When someone you love has relapsed, it can seem like everything suddenly fell apart.

Whether they have completed treatment or have been sober for months or years, a relapse can feel like betrayal. You may have thought that life was about to get back to normal and then this happens. You discover that they have been drinking again, started using drugs, disappeared for hours, or shown other signs that their addiction has returned.

The first reaction is often fear.

Soon after comes anger, disappointment, confusion, and sometimes even guilt. You may ask yourself:

What am I supposed to do now?

Relapse doesn’t mean that treatment has failed or their recovery is over. With addiction being a chronic condition, you need to understand that setbacks can occur. It does not wipe out their progress, and it can be part of many people’s recovery.

A quick response can sometimes prevent a relapse from becoming a full-blown return to active addiction.

First: Determine how serious the situation is.

Before figuring out what treatment your loved one needs, you need to determine what is happening right now.

Ask yourself:

• Are they currently using, intoxicated, or high?
• Are they using benzodiazepines, opioids, fentanyl, or alcohol?
• Are they driving while impaired?
• Are they talking about suicide or hurting themselves?
• Are they unconscious or hard to wake up, or having trouble breathing?
• Have they been using continuously for several days at a time?
• Are there children or other vulnerable people in danger?
• Do they seem like they are experiencing severe withdrawal?
• Have they stopped taking their recovery medications?

If you think that they are in an immediate medical or safety emergency, seek help from emergency medical assistance rather than trying to manage the situation yourself. Before worrying about finding the right rehab, determine whether your loved one is in immediate danger.

If there is no emergency, the next step should be getting the professional help they need as quickly as possible.

DO not wait until they want to get help.

One of the biggest mistakes we see is that when people relapse, the family waits to see if it is going to get bad again. Families may hear:

• I’ll stop tomorrow
• It was only one time.
• Don’t worry, I can handle it.
• I don’t need rehab again.

When someone relapses, their recovery is not over; it has been interrupted. Sometimes addiction can make a brief return to substance use and can be handled with recovery support services. Other times, what in the beginning looked like a 1-time lapse quickly becomes days or weeks of active addiction.

The important question isn’t as simple as that they promise to stop.

The important question is what level of support or treatment this person needs to safely return to recovery.

Our counselors can help you assess the situation and determine whether the person needs outpatient therapy, residential inpatient treatment, medication-assisted treatment, detox, or other levels of care. SAMHSA notes that, for treatment to be effective, it may need to incorporate medication, counseling, and behavioral therapies, depending on the needs.

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Do not turn a relapse into a family argument

When someone relapses, you may want to confront them immediately. You may want to tell them how much they let down or hurt everyone, remind them of everything they promised, or demand that they enter treatment immediately.

These feelings are understandable.

But arguments rarely produce solutions to immediate problems.

Try to keep the conversation focused on what happens next. You might say, “I’m concerned about what is happening, and I am not here to fight with you. All I want to do is help you and figure out what needs to happen next”

The goal is to try and keep communication open long enough to get the person the appropriate help.

Family support can be a very important protective factor in recovery; family members may recognize warning signs that the person is experiencing that the addict does not recognize themselves.

A relapse could mean that the treatment plan needs to change.

The most common mistake is thinking that the person relapsing needs the exact same treatment they previously received. This is not always the case.

Relapses can, in fact, provide important information about what was missing from the previous recovery plan.

For example, perhaps the person:

• Returned to old social environments.
• Stopped going to recovery meetings.
• Stopped taking their recovery medications.
• Developed depression or anxiety.
• Returned to their stressful work environment.
• Started to associate with people who are still using.
• Underestimated their triggers.
• Left residential rehab too early.
• Never received the appropriate help for an underlying mental health condition.
• Needed more structure in their aftercare plan.
• Experienced a major relationship or financial crisis.

NIAAA notes that relapse can indicate the need for additional recovery support, changes in therapy, education or a more intensive level of treatment. The right response in not necessarily “go back to the same program” It is “lets figure what went wrong and what needs to be different this time”.

When should you consider detox?

Depending on the substance or substances used detox may be appropriate. You first need to find out if this was a one-time thing or if they have been using it heavily or regularly, which may become dangerous for them to detox on their own.

This is very important for many substances, including alcohol and sedative medications, where withdrawal can become medically serious.

Detox, by itself, is just the beginning. Getting the substance out of the system does not address the behavioral, emotional, or social factors that may have contributed to the relapse. If detox is needed, the next question should be:

What happens next after detox?

While in detox, a comprehensive treatment plan should be considered to ensure that the underlying cause of the lapse in judgment is not left unchecked. Residential treatment may be appropriate when someone has relapsed repeatedly, cannot remain sober in their current environment, needs to have a structured environment, or requires more intensive therapeutic support.

When is inpatient treatment worth considering?

Residential treatment may be appropriate when someone has relapsed many times, has trouble staying sober in their current environment, needs a more structured environment, or requires intensive therapeutic support.

If they have been through outpatient therapy and it was not comprehensive enough, it may be worth trying inpatient treatment.

What information should you have before contacting us or a rehab center?

You do not need to have all the answers, but the more information you have, the better we can determine the best course of action.

• What substance is being used?
• How frequently is it being used?
• When did the relapse begin?
• How long were they sober?
• Are there any mental health concerns that need to be addressed?
• What medications have they been taking?
• Does the person have insurance?
• Are they willing to get help?

If you do not have all these answers, not to worry; we can still help.

Will insurance pay for rehab after a relapse?

Possibly.

Insurance plans can differ from company to company and will depend on the insured person’s specific plan, benefits, medical-necessity requirements, provider network, and the treatment program being considered.

Just because you have been to treatment before does not automatically mean that additional treatment cannot be covered.

Addiction No More can help you understand treatment options and consider insurance and program availability as part of the process. Callers can receive help verifying insurance, discuss treatment options, set up an intervention, and find programs based on their treatment preferences.

What if they refuse treatment?

This can be one of the hardest situations for families. You cannot force someone to enter a recovery program, but that does not mean that you can do nothing.

• You can establish boundaries
• You can stop providing money to support the addiction
• You can refuse to cover up for missed work, legal problems, or other consequences that have reared their ugly head because of addiction.
• You can protect children and other family members from unsafe situations.
• You can make it clear that when they want help, you are here when they are ready to accept it.

In some cases, it can be beneficial to have a professional help you and your family through an intervention. Hiring an interventionist can help the individual to understand that their addiction is affecting more than themselves and, in most cases, get their agreement to enter into treatment.