Introduction

Recovery is a lifelong process, one that often involves changes across multiple domains of a person’s daily life, such as physical, behavioral, inter- and intra-personal, psychological, financial, and sociocultural spheres.¹ Specific areas of change often include increasing self-awareness, self-care, and life balance; developing a sense of purpose; adequate nutrition, exercise, and sleep; developing healthy relationships with others and self; creating a recovery support network; improving coping and communication skills; addressing existing physical or mental health issues; learning how to manage cravings; and learning relapse prevention skills. All of these changes are crucial for successful maintenance of recovery.

Each person’s progression into and maintenance of recovery is unique. Therefore, it is important for individuals to develop and cultivate self-awareness of their individual relapse risk factors, so they can make changes to promote successful recovery maintenance of recovery. If a patient is ambivalent about change, brief interventions, such as Motivational Interviewing (MI) or others, can be used to help increase motivation to change.^2,3

The process of recovery (and relapse) is often influenced by relapse risk factors, such as: ¹

• Severity and consequences of addiction
• Co-occurring mental or medical conditions
• Motivation and coping skills
• Presence and quality of the individual’s support system

It is important for clinicians to be aware of the complexities of substance use disorders (SUDs) and recovery, so that they can provide optimal support for the patient’s progress and maintenance of recovery.

What Is Relapse?

Relapse is both an event and a process.¹ A lapse is the initial use of a substance or re-engagement in an unhealthy behavior (e.g., gambling) after a period of recovery; a relapse is continued use/behavior after the initial lapse.¹ The relapse process often begins long before the lapse. It can start with letting go of some of the changes the individual has made in the process of recovery and reverting back to old patterns of thinking and behaviors that pave the way for a lapse or relapse to occur. Common early warning signs of relapse can include the following⁴:

• Thinking about future use/behaviors, minimizing consequences of use, or fantasizing about past use/behaviors
• Starting to re-associate with people and places linked to past substance use;