When someone you love has a history of addiction, it can feel as though you are constantly looking over your shoulder to make sure they’re okay. Is she going to meetings? Is that water or vodka? Did he really have to work late or is he using again? You struggle to trust what your loved one tells you, knowing all too well the lies addiction breeds. At times it can be confusing to separate your fears from reality, never knowing if your instincts are right or if your default setting is now to assume the worst regardless of reality.
In other cases, you may so desperately want to believe in your loved one’s recovery that you ignore even the obvious signs of relapse, falling back into patterns of denial to protect yourself from the pain of their substance use. You tell yourself wild tales to justify their behaviors, latching onto any reason aside from drugs or alcohol to explain away the missing money, the skipped work, the emotional blowup.
Despite the pained history that so often clouds the perception of families of addicts, it is vital to cut through distorted thinking and look at your loved one’s situation with clear eyes. Knowing how to tell if an addict has relapsed is one of the most important skillsets you can develop to support your family member through their healing process. By understanding the early warning signs of relapse and taking an honest inventory of your loved one’s behaviors, you can help ensure that they stay on the road to recovery.
Early recovery can be an emotionally volatile time and mood fluctuations are to be expected as your loved one learns how to live their life without the use of drugs or alcohol. This is often normal and a part of settling into one’s skin as a sober person. However, if your loved one is exhibiting unusual mood changes—particularly anger, depression, or anxiety—it may be a sign of vulnerability to relapse or that relapse has already happened.
Change is perhaps the only constant when it comes to early recovery, and many changes are simply new patterns emerging in sobriety. However, there are certain changes that suggest relapse, including:
- Skipping work
- Not attending 12-step meetings
- Neglecting personal hygiene and other forms of self-care
- Evading responsibilities at home
- Lack of involvement in hobbies or personal interests
- Unexplained sleep or appetite changes
- Withdrawing from social contact with their sober support network
You may notice them falling back into familiar patterns that you recognize from their periods of active addiction or notice new, alarming changes that suggest they are using again.
Recovery involves making significant changes in your understanding of yourself and the world around you in order to foster new, healthy thoughts, emotions, and behaviors. When you find your loved one starting to slip away from those healthy new attitudes, it may be a sign of relapse. For example, romanticizing past drug use, insisting that they don’t need to be in a recovery program, and believing that they can use in moderation can all indicate that they are close to relapse or have already started using again.
Part of recovery involves removing oneself from harmful social environments and creating meaningful social bonds with people who support sobriety. This can be a difficult process and one that takes time; it is common for people in early recovery to struggle to find their bearings socially and the temptation to go back to what they know can be overwhelming. However, as substance abuse counsellor Carole Bennett writes, “If your loved one is starting to hang out with the old gang and visiting sites where his/her addiction was in full bloom, no matter how hard they try, eventually it is more likely than not that they will succumb to their old ways.” Even with the best of intentions, reconnecting with old friends can make your loved one highly vulnerable to relapse.
While some signs are subtle and require close analysis of your loved one’s thoughts and behaviors, there are some signs of relapse that are unmistakable. These include:
- Alcohol or medication missing from the house
- Finding drug paraphernalia or alcohol bottles
- Money missing from your bank account or wallet
- Overt signs of intoxication
Unfortunately, the impulse to deny your loved one’s relapse can be so strong that you gloss over even these explicit signs and find inventive ways of explaining them away. However, it is vital to take these indicators seriously and not brush them under the rug.
Why Catching Relapse Early Matters
Knowing how to tell if an addict has relapsed or is at risk of relapsing is an important way you can support them through their recovery process. Relapses are exceedingly common, and catching them as early as possible helps your loved one stay on the path to healing. As Tim writes in a moving series published in The Guardian:
Addiction has a way of making these REALLY compelling arguments toward self-destruction and isolation. Even in the face of so much evidence to the contrary, addiction will convince you that you don’t deserve to live a good life. Then, once you’ve relapsed, and are in this shame spiral and you’re creating more damage and living more lies … it becomes harder to ask for help again. The life you once had in recovery seems like someone else’s life.
In a few words, Tim hits at the heart of why early assessment of relapse risk and early relapse intervention matters—it interrupts that cycle of self-destruction and can drastically limit the damage done.
If your tendency is toward hypervigilance, on the other hand, knowing the signs of relapse can help you reality-check your worries and evaluate whether you have cause for concern. After all, constant, unfounded accusations of relapse can damage your relationship and cause your loved one to close themselves off to you. As such, it is imperative to separate your fears from the facts.
What to Do if Your Loved One Relapses
If you think our loved one truly has relapsed, don’t panic. It can be easy to see relapse as a failure, to lose faith in the treatment process and turn to catastrophic thinking. But in reality, relapse is often a part of the recovery process; research suggests that 70-90% of people who try to get sober “experience at least one mild to moderate slip.” A relapse doesn’t mean that treatment has failed or that recovery is not achievable, it means that recovery is not complete. The reasons for this lack of completeness of recovery can vary from person to person and may include:
- Skills learned in treatment were not fully integrated
- Duration of treatment was too short
- The environment was not conducive to healing
- The continuing care plan was inadequate
- A co-occurring mental health disorder remains untreated
Relapse is an opportunity to identify the areas of recovery that must be strengthened to support ongoing sobriety and modulate the recovery plan to attend to unmet needs.
It is vital to keep the lines of communication open and to talk with your loved one about your concerns without judgment or fatalism. Encourage them to seek help in a treatment residential environment that will tailor their care to their unique situation and give them the insight and skills needed to make lasting changes. This includes a thorough psychological assessment to ensure all of their needs are identified, intensive individual and group therapies designed to nurture personal growth, dedicated family programming to support your entire family in the project of healing, and a thoughtfully implemented continuing care plan to preserve the gains made in treatment. Also consider the duration of care; if your loved one has already been to treatment and has relapsed, it is likely that a longer stay is needed in order to allow for true integration of coping skills.
Matching your loved one with a program that is right for them is instrumental in creating transformative treatment experiences that will continue to buoy them as they learn to successfully manage their addiction as a chronic illness. With the right care, they harness their inner resources to create a new, more purposeful life free from the bonds of addiction.
Bridges to Recovery offers comprehensive treatment for people struggling with drug and alcohol addiction as well as co-occurring mental health disorders and process addictions. Contact us to learn more about our renowned Bay Area programs and how we can help you or your loved one start on the path to lasting recovery.
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