What to do after a relapse
If you used again after a stretch of recovery, make sure you are safe first, then tell one person and call your treatment provider today. A relapse is a reason to resume, adjust or change treatment. It does not mean treatment failed.
Reviewed against public records, October 2026: NIDA, SAMHSA, FDA and peer-reviewed research. General information, not medical advice.
Overdose risk
Is a relapse after time sober more dangerous?
Yes. After time without using, your body is no longer used to the old amount, so using what you used before can cause an overdose. NIDA warns that for some drugs a relapse can be deadly.
Source: NIDA, Treatment and Recovery.
Call 911Call 911 right away if someone:
- Has a face that is extremely pale or feels clammy
- Goes limp
- Has purple or blue lips or fingernails
- Is vomiting or making gurgling noises
- Can’t be woken up or can’t speak
- Is breathing slowly, or their breathing or heartbeat stops
Signs: SAMHSA, Opioid Overdose Prevention and Reversal.
Naloxone rapidly reverses an opioid overdose, and the FDA approved a naloxone nasal spray for sale without a prescription in 2023. Give it if you have it, and still call 911: it wears off while opioids can stay in the body. Sources: NIDA, Naloxone DrugFacts; FDA.
What should you do in the first 24 hours after a relapse?
Do these five things, in this order.
Get safe.
Stop using, and know the overdose signs above. If opioids were involved, keep naloxone nearby and tell someone where it is.
NIDA; SAMHSA
Tell one person today.
A sponsor, counselor, house manager, family member or SAMHSA’s National Helpline. Being completely honest and asking for help are two of the five rules of recovery.
Melemis, 2015
Call your treatment provider or doctor.
Ask whether to resume your treatment, change it, or try another kind.
NIDA
Go back to your supports.
Your next meeting, group or session, today or tomorrow. Joining a self-help group significantly raises the chances of long-term recovery. Looking for one? See SMART Recovery meetings in NJ.
Melemis, 2015
Write down what led up to it.
Where you were, who you were with, how you were sleeping and feeling. Most physical relapses happen when an opportunity opens, so the details show what to change.
Melemis, 2015
Was it a lapse or a relapse?
A lapse is the first drink or drug use; a relapse is a return to uncontrolled use. One can quickly lead to the other.
Melemis, 2015
- Lapse
- One drink or one use. Don’t judge it by how much you used: even one use can quickly lead back to uncontrolled using.
- Relapse
- Using the way you used before. It usually starts weeks or months earlier, in the emotional and mental stages below.
Relapse usually builds in three stages:
Emotional relapse
Bottling up emotions, isolating, skipping meetings or sitting through them without sharing, eating and sleeping poorly. The common thread is poor self-care.
Mental relapse
Cravings, thinking about people and places tied to past use, playing down past consequences, bargaining, lying, planning a relapse.
Physical relapse
Starting to use again. Spotting the earlier stages gives the best chance of stopping it here.
How should your recovery plan change after a relapse?
A relapse means the plan needs to change, not that it failed. NIDA compares it to high blood pressure or asthma, where symptoms coming back means treatment is resumed or adjusted.
NIDA
Ask your provider whether to restart, add sessions or move to a more intensive level of care. That decision comes from a clinical assessment with your provider, not from a housing program. NIDA
Return to AA, NA or SMART Recovery. A self-help group reduces isolation, guilt and shame, and recovery works best when a group is combined with a treatment program. Melemis, 2015
A substance-free house with rules, such as a sober living home or recovery residence, makes it easier not to use. NJ Sober Living’s homes in Bergen County suit people with previous relapses who need accountability: a live-in operator and an operator on site overnight, plus house management and behavioral health technicians, with a curfew, periodic drug testing and rides to evening treatment. How sober living works here.
- Change your life, so that not using is easier.
- Be completely honest.
- Ask for help.
- Practice self-care.
- Don’t bend the rules.
Melemis, 2015
At a glance
Relapse, in four facts
- Like asthmaRelapse rates for drug use are similar to those for high blood pressure and asthma (NIDA).
- 3 stagesEmotional, then mental, then physical relapse (Melemis, 2015).
- 5 rulesChange your life, be completely honest, ask for help, practice self-care, don’t bend the rules (Melemis, 2015).
- 24/7SAMHSA’s National Helpline, 1-800-662-4357: free, confidential treatment referrals.
Sources: NIDA; Melemis, 2015; SAMHSA.
See NJ Sober Living’s Closter home.
What can family members do after a loved one relapses?
Make safety the first conversation, keep naloxone nearby if opioids are involved, and get support for yourself.
NIDA; SAMHSA
Check for safety first
Know the overdose signs. If you see any of them, call 911 before anything else.
SAMHSA
Keep naloxone nearby
Ask your loved one to carry it, and tell friends where it is kept.
NIDA
Point toward treatment
A relapse is a reason to resume or adjust treatment. SAMHSA’s National Helpline at 1-800-662-4357 also helps family members find care.
NIDA; SAMHSA
Get support for yourself
Your own support matters too. Read what Al-Anon is or our guide for families.
Questions people ask after a relapse
Yes. NIDA reports that relapse rates for drug use are similar to rates for other chronic medical illnesses, such as high blood pressure and asthma. A relapse is a common part of recovery, not proof that recovery is impossible. NIDA
Not necessarily. NIDA says a relapse means you should speak with your doctor to resume treatment, modify it, or try another treatment. Your provider decides with you which of those fits. NIDA
A free, confidential line at 1-800-662-4357 (1-800-662-HELP), TTY 1-800-487-4889, open 24 hours a day, 365 days a year, in English and Spanish. It serves individuals and family members facing mental and substance use disorders and refers callers to local treatment, support groups and community organizations. It does not provide counseling. SAMHSA
Yes. On March 29, 2023, the FDA approved Narcan 4 mg naloxone nasal spray for use without a prescription. NIDA notes that community programs and health departments may also give naloxone out free. Naloxone works only on opioids, and you should still call 911 after giving it. FDA; NIDA
All four NJ Sober Living recovery homes run on the same written house rules, gone through with you before move-in. Using alcohol or drugs is a serious violation that can lead to discharge from the house, which does not automatically end outpatient treatment. Tell staff if it happens.
If you are ready to change where you live, NJ Sober Living has four recovery homes in Bergen County, each Class F licensed by NJ DCA, with rides to evening treatment.
In a crisis, call or text 988. For a possible overdose, call 911.
Sources
- National Institute on Drug Abuse, “Treatment and Recovery,” Drugs, Brains, and Behavior: The Science of Addiction. nida.nih.gov
- National Institute on Drug Abuse, Naloxone DrugFacts. nida.nih.gov
- SAMHSA, Opioid Overdose Prevention and Reversal. samhsa.gov
- SAMHSA, National Helpline, 1-800-662-HELP (4357), TTY 1-800-487-4889. samhsa.gov
- 988 Suicide & Crisis Lifeline. 988lifeline.org
- U.S. Food and Drug Administration, “FDA Approves First Over-the-Counter Naloxone Nasal Spray,” March 29, 2023. fda.gov
- Melemis, S. M. (2015). Relapse Prevention and the Five Rules of Recovery. Yale Journal of Biology and Medicine, 88(3), 325–332. PMC4553654