Warning Signs of Relapse: Early Recovery and Beyond

warning signs of relapse sign on beach

A variable to be ever cautious about in recovery is complacency!


In my most recent article, Understanding Relapse – A Family Guide, we reviewed some of the realities of addiction relapse. We also looked at individual recovery plans designed to provide support and accountability towards family recovery.  Now we will look at the bigger picture of relapse in addictive disease and the warning signs in early and later recovery.


The “Right Conditions” for Relapse

In the early 2000’s, Dennis, Foss and Scott, studied close to 1,200 people recovering from a substance use disorder (SUD). They found that approximately two thirds of the test group relapsed within their first year following treatment.  A solid sober year after treatment, the percent of relapse was reduced by about half.  And after five years of sobriety, less than 15 percent of those folks relapsed.


There are some “right conditions” for relapse to occur. Consequently, the more we know and understand about relapse, the better off the whole family will survive the possible, impending event.  We know from our last article that  maintaining recovery from addictive disease is a lifelong process. We also know that addiction requires continuous management to maintain recovery.


What’s more, we know that when a family acknowledges the reality of relapse and creates lasting methods of keeping recovery as a priority, they increase their success outcomes. We also acknowledge that life in recovery is full of changes – our lives march on. In fact, the family recovery process requires change as the family adapts with time. We know that relapses are not magical events. There are multiple warning signs along way. This is a fortunate fact, as we have opportunities to intervene and perhaps avoid the possible event.  We need to keep our eyes open and remain alert to the early signs of addiction relapse.


warning signs of relapse

It requires continuous management to maintain recovery.


Warning Signs of Relapse in Early Recovery

Very early recovery, by its existence, is a “right condition” for relapse. Things that fuel the “right conditions” in early recovery are:

A healing brain

Strong symptoms of Post-Acute Withdrawal Syndrome (PAWS)

Euphoric recall may still be present

Coping skills are new and unpolished

High levels of stress are present in emotionally charged areas

Stress also exists from facing consequences of previous substance use in multiple areas of life


Warning signs:  rapid mood changes, impulsivity, stopping or reducing prescribed discharge planning or relapse prevention plans, isolation, avoidance, expressions of old addiction defenses.


Warning Signs of Relapse in Later Recovery

“Right Conditions” in later recovery tend to be regular life events that come together with changes in attitudes and beliefs.

Positive life events – new relationships, promotions, new home, children’s major accomplishments

Negative life events – change in health status, loss of a loved one, ending a relationship

Accomplishing goals and milestones in life, such as retirement


Time spent with old faces and old places

Unexpected exposure to substance of choice

Major life changing events


Warning signs: isolation, deception, verbalized attitude and belief changes, lack of follow-through with previous sobriety maintaining activities, stop engaging in what has worked in the past, down mood, agitation.


warning signs of relapse sidewalk warning sign

When you lose the feeling of gratitude, it’s a warning sign in any stage of recovery.


Beware Complacency!

A variable to be ever cautious about in recovery is complacency. This includes your loved one and yourself! Do not think you have done all there is to do with respect to SUD recovery. When you lose the feeling of gratitude, no longer believe support groups or meetings are needed, or are no longer concerned with the opinions or beliefs of others, this is a warning sign in any stage of recovery.


In our last article there was list of 11 steps a family can take to bring attention to the warning signs in your loved one. Now we will take this a little further. When you see what you consider to be warning signs in your loved one, check yourself. Ask the following questions:


  1. Am I feeling more anxious and preoccupied?
  2. Do I share these feelings with my loved one or my support system?
  3. Am I making excuses to not follow my selfcare plans?
  4. How am I following up with all the elements of my recovery plan?
  5. Am I feeling resentment and engaging in former defensive behaviors?


If you recognize you are engaging in former defensive/reactive behaviors and not following your recovery plan, there is trouble brewing. The trouble is happening in you and likely your loved one, as well. It is time for action! Return to your recovery plan, start a dialogue with your loved one and increase contacts with your support system.


In our next article we’ll discuss the specific strategy of engaging in family recovery meetings. These meetings can be a positive, constructive support for continued family recovery from addictive disease.



Caroline (Carli) Parmelee-Noffsinger has 20 years clinical experience including: primary therapist and case manager for residential, IOP and outpatient therapy. Carli’s primary role at Sanford House is facilitating the Family Program. She is currently updating and revising the program design and content and hopes to improve upon an already successful approach to family intervention. In her free time, Carli spends time with her horse. She has been a horse lover and owner for most of her life and has facilitated equine therapy sessions. She says, “The back of a horse is good for the inside of a person.” You can reach Carli with questions about The Sanford House Family Program at cnoffsinger@sanfordhouse.com