Relapse: what to do after a relapse in addiction

What does relapse mean?

In addiction, relapse means drinking, drug use or another addictive behaviour coming back after a period of stopping. The charity We Are With You separates two ideas. A lapse is when a person first uses alcohol or drugs after not doing so for a while, and a relapse is when someone goes back to drinking or using regularly ^[5]. They describe relapse as a process that starts with a lapse, and point out that a lapse does not necessarily lead to a relapse ^[5].

The difference is a practical one. A single evening of drinking after three months sober can feel like the end of everything, yet with support, encouragement and early action a lapse can stop there ^[5]. What you do in the days that follow counts for a great deal.

Relapse describes a pattern returning. It carries no verdict on your character. I have my own recovery behind me, and I remember how loudly shame insists that everything is ruined. Drinkaware's guest writer, a nurse who lapsed after years of sobriety, makes the point that if you cannot forgive yourself, another lapse becomes more likely ^[8]. Honesty and some kindness towards yourself are a better place to start from.

What should I do straight after a relapse?

If you are reading this the morning after, or partway through a run of using, deal with safety first and leave the bigger questions for later.

Start with your body. If you have become dependent on alcohol again, please do not try to stop today on willpower alone. The NHS warns that a sudden stop carries real danger for anyone who is dependent on alcohol, and that withdrawal symptoms mean you should see a doctor or nurse before stopping ^[1]. Stopping benzodiazepines or GHB suddenly can also be dangerous and needs medical advice. Call 999 or go to A&E for any of the severe withdrawal signs the NHS lists: shaking you can see, being unusually restless or irritable, being confused enough to lose track of the date, hallucinations, or a seizure ^[1].

Next, tell one person. Whether you tell anyone is your decision ^[4]. If you already see a drug or alcohol service, telling your recovery worker helps them support you better, and they are trained to understand that treatment is a process ^[4]. If you have never been in touch with a service, We Are With You suggests that now could be a good time to speak to one ^[4].

If you might be physically dependent again, get medical advice before stopping, and do not drive.
Tell one person you trust, or your keyworker, sponsor or GP.
Clear out what you can from your home for the next few days, without punishing yourself for having it there.
Eat something, have some water and rest if you can, since hunger and tiredness make cravings harder to manage ^[8].
Jot down briefly what happened in the days before. You will use it later.

Is it safe to stop again on my own?

That depends on what you were using and how much. This is the part of relapse I worry about most, because shame can hide a real physical risk.

With alcohol, going back to daily drinking can mean your body is dependent again. Anxiety, difficulty sleeping, feeling or being sick, a racing heartbeat, sweating and shaking when you cut down are withdrawal symptoms, and the NHS describes them as a sign that your body is dependent on alcohol ^[1]. According to the NHS, these symptoms start 6 to 12 hours after the last drink ^[1]. Please talk to your GP, or to an alcohol support service, before you stop, so that withdrawal can be managed with medical help. My article on alcohol withdrawal symptoms goes into more detail.

Heroin carries a different danger. FRANK explains that if someone who has been taking heroin regularly stops for just a few days, their tolerance drops rapidly, and simply taking the dose they took before risks an overdose ^[7]. If you have already used again, or think you might tonight, please do not use alone. Start with a very small amount, and know that even a small amount can kill if the drug contains nitazenes, the synthetic opioids that FRANK warns are killing people across the UK ^[11]. Mixing heroin with alcohol, benzodiazepines or methadone is extremely dangerous ^[7]. Keep naloxone, the antidote to an opioid overdose, with you: FRANK says you should be able to get it free, and your local drug treatment service can tell you where ^[10]. If someone cannot be woken, or their breathing is very slow or has stopped, call 999 straight away, use naloxone if you have it, and stay with them until help arrives ^[9]. Never leave someone to sleep it off on their own ^[11].

Whatever has happened, contact your local drug service today. Staff there will help reduce the risks of your drug use ^[2], and We Are With You says its services can help whether this is your first lapse or the most recent ^[4].

If your relapse is with gambling, the National Gambling Helpline on 0808 8020 133 is free to call, and my article on gambling addiction sets out the routes to help.

Why does relapse happen?

A relapse can seem to come from nowhere, though looking back there are usually signs. We Are With You notes that some people say a relapse happens weeks or even months before they actually drink or use again, through small changes in mood, thinking or behaviour that get ignored or dismissed ^[6].

Those changes are often ordinary ones, like a routine falling away or stress at work that nobody hears about. Having too much time on your hands can raise the risk of drinking or using again ^[6]. Triggers can include people, objects, moods and feelings, places, and times of the day or week ^[5].

Memory plays its part too. Once you have stopped for a while, it is easy to remember only the good nights. Drinkaware's guest writer calls this euphoric recall, and suggests catching it each time it happens and playing the tape forward to the end of the night ^[8]. I remember this well from my own drinking, and it still helps me to say out loud what the later drinks actually led to.

Complacency is quieter. After a long stretch sober it is easy to stop doing what kept you well and simply count the days. The same writer describes being proud of the number of days while she was no longer working at her sobriety ^[8]. Counting days is worth doing, as long as the daily habits that protect them carry on alongside.

Does a relapse mean treatment has failed?

No. We Are With You says a relapse does not mean a person has failed or that their treatment has not worked, and that most people who stop drinking or using drugs for good have lapses or relapses along the way ^[5].

You are also not back to square one ^[6]. Your health, relationships or finances may have taken a knock, and that matters. You still know what helped before and who picked up the phone when you called.

Shame can keep a lapse going. I know the pattern from the inside: one drink turns into I have blown it, and that turns into I might as well carry on. Treating the relapse as something to learn from interrupts that chain, uncomfortable as it is to look at.

If the shame tips into thoughts of not wanting to be here, please speak to someone tonight. The Samaritans are free on 116 123, and if you are in immediate danger, call 999.

How can I learn from a relapse?

When you are safe and have some support around you, sit down with a pen. We Are With You suggests thinking through three things, and I use them in much the same form ^[6]:

What was working well before the relapse?
What happened, over days or weeks, that led up to it?
What would you do differently if the same situation came round again?

How do I make a relapse prevention plan?

Expect cravings to be strong for a while. Drinkaware's guest writer warns that cravings after a lapse may be more intense than before it, and recommends a written lapse and relapse prevention plan that includes ideas for managing your triggers ^[8]. She also suggests asking yourself whether your thinking had started to change, and what stress you were under at the time ^[8]. A cravings diary helps you spot patterns: note the time, the place, who you were with, how you felt and what happened next ^[6].

For the craving itself, she suggests HALT, which means checking whether you are hungry, anxious or angry, lonely or tired, and dealing with that first ^[8]. For more ways to ride out an urge, see three strategies for cravings and urges, and for the wider pattern that leads up to using, the cycle of addiction.

Write down who you will call, and when. The NHS names Alcoholics Anonymous and SMART Recovery among the peer support groups where you can get support from other people going through the same thing ^[1], and for drugs it mentions Narcotics Anonymous and SMART Recovery ^[2]. Small, achievable goals, such as joining an online support group every week, are easier to stick to than one big goal ^[6].

What help does the NHS offer to prevent relapse?

For alcohol, NHS treatment can include help to prevent relapses, such as medicines to reduce cravings ^[1]. Acamprosate and naltrexone help reduce alcohol cravings, and disulfiram causes unpleasant effects when combined with alcohol ^[1]. These are usually offered once you have stopped drinking and need help to stay sober ^[1].

NICE, which writes guidance for NHS treatment, says that after a successful withdrawal, people with moderate or severe alcohol dependence can be considered for acamprosate or oral naltrexone, combined with an individual psychological intervention focused on alcohol ^[3]. A doctor or specialist service makes those decisions. I am a counsellor and cannot prescribe, so if this sounds relevant, raise it with your GP or the alcohol team.

For drugs, a GP can refer you to your local drug service, or you can approach it yourself, and you will be given a keyworker who supports you through treatment ^[2]. If you are unsure where to begin, the Frank drugs helpline is 0300 123 6600 ^[2]. You can find alcohol addiction support services near you through the NHS website ^[1], and the Frank website can find drug support in your area ^[2].

What if someone I love has relapsed?

When someone you care about starts drinking or using again, you may feel frustrated, angry or upset, and it can feel personal if they had promised to change ^[5]. We Are With You reminds families that the decision to use is the person's own, and for some people it is linked to managing a physical dependence, so try to hold on to that even when it feels personal ^[5].

You are allowed limits. Their examples include refusing to be lied to or sworn at, and not having alcohol or drugs in your home ^[5]. Boundaries like these protect both you and the person you love ^[5]. If they already attend a service, encourage them to be open with it about what is happening, and if they have never been to one, a relapse may be what prompts them to go ^[5].

Look after yourself as well. For families affected by someone's drinking, the NHS points to Al-Anon UK, the SMART Recovery family and friends programme, and Adfam ^[1]. If you share a home with someone whose drinking or drug use has returned and you are in immediate danger, call 999.

How counselling can help after a relapse

Counselling gives you room to look at a relapse without being judged for it. With me, we usually start by slowing the story down and going through the days before, the moment of deciding and the morning after. Sometimes a relapse has been doing a job, such as numbing grief or quietening anxiety, and once we can see that, we can look for other ways to meet the need.

I am registered with the BACP, I have been in recovery myself, and I see people in one room in Hove and online. I do not offer detox, medication or diagnosis, and I will encourage you to keep your GP and local service involved alongside our sessions. You can read more about addiction counselling, counselling for drinking problems or substance use counselling. If you are nearby, there is detail on counselling in Hove and addiction counselling for people in Brighton.

Common questions

What is the difference between a lapse and a relapse?

A lapse is when a person first drinks or uses after not doing so for a while, while a relapse is a return to drinking or using regularly ^[5]. We Are With You suggests seeing relapse as a process that starts with a lapse, and says a lapse does not necessarily lead to one ^[5]. With support, encouragement and early action, a person can stop a lapse from becoming a relapse ^[5].

Is relapse part of recovery?

For many people it is. We Are With You describes lapses and relapses as a common part of recovery ^[6], and notes that most people who stop drinking or using drugs for good have them along the way ^[5]. That is no reason to plan for one. If it happens, treat it as a setback you can learn from and go back to the support that was helping you.

Can I just stop again on my own after a relapse?

It depends on what you were using and how heavily. If you are dependent on alcohol and get symptoms such as shaking, sweating or anxiety when you cut down, the NHS advice is to see a doctor or nurse first, before stopping ^[1]. Severe symptoms such as confusion, hallucinations or a seizure mean calling 999 ^[1]. With heroin, tolerance drops rapidly if you stop for just a few days, so an old dose risks overdose ^[7]. Speak to your GP or local service first.

Should I tell my keyworker or sponsor that I relapsed?

If you can, yes. We Are With You says recovery workers are trained to understand that treatment is a process, that telling them about a lapse helps them support you better, and that they will be glad you did ^[4]. It is understandable to worry about letting people down. Knowing what happened lets them work with you to make another lapse less likely ^[4].

How do I stop a lapse turning into a full relapse?

Act quickly and talk to someone the same day. Clear out what you can from your home, look after food and sleep, and go back to the meetings, people or service that helped before. Write down what led up to the lapse and what you would change. Drinkaware's guest writer recommends a written prevention plan that includes ideas for managing your triggers ^[8].

Sources

Alcohol-use disorder, NHS (accessed 12 Nov 2026)
Drug addiction: getting help, NHS (accessed 12 Nov 2026)
Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence (CG115), recommendations, NICE (accessed 12 Nov 2026)
What to do if you lapse or relapse, We Are With You (accessed 12 Nov 2026)
What to do if someone you know relapses, We Are With You (accessed 12 Nov 2026)
How to stay free of alcohol or drugs, We Are With You (accessed 12 Nov 2026)
Heroin, FRANK (accessed 12 Nov 2026)
Guest blog: How to recover from a lapse, Drinkaware (accessed 12 Nov 2026)
What to do in an emergency, FRANK (accessed 12 Nov 2026)
New synthetic opioids, FRANK (accessed 12 Nov 2026)
Drugs cut with dangerous substances, FRANK (accessed 12 Nov 2026)

Written by Bradley Riddell, a BACP-registered counsellor (registered member 109340) with over 25 years' experience and lived experience of recovery. He is not a doctor: this article is general information, not medical advice. Check his registration. Sources checked 12 November 2026.

Relapse: what to do after a relapse, and how to start again safely

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