggered by various factors, including emotional, environmental, and social cues, and they are a normal part of the recovery process. Preventing relapses requires a strong recovery plan, support from loved ones, and the development of new coping strategies.
| Characteristics | Values |
|---|---|
| Chance of relapse within the first 6 months of treatment | 40% to 60% |
| Chance of relapse within the first year | 40% |
| Chance of relapse after 5 years of sobriety | Less than 15% |
| Factors that increase the chance of relapse | Triggers in the environment, exposure to alcohol, emotional triggers, pre-existing mental health issues, poor physical health, internal conflict or guilt about lapsing, stress, financial hardship, rejection by social support networks, challenges in personal relationships |
| Factors that decrease the chance of relapse | Recognising alcohol use problem, seeking help, lower alcohol consumption, fewer drinking problems, more self-efficacy, reliance on support groups, therapy, cognitive behavioural therapy, individualised treatment plans, building relapse-prevention skills |
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What You'll Learn
Alcohol relapse statistics
Relapse is a common challenge during the recovery journey from alcohol addiction, but it doesn't mean the end of progress. It is a normal part of recovery and can be managed with the right tools and support. Relapse occurs in almost one-third of recovering alcoholics during their first year of sobriety, with rates declining the longer someone stays sober.
There are different types of relapses: short-term slips, lapses, and full relapses. A slip is a single instance of drinking after a period of abstinence, a lapse involves multiple instances of drinking without returning to regular alcohol abuse, and a full relapse occurs when a person returns to their previous patterns of excessive drinking. Relapse usually happens gradually and can be broken down into three stages: emotional relapse, mental relapse, and physical relapse.
During the emotional relapse stage, a person may not be actively thinking about drinking, but their emotions and behaviours are leading them in that direction. Their self-care habits may begin to slip, and they may start to experience cravings. The mental relapse stage is when the internal battle between wanting to drink and staying sober begins. People may start to glamorise their past alcohol use, think about people, places, and things linked with past use, or try to bargain with themselves. They may also start lying, looking for relapse opportunities, and planning a relapse. The final stage, physical relapse, is when someone starts drinking alcohol again, often due to triggers such as stress, environmental cues, or emotional vulnerabilities.
According to various studies, 70% of individuals with alcohol use disorder will experience a relapse at some point, with the relapse rate decreasing over time. In one study, 21.4% of recovering alcoholics relapsed in their second year of recovery, 9.6% relapsed in years three through five, and only 7.2% relapsed after five years in recovery. Among individuals who stay sober for five years, the risk of relapse drops to below 15%.
While relapse is common, it is important to remember that it is not a failure but rather a part of the recovery process. With proper support and treatment, many people successfully maintain long-term recovery. Understanding relapse statistics and taking proactive steps can help individuals stay on track and avoid potential relapses.
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Triggers and cravings
Triggers can be internal or external. Internal triggers are based on feelings and memories of past events and experiences. They can include thoughts, emotions, physical sensations, and intense negative or positive feelings. For example, stress, anxiety, and conflict are common internal triggers that can lead to alcohol cravings as a form of self-medication. External triggers refer to environmental cues and can include sounds, smells, tastes, locations, people, and activities associated with past drinking. Bars, liquor stores, and places where one frequently drank alcohol are common external triggers.
Cravings often occur as an automatic response to these triggers. They can be intense, but they typically last for only a few minutes. Acknowledging and understanding cravings and their connection to triggers is important in managing them. Distractions, such as a comforting book, a favourite snack, or a treasured possession, can help occupy one's thoughts and energy during a craving. Creating a list of distractions that can be easily accessed on a phone or in a journal can be useful. Additionally, positive thinking, mindfulness, breathing exercises, self-compassion, and affirming mantras can help manage cravings.
It is important to constantly work on ways to avoid relapse. This includes knowing one's triggers and developing a relapse prevention plan. Support from a sponsor, family member, or friend or mental health professional can also help individuals manage cravings and maintain sobriety.
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Treatment and recovery plans
Relapse rates for alcohol addiction are estimated to be between 40% and 60%, which is comparable to the relapse rates for other chronic illnesses such as asthma and hypertension. Over 30% of people who attempt to stop drinking relapse within their first year of sobriety. However, the relapse rate decreases over time: 21.4% of recovering alcoholics relapse in their second year, 9.6% in years three to five, and 7.2% after five years. This means that more than 70% of people struggling with alcohol abuse will relapse at some point. The longer an alcoholic stays sober, the better their chances of long-term sobriety.
- Individualized treatment plans – Following a treatment plan that is tailored to the individual's needs can help prevent relapse. This could include therapy, medication-assisted treatment, detox, rehab, and counseling.
- Early intervention – Intervening early in alcohol addiction can increase the chances of successful recovery by up to 40%.
- Cognitive-Behavioral Therapy (CBT) – CBT has been shown to have a recovery success rate of approximately 60%. It helps individuals identify and manage high-risk situations that might trigger a relapse.
- Medication-assisted treatment (MAT) – MAT is considered the gold standard for opioid use disorder and is also highly effective for alcohol use disorder. The U.S. Food & Drug Administration has approved naltrexone and acamprosate as alcohol use disorder treatments. Topiramate and gabapentin can also decrease cravings. MAT can increase the likelihood of long-term recovery by up to 25%.
- Family involvement – Involving family members in the recovery process can increase the success rate by up to 50%. Family support provides encouragement, accountability, and assistance in managing stressors that may trigger a relapse.
- Dual diagnosis treatment – Addressing co-occurring mental health disorders alongside alcohol addiction treatment increases the chances of successful recovery by 35%.
- Support groups – Support groups such as Alcoholics Anonymous (AA) provide a space to connect with others in recovery, share experiences, and heal together. Regular attendance at AA meetings can provide valuable peer support and help reinforce coping strategies for maintaining sobriety.
- Exercise – Exercise is a great way to manage stress and cravings for alcohol.
- Know your triggers – Certain circumstances, such as stress, environmental cues, or emotional vulnerabilities, may trigger the urge to drink. Identifying these triggers can help individuals avoid or manage high-risk situations.
- Build a strong support system – Individuals with strong social support networks are less likely to relapse. Support can come from family, friends, sober peers, support groups, treatment centers, and faith-based recovery programs.
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Abstinence and sobriety
Abstinence refers to completely refraining from alcohol consumption, which is often considered a central characteristic of addiction recovery. Sobriety, on the other hand, has a broader meaning and implies achieving a ""life balance" or a state free from the influence of mind-altering substances. In the context of AUD, sobriety may refer specifically to being free from the effects of alcohol.
The traditional view of recovery from AUD has primarily focused on abstinence, with programs like Alcoholics Anonymous (AA) advocating for it as a necessary component of recovery. However, recent research has challenged this notion, suggesting that non-abstinent recovery is also possible and viable for some individuals. Non-abstinent recovery involves drinking in a way that is no longer problematic, and it has gained attention as a valid approach, particularly in the scientific literature.
It's important to recognize that relapse is a common occurrence during the recovery process. According to various sources, approximately two-thirds to 70% of individuals with AUD will relapse at some point, with the highest risk occurring within the first year of sobriety. However, the longer an individual stays sober, the better their chances of maintaining long-term sobriety. Relapse does not mean failure, and individuals can seek help and strengthen their treatment plans to prevent a return to substance use.
Overall, while abstinence and sobriety are important concepts in the recovery journey from AUD, they may manifest differently for each individual. Recovery is a dynamic process, and seeking professional support and guidance can help individuals navigate their unique paths toward healing and sustained well-being.
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Risk factors and prevention
Relapse is a common occurrence during the recovery process, with almost two-thirds of individuals treated for an alcohol use disorder (AUD) relapsing within the first six months. About 70% of individuals struggling with alcoholism will relapse at some point, and the longer the sobriety period, the lower the chances of relapse.
Risk Factors
- Lack of Support and Motivation: The absence of a supportive environment and intrinsic motivation to recover can increase the likelihood of relapse.
- Triggers: Various triggers, such as stress, environmental cues, emotional vulnerabilities, and exposure to alcohol, can initiate a relapse.
- Negative or Positive Intense Feelings: Intense emotions, whether negative or positive, can trigger a relapse. For example, feelings of stress, anger, sadness, hopelessness, or even boredom can lead to a relapse, especially when they stem from conflicts with loved ones.
- Ineffective Coping Mechanisms: Individuals with ineffective or unhealthy coping strategies may be more prone to relapse.
- Cognitive Distortions: Negative thinking patterns and cognitive distortions, such as believing recovery is impossible or too difficult, can hinder progress and increase the risk of relapse.
- Low Self-Efficacy: Low self-efficacy, or a person's belief in their ability to overcome challenges, can make it harder to resist relapse.
- Guilt and Shame: Feelings of guilt and shame related to past relapses or alcohol use can be risk factors for future relapses.
- Social Influences: Social circles, peers, co-workers, or events that normalise or encourage alcohol use can increase the risk of relapse.
- Access to Substances: Easy access to alcohol or other substances can make relapse more likely.
Prevention
- Understanding Relapse Statistics and Triggers: Educating oneself about relapse statistics and common triggers can help individuals recognise high-risk situations and develop strategies to avoid or manage them effectively.
- Support Systems: Developing a strong support system, including family, friends, sponsors, and support groups like Alcoholics Anonymous, can provide ongoing encouragement and accountability.
- Cognitive Behavioural Therapy (CBT): CBT can help individuals identify and challenge negative thinking patterns that contribute to relapse. It focuses on practising coping skills rather than relying solely on willpower.
- Journaling: Keeping a journal can aid in maintaining recovery. Writing out a recovery plan, relapse prevention strategies, and a list of personal triggers, along with corresponding management techniques, can help individuals stay focused and proactive.
- Addressing the Root Cause: Instead of solely treating the symptoms of alcohol use disorder, addressing the underlying causes and behaviours that led to addiction can help prevent relapse.
- Long-Term Sobriety: The longer an individual maintains sobriety, the better their chances of avoiding relapse.
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