EXPLAINER
A relapse isn't the end of the world, experts say. Here's why, and what you can do to pick yourself up
By Matthew Rozsa
Staff Writer
Published February 8, 2023 7:30AM (EST)
Young caucasian female addict preparing heroin dose.(Getty Images/urbazon)
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Many recovering drug addicts (myself included) have a recurring nightmare: You wake up one morning and suddenly all of the work you have put into staying sober is gone. Maybe you're returning to prescription medications; perhaps it is fentanyl, or an addiction as ancient as alcoholism. Regardless, the underlying fear expressed in that bad dream is that one day a person who has remained sober will again start abusing drugs. If that happens, does that mean you should give up hope about remaining in recovery?
Experts agree: Absolutely not. Indeed, a "lapse" may not even mean that you have "relapsed."
"If a person is abstaining from alcohol, and they're choosing to abstain, and they have an episode where they drink some amount, that's usually considered a 'lapse.'"
"We tend to think about lapses and then relapses," explained Dr. Kenneth E. Leonard, the director of the University of Buffalo's Clinical and Research Institute on Addictions. As Leonard noted to Salon, there is a crucial difference between lapsing and relapsing. A person can engage in addictive behavior on one occasion and, if they make sure it never happens again, avoid serious long-term damage.
"If a person is abstaining from alcohol, and they're choosing to abstain, and they have an episode where they drink some amount, that's usually considered a 'lapse,'" Leonard told Salon. "Then the key is preventing that from turning into a 'relapse,' which is where they return to their previous levels of excessive drinking. You can apply that same kind of concept to other substances as well."
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Distinguishing between "lapses" and "relapses" matters, according to Leonard, because it puts the phenomenon of breaking sobriety into a healthier context. While lapsing should never be taken lightly, it is common, and therefore a recovering addict should not feel ashamed. Most recovering addicts will lapse at one point or another. If they emotionally batter themselves over "failing" and decide to give up altogether, they will have made a terrible mistake — and will have held themselves to an unrealistically high standard.
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"My advice would be to try again!" Leonard said when asked about a hypothetical lapsing addict. "Most people who achieve stable recovery have some number of lapses. They make a number of serious attempts, and we know that some for some people that can be two or three, but it could be as many as five or six or ten. People who get back into a recovery mode can go on to achieve, valuable outcomes in their lives."
"If a person is abstaining from alcohol, and they're choosing to abstain, and they have an episode where they drink some amount, that's usually considered a 'lapse.' Then the key is preventing that from turning into a 'relapse,' which is where they return to their previous levels of excessive drinking.
Yet why does the lapse happen in the first place? As it turns out, there are complex neurochemical reasons underlying why addicts may return to their substance of choice.
"One thing is clear: Addictions set up long-term changes in the brain that promote drug-seeking behavior," explainsDr. Steve Maren, who studies how highly valence memories (whether for aversive stimuli or drugs) are suppressed, and how individuals relapse, at Texas A & M. "There areimportant psychological variables that interact with those brain changes. The context in which drugs are taken, and the stimuli-associated with drug taking, are key variables in the maintenance of drug use and abuse."
When an addict decides to abstain from drug-seeking and drug-use, the changes circuits in their brain that supported the addictive behavior are reactivated. This is particularly true when a recovering addict is an environment which reminds them of why they became addicted.
"The reactivation of those circuits are essentially reminders of drug-taking and that experience," Maren explained. "And so I think that's one of the major factors that can drive relapse, the sort of memories that are associated with drug-taking and that caused the drug seeking behavior to kind of reappear after it's been silent for some period of time."
Harvard University physician and addiction specialist Dr. Peter Grinspoon writesthat one should view a lapse as the final step in a larger breakdown of the recovery process. If a recovering addict has fulfilling relationships and overall is satisfied with their current life, it is far less likely that they will slip back into addictive behavior. Lapsing and relapsing addicts behave as they do because there has been a larger deterioration in their life. The decision to abuse a substance is simply the final step before they hit the bottom.
"It is often said that when a person relapses, the act of taking the drug or the drink is the final manifestation of the breakdown in their recovery process," Grinspoon explains. "That is, people lose sight of — and stop practicing — the positive ways of being and interacting that have supplanted their drug use. The drug or the drink is left to fill the vacuum, and to erase the pain."
While there is no quick and easy way to snap out of a spiral that might lead to lapses, there are some techniques that can be helpful. First and foremost, see if your HALT needs are being met — that is, are you hungry, angry, lonely or tired? If there are problems in those areas of your life, try to fix those immediate physical and emotional health concerns, as addressing them early can nip a potential lapse in the bud. It also helps to exercise, as physical fitness releases endorphins in the brain, which help you feel good. There is also nothing wrong with distracting yourself with sedentary and harmless escapism like watching TV, reading a book or playing a video game. Finally you should never feel like a burden for reaching out to your support network. Recovering addicts are there for each other.
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By Matthew Rozsa
Matthew Rozsa is a professional writer whose work has appeared in multiple national media outlets since 2012 and exclusively at Salon since 2016. His diverse interests are reflected in his interview, including: President Jimmy Carter (1977-1981), Israeli Prime Minister Ehud Barak (1999-2001), animal scientist and autism activist Temple Grandin, inventor Ernő Rubik, comedian Bill Burr ("F Is for Family"), novelist James Patterson ("The President's Daughter"), epidemiologist Monica Gandhi, theoretical cosmologist Janna Levin, voice actor Rob Paulsen ("Animaniacs"), mRNA vaccine pioneer Katalin Karikó, philosopher of science Vinciane Despret, actor George Takei ("Star Trek"), climatologist Michael E. Mann, Washington Gov. Jay Inslee (2013-present), dog cognition researcher Alexandra Horowitz, Libertarian presidential candidate Gary Johnson (2012, 2016), comedian and writer Larry Charles ("Seinfeld"), Democratic vice presidential nominee Joe Lieberman (2000), Ambassador Michael McFaul (2012-2014), economist Richard Wolff, director Kevin Greutert ("Saw VI"), model Liskula Cohen, actor Rodger Bumpass ("SpongeBob Squarepants"), Senator John Hickenlooper (2021-present), Senator Martin Heinrich (2013-present), Egyptologist Richard Parkinson, Rep. Eric Swalwell (2013-present), media entrepreneur Dan Abrams, actor R. J. Mitte ("Breaking Bad"), theoretical physicist Avi Loeb, biologist and genomics entrepreneur William Haseltine, comedian David Cross ("Scary Movie 2"), linguistics consultant Paul Frommer ("Avatar"), Maryland Gov. Martin O'Malley (2007-2015), computer engineer and Internet co-inventor Leonard Kleinrock and right-wing insurrectionist Roger Stone.
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Related Topics ------------------------------------------
AddictionAlcoholismExplainerHealthMental HealthRecoveryRelapses
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FAQs
What does lapse mean in addiction? ›
A lapse refers to a short return to alcohol or other drug use, or gambling. It is a one-time (or temporary) step back on a recovery journey. For example: June has been abstinent from alcohol for three weeks.
Is a lapse more severe than a relapse? ›Literature on substance abuse treatment distinguishes lapse and relapse. Lapse is defined as a temporally restricted and isolated pattern of drug use, whereas relapse is defined as a more severe and prolonged pattern of drug use.
Which of the following is the best definition of a relapse? ›A relapse happens when a person stops maintaining their goal of reducing or avoiding use of alcohol or other drugs and returns to their previous levels of use. This is different to a lapse, which is a temporary departure from a person's alcohol and other drug goals followed by a return to their original goals.
What is the primary distinction between a slip and a relapse? ›A slip is a single unplanned use of alcohol or drugs. Relapse happens when a recovery plan is completely abandoned.
Is lapse another name for relapse? ›In a relapse, a person has returned to addiction. This is not the same as a lapse, though many may think it is. A lapse, by definition, is a temporary failure of concentration, memory, or judgment. The key word in the definition of a lapse is temporary.
What is an example of a lapse? ›After a few polite words the conversation lapsed. Her interest in politics lapsed while she was in medical school. She didn't pay the premium and her life insurance policy lapsed. He forgot to renew his driver's license, so it lapsed.
What is the difference between lapse and relapse depression? ›A lapse is a brief return to old and unhelpful habits. It is a common and normal phenomenon. Sometimes lapses are triggered by stress and low mood, or simply fatigue. A relapse is a complete return to all of your old ways of thinking and behaving when you are anxious.
What is lapse and relapse in mental health? ›While a lapse is short-lived, a relapse entails the loss of recovery gains already made, which means the person falls back into using the unwanted substance or engaging in the undesired behavior.
What is the difference between relapse and recurrence addiction? ›Consensus posits that relapse occurs during the continuing phase of treatment after remission while recurrence occurs during the maintenance phase of treatment after recovery (i.e., sustained remission of period of time).
What are the three phases of relapse? ›There are three stages of relapse: emotional, mental, and physical. Understanding these different stages can help individuals recognize the warning signs that their abstinence is in danger of faltering.
What does the big book say about relapse? ›
writes, “For if an alcoholic failed to perfect and enlarge his spiritual life through work and self-sacrifice for others, he could not survive the certain trials and low spots ahead. If he did not work, he would surely drink again, and if he drank, he would surely die. Then faith would be dead indeed.
What is the full meaning of relapse? ›verb [ I ] us. /rɪˈlæps/ to return to a previous bad condition or a worse way of life after making an improvement: She briefly relapsed twice after being released from the hospital.
What is the 1st step in keeping a lapse from becoming a relapse? ›Step 1: The first step in dealing with lapses is to recognize that 99.9% of all people trying to lose weight and be active experience lapses. Lapses can and should be useful learning experiences. Step 2: The second step is to resist the tendency to think negative thoughts.
What are the 5 determinants of relapse? ›- Motivation.
- Mental Strength.
- Family & Relationships.
- Anxiety & Depression.
(REE-laps) The return of a disease or the signs and symptoms of a disease after a period of improvement. Relapse also refers to returning to the use of an addictive substance or behavior, such as cigarette smoking.
What is the new term for relapse? ›Instead of “relapse,” use “recurrence of a substance use disorder.” Instead of “one-time” or “short-term period of use,” use “episode.” Instead of saying someone relapsed after a treatment program, simply say that they resumed using or experienced a recurrence.
What word is similar to lapse? ›Some common synonyms of lapse are blunder, error, mistake, and slip. While all these words mean "a departure from what is true, right, or proper," lapse stresses forgetfulness, weakness, or inattention as a cause.
What are two synonyms for lapse? ›- blunder.
- breach.
- crime.
- error.
- failing.
- failure.
- fault.
- indiscretion.
A Bill that originates in the Lok Sabha and remains pending in the Lower House itself is considered lapsed with the dissolution of the House. A Bill that originates and is passed by the Rajya Sabha, but is pending in the Lok Sabha also lapses with the dissolution of the Lower House.
What does process lapse mean? ›A lapse occurs when the benefits and rights stated in a contract no longer remain active due to the contract holder failing to honor requirements and conditions set forth by a contract or agreement. A lapse can occur, for instance, due to inaction, the passage of time, or failure to pay what is due.
How long is a lapse? ›
A lapse can be as short as one day — if there's any period you're without car insurance, that counts as a lapse. However, some insurers may not penalize you for a short lapse of under two weeks.
What are the different types of relapses? ›- Emotional relapse.
- Mental relapse.
- Physical relapse.
Recognize Your Progress
The fact is that a relapse doesn't delete your progress. If you've gone through addiction treatment, you still have the knowledge and tools to help you deal with triggers, cravings, and risky situations.
The relapse prevention model relies on the idea that relapse is a gradual process that begins before a lapse and ends after the individual returns to using substances. Understanding this helps you recognize the stages of relapse so that you can intervene as early as possible, when treatment is most effective.
How does the relapse process occur? ›Relapse begins in the mind; and it begins much earlier than when we actually take drugs again. 'Relapse patterns' are formed by our attitudes and thought processes. In other words, we begin to 'slip' at the thought level. A common mistaken belief is that relapse occurs suddenly and spontaneously without warning signs.
What are the two principles of the relapse prevention model? ›Principles of relapse prevention include identifying high-risk situations for relapse (e.g., drug/alcohol use during sex) and developing appropriate solutions (e.g., abstaining or moderating drug/alcohol use during sex).
How do you know if you're having a relapse? ›The individual usually starts to experience negative emotional responses, such as anger, moodiness and anxious feelings. They also may begin to experience erratic eating and sleeping habits, and their desire for recovery often wanes due to a lack of using their support systems.
What is lapse status? ›A lapse occurs when the benefits and rights stated in a contract no longer remain active due to the contract holder failing to honor requirements and conditions set forth by a contract or agreement. A lapse can occur, for instance, due to inaction, the passage of time, or failure to pay what is due.
What is lapse period? ›Definition: The policy for which all benefits to the policy holder cease and is terminated due to non payment of premium amount on the due date or even after the grace period is called a lapsed policy. Description: Excessive delay in payments and servicing of the policy leads to the policy being dead or lapsed.
What is process lapse? ›The rate of decrease of the temperature of an air parcel as it is lifted, -dT/dz, or occasionally dT/dp, where p is pressure. The concept may be applied to other atmospheric variables, for example, the process lapse rate of density.