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After Alcohol Rehab: 7 Relapse Indicators Plus Triggers to Watch For

by Cedric Dent

June 25, 2022
A young man in recovery after alcohol rehab, struggling with the threat of alcohol relapse.

There are several meaningful indicators that you or someone you know could be on the verge of a relapse after going through alcohol rehab. However, there are also risk factors that can lead to that vulnerability in the first place. It’s important to take stock of both in order to fend off the threat of relapse on multiple levels.  If you see any of the following in yourself or someone you know, call (888) 448-0302.

7 Relapse Indicators  

Beware the following relapse indicators in your behavior or the actions of someone who recently recovered from an alcohol use disorder. Avoid them if you’re trying not to fall off the wagon: 

  • Isolating yourself, especially avoiding the people who are supporting your recovery 
  • No longer taking prescribed medication used to manage your habit 
  • Getting back into drinking-related activities that you only did when you were drinking 
  • Dwelling on memories of your heavy drinking days 
  • Getting back in touch with friends with whom you used to drink or revisiting the places that facilitated your habit 
  • Repressing emotions that need to be expressed 
  • Slacking in your fitness routines, your commitment to healthy foods, your sleeping habits or your hygiene 

Understanding the Indicators 

These signs often appear unexpectedly even within your own behavior. You’re more susceptible to that happening when occupying a negative emotional mindset with relative consistency. Therapists would likely point this out to you as manifesting in the form of anxiety or depression. These are usually lasting frames of mind rather than just fleeting emotions, which is what makes them difficult to endure. This is what can cause that level of vulnerability, and something in your daily routine needs to change for the better to fix that. 

Some personalities find the same vulnerability presented as a result of positive emotional states. If you have something to celebrate whether large or small, you might’ve been the type to drink because you feel good and want to build on that positive momentum. Now that you’re in recovery, that desire won’t go away automatically. You’ll be tasked with resisting certain positive cues to drink because that’s where you’ll encounter your triggers often. 

There’s also a societal stigma to being “addicted” to something. Some people may treat you like a downer for not being able to consume alcohol with them. On the other hand, that may be entirely in your head just because they’re your friends and you feel like you’re letting them down regardless of whether they support your recovery. These are social pressures either way, and they push you toward drinking. 

What’s a Trigger to Relapse

Whether you’ve recently completed recovery treatment or are still in outpatient rehab you must be increasingly aware of your own triggers. The term, “trigger,” is a word with which you’ll become intimately familiar as you endeavor to sustain your recovery. By this point, you’ve likely heard about the hazard of triggers from therapists and, perhaps, others with experiences similar to yours. That’s assuming you’ve been in a treatment facility that provided group and one-on-one therapy. 

Triggers are cues that can lead you to relapse by activating in response to any of a variety of circumstances. What those circumstances are differs from person to person. For instance, being with a group of friends who are drinking is an obvious trigger a lot of people when recovering from alcoholism. On the other hand, there are many people for whom that wouldn’t trigger them to drink. A trigger could even be more nuanced like a drinking-related memory cued an experience similar to it or déjà vu.  

Triggers after Alcohol Rehab

It would be impossible to list all the different possible triggers you might experience. Virtually anything tied to a sense of reward could trigger you to drink. It could also just be the memory of what it’s like to be intoxicated or whatever you liked most about drinking. Many recovering from alcohol or even from other drugs can be triggered by boredom, too. Arguably the most ironic and unavoidable triggers when you first embark down the road of recovery might be the fear of withdrawal. Being alone can easily be a trigger for you, too, even if you don’t think so.  

Isolation is another common trigger for many people in recovery from not only alcohol but other substances, too. The National Institute on Drug Abuse reports studies during the pandemic showing that drug overdoses accelerated since the onset of COVID-19. They cite an estimated 93,000 drug overdose deaths in the U.S. in 2020, the highest number of overdose deaths ever recorded in a year’s time. It represented a 30% uptick from 2019. This is partly attributable to the level of isolation that quarantine culture required. 

Stress As a Sign

How a person handles stress can be a clue to whether they have or may be developing a substance use disorder.  There is a neuroscientifically discernible likelihood that the regular use of drugs or alcohol will become or already is part of an addictive habit for people that poorly handle stress. Six examples of stress indicators would be:

  • Chronic irritability
  • Consistent inability to concentrate
  • Frequently spending money on something unnecessary
  • Lying awake despite fatigue
  • Frequently misplaced anger
  • Denial of being stressed

Cross-reference these indicators with the following five common signs of alcoholism, and you’re likely to make more accurate observations:

  • Drinking more or for a longer period than intended
  • Trying yet failing to cut back on drinking
  • Spending lots of one’s time drunk, sick, or hungover
  • Thoughts about drinking during activities unrelated to drinking
  • Continuing to drink often even though inebriation coincides with depression, anxiety or memory blackouts

What Relapse Means for Recovery after Alcohol Rehab

Even though we want you to avoid relapse at all costs, addictionologists will remind you that addiction is a chronic disease, and relapse can be a normal part of recovery. In other words, it comes with flare-ups, and your job is to figure out how to best manage them. You don’t cure addiction; you treat it. Don’t count an alcohol relapse as a personal failure on your part. It’s very likely that you’ll relapse at some point, but how you handle the relapse is the entire ballgame. What matters more is what you do next. 

If you relapse, don’t hide it. Share the experience with your support system so that you can maintain accountability for your recovery efforts. If you can’t stop using drugs or alcohol call tel:888-448-0302 so that Landmark Recovery can help you figure out what your real needs are. 

Neuroscience of addiction

Today, we see increasing evidence that certain neural pathways allocate incentive salience to rewards. Those same pathways also control people’s excessive desire for alcohol and cue-triggered cravings. They influence not only compulsive drinking but especially relapse. Sensitization of the mesolimbic dopamine pathway, for example, has been correlated with substance abuse in general. It’s also been correlated with anxiety and stress-related pathology, suggesting these things all feed each other cues in the brain that trigger relapse. 

Say you succumbed to alcoholism but were also a smoker during that time. Recovery from only alcoholism might very well make nicotine, for example, a cue that eventually triggers alcohol relapse due to what’s called cross-sensitization. Stress, alcoholism and other compulsive behaviors are all stimuli that enhance your sensitivity and dopaminergic response to one another.

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