Why do alcoholics relapse after rehab?

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Why do alcoholics relapse after rehab? 

Alcoholics often relapse when withdrawal symptoms take over. Relapse can also happen due to poor mental health, social circumstances, loneliness, difficult relationships, stress, and other factors that influence the addict.  

Addiction happens for several reasons; one is that alcoholism is a chronic and incurable disease that takes a lifetime to manage.   According to the Recovery Village, about 30% of people recovering from alcohol and drugs relapse even before the year ends.

 But the good news is that the first year is the only hardest year. As the days go by, the drugs and alcohol relapse rate also slow.  

Out of the people who enter rehab, about 70% will go back to drinking at some point in life. It's extremely hard for an addict to recover. But when they are in rehab, they are not in their usual environment, so the temptation to drink is much less. (1) 

Addiction is a chronic illness, which can be hard to beat. Rehab from alcohol abuse does well to help the addict cope with the consequences of choosing to drink in their environment. Why would addicts relapse after rehab?

The following are some of the reasons why there's alcohol relapse: 

1) Withdrawal 

Withdrawal symptoms are among the reasons why there's alcohol relapse after rehab. They can last up to six to eighteen months. The symptom will vary depending on the individual substance use.  

Symptoms may include vomiting, diarrhoea, muscle ache, and insomnia. Alcoholics will easily be lured to their old habits to curb these feelings. 

2) Mental Health 

Mental health issues are an increasing problem in England; according to the latest statistics, one in four people experience a mental health problem every year.

Also, one in six people is diagnosed with common mental health issues such as anxiety and depression weekly (2).   

It is no wonder that people with alcohol addiction are at a heightened risk of future relapse.  

People who suffer from mental illnesses often feel a sense of shame, inadequacy, and a lack of connection to others. It can lead to a heightened sense of loneliness and isolation, leading to further mental health deterioration.  

Mental illness may also cause people to avoid taking on new responsibilities, which can make it difficult to maintain sobriety.

In many cases, mental relapse occurs and will need to be attended to as a part of a person's recovery from alcohol addiction. 

3) Poor self-care 

Self-care is an integral part of recovery from alcoholism. Without proper self-care, it's easy for the alcoholic to relapse.

Not only do addicts risks returning to their addiction, but also alcoholics can put themselves in life-threatening situations.  

Many addicts will find themselves looking to find a drink within the first few days of their sobriety. Alcoholics need to take care of themselves. They need to eat plenty of nutritious foods, drink water, and exercise regularly 

4) Relationships and Intimacy 

Relationships and intimacy cause alcoholics to relapse because they can cause an addict to start longing for their drug and alcohol of choice again.

For example, an addict may feel like they are no longer themselves due to the lack of intimacy in the relationship.  

On the other hand, the addict could be satisfied with the intimacy but still want to drink due to stressful situations like arguments or insecurity.  

 Intimacy is beneficial to both the addict and the relationship, but there are situations where intimacy can cause an alcoholic to relapse.

For instance, a recovering alcoholic may never have had sober sex; therefore, they find sexual experiences being very triggering.  

5) Isolation and Boredom 

When an alcoholic is isolated and bored, they are likely to relapse. Isolation for an alcoholic is very important during the early stages of recovery. It can help to stay sober, but it can also lead to boredom.  

When alcoholic becomes bored, they are more likely to drink. They may start to fantasize about drinking, or they may start to crave alcohol. A relapse is often the result of boredom.

Sometimes alcoholics will drink because they want to fit in with the sober people around them. 

Being around sober friends who do not drink can be difficult, and alcoholics will sometimes drink to be around them. 

6) People and Places 

The most common causes of chronic alcoholism are people and places. People are triggers for alcoholics because of the idea that they may be judged or pressured into drinking.  

They feel that if they can't handle it, there will be judgment and feel like they are the only ones in the room who don't know how to drink responsibly or will be seen as hypocrites. 

In this sense, many people don't even remember the time before they became an alcoholic and became dependent on alcohol to alleviate their emotional state. 

What happens when alcoholics relapse? 

When alcoholics relapse, they often feel they have no one to turn to for help. The old signs of alcoholism can return, and it's easy for them to be tempted again by the old lifestyle they know.  

They might feel like they're a failure and can't do anything right. It's a dangerous cycle because the more they drink, the more it takes control of their life.

The person might start to lose everything they have gained from sobriety, and their life starts to spiral out of control. 

- Loneliness 

After the first relapse, the alcoholic loses their social connections because all their friends either cut ties or are disappointed.

The social connections that the alcoholics first gained when they started attending Alcoholics Anonymous meetings are also gone. It makes loneliness even more difficult to overcome.  

After the first relapse, the alcoholic is often depressed and overwhelmed with guilt, not to mention financial difficulties because they have often lost their job.

Although sometimes, after the first relapse, the alcoholic may have gained a renewed desire to recover, they are also faced with memories of the stigma they encountered after their first relapse.  

- Secrecy 

Relapse is usually secretive. The individual knows that they can't tell anyone, or else it will feel like they failed. The second time relapse occurs, the relapse is more open.

The person feels like they need to seek support and tell someone. They can't be secretive anymore.  

Alcoholics who relapse want to be secretive because they don't want other people to know that they are struggling. They don't want to feel like they are failing again. Relapse also brings up other emotions like shame and guilt.  

- Organ Damage 

Individuals who have relapsed are more likely to suffer from organ damage as their body tolerance levels are tremendously low, and they can end up overindulging.

Because their bodies are no longer processing excess alcohol and drugs, they are susceptible to organ failure. As a result, there are so many deaths.  


What is the primary cause of relapse? 

According to the National Institute of Drug Abuse, substance use disorder is a severe relapsing disease like asthma, hypertension, or diabetes [3]. 

So, if you find yourself relapsed, don't give up. You're in the recovery process. According to certain research, the relapse rates are approximately two-thirds in the initial month of addiction treatment. [4] 

There are various reasons for relapse, and all are related to some triggers. We have environmental causes, and they are all drug-related prompts that activate memories. 

They can be:  

  • A place that you were taking alcohol or drugs from 
  • People that remind your alcohol or drugs use 
  • A song during your drug addiction time 
  • Objects such as plates or a chair you loved at that time of drug use 
  • A stressful moment that you used to lessen the addiction

Another cause is emotional or mental causes. Here stress is the most apparent cause of relapse as it has a significant damaging effect on the brain.

High levels of stress expose one to addiction, while those already in it become more oversensitive.  

And thus, high risk of relapse to anyone on the recovery journey. When you manage stress, you're on a great path of relapse prevention plan. 

Other primary causes are depression, anger, loneliness, hunger, tiredness, negative feelings, physical and sexual abuse, a bad relationship, a bad workplace, and high triggers of relapse. 

Can withdrawal symptoms trigger a relapse? 

It has been shown that withdrawal symptoms can trigger a relapse, especially when exploring alternative ways to stop an addiction and enter treatment.

They are often the most difficult part of withdrawal, and when these physical symptoms are combined with emotional distress, it can be a recipe for relapse.  

Acute withdrawal symptoms are nausea, cramping, aches, and chronic pain. And the symptoms can be worse and risk anyone of relapse while attempting to avoid the discomfort. [5] 

Although it seems logical that detox can be risky, sometimes withdrawal symptoms don't often trigger a relapse, so there's no need to fear the withdrawal process.

Patients who go through withdrawal usually experience symptoms like agitation, anxiety, insomnia, nausea, or vomiting.  

These symptoms usually occur in the first few days of the withdrawal process and last for weeks. Withdrawal is challenging, but it does not usually cause any long-term effects.  

The difficulty individuals experience with withdrawing will vary depending on the drug and alcohol class. so, though is a challenging process, it's not the reason that people relapse. 

Warning signs of alcohol addiction relapse 

Progress is one of the most difficult things to maintain. Early recovery is not easy but working with like-minded people makes the world feel that much brighter.  

When one starts to fall back into old habits, it cannot be easy to regain what you had. Experts warn of warning signs of alcohol addiction relapse and provide medical advice.  

So, to stop drinking and attain stable foundation, these are things to watch for:     

  • A person starts going through their savings.       
  • A person's performance at work or school starts to suffer.  
  • Unexplainable mood swings and signs of euphoric feeling.     
  • An individual starts coming home early from work or school.       
  • A person starts lying to their loved ones about their actions.        
  • A person starts staying up late at night.      
  • The individual starts drinking alone.     
  • They show a lack of interest in attending social events.    
  • They start to make careless mistakes at work. 
  • The individual starts to skip appointments.    
  • They show a lapse in judgment as to their responsibilities and obligations. 

Why does addiction treatment not always work? 

Many people who have a drug use problem will go to a drug addiction rehabilitation centre to find treatment options and fix the problem.

To these people, the rehabilitation centre is a sanctuary where they hope they can find peace a support system and find a way to be free from their addiction.  

However, the odds are that rehab as one of the treatment options might or might not be successful in attaining long term sobriety. Addiction treatment does work but sometimes not.

When substance abuse treatment does not work, it is often because the individual with the addiction is not interested in getting help and in setting healthy boundaries.  

They may not believe that they need to change and will not try the suggested treatments.

This is often because the individual feels that they do not need to change as addiction is not as bad as it is made out to be, or they do not want to stop their current lifestyle as it is more pleasurable.  

Another reason is that there is no single effective treatment for addiction. It can depend on the type of addiction the individual has and its circumstances. A good treatment plan must have medical supervision from an experienced medical director 

Addiction treatment should be a team effort with a support system, and you should take all factors into account.

Feelings about the addiction, the person's mental and physical health, social relationships, and physical well-being all need to be considered when deciding if addiction treatment will work.  

Related article: Relapse prevention after alcohol rehab

How to avoid alcohol or drug relapse? 

Reaching for a glass of wine, vodka and cranberry juice, and a beer at a time can make it seem like an everyday habit.

But one day, you might not be able to afford the financial burden of your addiction, or you might want to make a change and cut down on your intake.  

To remain sober can be difficult without help, and support group meetings is essential for breaking the addiction cycle.

Seek out a support group such as Alcohol Anonymous twelve step groups or Narcotics Anonymous for those who want to stop alcohol abuse or using drugs.  

It's not easy to get the right treatment programmes or support groups, but you can also seek professional medical advice from a counsellor or therapist in private practice.

Besides, staying sober away from people who use or abuse alcohol or indulge in substance use is great for smart recovery.  

It would help as well to embrace coping strategies like avoiding places where alcohol might be easily accessible, such as bars, clubs, and parties before you enter a full-blown relapse.  

In addition, it's important not to attend any function where alcohol or drugs is prominently served. This could be a place like your next family celebration. As well, stay away from people who might pressure you to use again.  


There are plenty of things to keep in mind when deciding whether to seek a rehabilitation programme or treatment providers for alcohol abuse.

Alcohol rehab facilities offer potentially life-saving support, but they cannot guarantee a complete recovery process, which can sometimes be distressing.  

The truth is it takes an individual for continued recovery effort. The most important part of the journey is probably your decision, however difficult you think it might be.

There's nothing that compares to the process of self-awareness, and this is what will carry you towards long term sobriety. 

Remember there are numerous places like in the New York City that you might just land yourself some great expert advice! 

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About the author

Laura Morris

Laura Morris is an experienced clinical practitioner and CQC Registered Manager with over twenty years experience, over ten of which have been as an Independent Nurse Prescriber.

She has held a number of senior leadership roles in the substance use and mental health sector in the NHS, the prison service and in leading social enterprises in the field.

Last Updated: February 22, 2024