Summary: Two reasons you keep relapsing with drinking alcohol are likely (1) because quitting drinking is hard and (2) if you don’t have a good relapse prevention plan, your risk of relapse is high.
Key Points:
- Among people with alcohol use disorder (AUD), a.k.a. alcohol addiction, rates of relapse are high.
- Alcohol use disorder (AUD) is classified as a “chronic, relapsing condition,” and therefore, relapse is an aspect of the disorder every person with alcohol addiction must understand and accept as a real possibility.
- Engaging in professional support for alcohol addiction, i.e. going to a residential alcohol rehab program, can help you develop an effective relapse prevention plan to reduce your risk of relapsing with drinking alcohol.
Understanding Alcohol Addiction and Relapse
Here’s how the National Institute on Alcohol Abuse and Alcoholism (NIAA) defines alcohol addiction, known by medical professionals as alcohol use disorder (AUD):
“Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. Considered a brain disorder, AUD can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.”
That last sentence is important in helping you understand why you keep relapsing with drinking. Here it is again:
Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.
If you keep relapsing with drinking, then it’s likely you have alcohol use disorder (AUD), which can cause changes in both the structure and function of your brain, which increases your risk of relapse.
Studes show that among people with alcohol addiction who try to quit drinking, roughly half relapse within several months, and between fifty and seventy percent relapse within a year.
Therefore, the presence of alcohol addiction may explain why you keep relapsing with drinking alcohol. However, reading an article like this cannot confirm or rule out alcohol addiction, but the information we provide here can give you a greater understanding of alcohol addiction, treatment for alcohol addiction, and why you keep relapsing with drinking alcohol.
Before we continue, the NIAA also shares an encouraging fact about treatment for alcohol addiction:
“No matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery. National surveys show that millions of Americans have AUD.”
We share that to remind anyone and everyone in recovery from alcohol addiction or anyone seeking treatment for alcohol addiction that they are not alone, and millions of people in the U.S. face similar challenges every day.
How Many People Have Alcohol Addiction?
Data from the 2024 National Survey on Drug Use and Health (2024 NSDUH), an annual national survey on drug/alcohol use, mental health disorders, and related topic shows the following facts and figures on alcohol addiction in the U.S.:
AUD in the U.S. in 2024
Received clinical diagnosis for alcohol use disorder (AUD):
- Overall:
- Percentage: 9.7%
- Total: 27.9 million
- Age 12-17:
- Percentage: 3.0%
- Total: 775,000
- Age 18-25:
- Percentage: 14.4%
- Total: 5.0 million
- Age 26+:
- Percentage: 9.7%
- Total: 22.1 million
Additional data from the NSDUH shows the facts and figure on treatment for alcohol use:
Treatment for Alcohol Misuse in the U.S. in 2024
Received treatment alcohol use, with or without alcohol use disorder (AUD):
- Overall:
- Percentage: 1.4%
- Total: 4.1 million
- Age 12-17:
- Percentage: 0.7%
- Total: 171,000
- Age 18-25:
- Percentage: 1.2%
- Total: 428,000 million
- Age 26+:
- Percentage: 1.5%
- Total: 3.5 million
The last fact we’ll share is this:
Among the 27.9 million people with alcohol use disorder, only 528,000 – or 1.9 percent – received treatment from an addiction professional or received treatment in a specialized alcohol addiction program.
This is important because one thing that happens when you go to alcohol rehab, you learn everything there is to know about relapse prevention. And when you go to treatment, one thing you start working on from the very beginning is a relapse prevention plan.
What is a Relapse Prevention Plan?
A relapse prevention plan is exactly what it sounds like. It’s a plan you create with your treatment team that includes a comprehensive list of everything you need to stay in recovery, stay on your program, reduce your risk or relapse, and what to do in case you do relapse.
On that note, here’s something you should know:
If you relapse, you won’t be the first, you won’t be the last, and it’s not the end of the world. All the work you’ve done before counts, and the key to bouncing back is talking to key people and getting back on your program.
When you’re in treatment – while you’re learning about recovery – one thing you learn about that’s essential to avoiding relapse are called triggers. Triggers are people, places, things, feelings, and patterns of thought associated with drinking. When you encounter a trigger – you see a person you used to drink with, you drive by a bar you used to drink in, you have a vivid memory from your drinking days – it can lead to relapse.
Here’s how:
- You start thinking about drinking.
- You start craving alcohol.
- Cravings may overwhelm your relapse prevention skills.
- You relapse.
To prevent this chain of events, you learn to identify the two main types of triggers: internal and external. We’ll discuss these in the next section.
Preventing Relapse: Know Your Triggers
Internal triggers may appear as some, but not all, of the following:
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- States of feeling or emotion that used to cause you drink
- States of feeling or emotion you used to experience when you drank
- Emotion such as fear, anger, anxiety, or loneliness that make you think about drinking
External triggers may appear as some, but not all, of the following:
-
- People who remind you of drinking:
- People you drank because of (in your mind)
- People you drank with
- Locations/places:
- Specific bars where you drank
- Parts of town with the bars where you drank
- Places where things went wrong when you drank
- Objects/things:
- Wine glasses, whiskey tumblers, frosted mugs
- A book of matches from a bar you used to frequent
- TV commercials
- Activities:
- Holiday events
- Common social functions
- Concerts
- Live sports, or watching sports with friends
- People who remind you of drinking:
Once you learn about triggers, you can engage in what’s called trigger management, which can help if you keep relapsing with drinking.
Trigger Management: The Basics
Step 1: Name Them
Know and identify your triggers:
-
- Check the bullet lists above
- Write down your known triggers
- Make sure you identify both types: external and internal
Step 2: Avoid Them
Reduce likelihood of encountering your triggers:
-
- Write down what you can do to avoid them
- Use your therapist, counselor, or recovery peer to help
- Take real actions:
- Remove old drinking buddies from all your contact lists: phone, email, social media
- Take driving routes that don’t go by places you used to drink
- Say no to Friday happy hour with coworkers
Step 3: Develop Skills to Manage Them
Plan how to deal with unavoidable triggers.
-
- For instance, if you know you’re going to have a meeting at the end of the day with a coworker who pushes all your buttons, plan a recovery friendly activity right after the meeting: take a walk, call a recovery peer, go exercise
- If you have to go to an event – say a family dinner – where you know you’ll be triggered, prepare yourself ahead of time by reviewing your internal state, including how your body, mind, and emotions are doing, then do the same afterwards. Review your internal and external state, and assess your current risk of relapse.
- If you can’t avoid a situation you know may trigger you, have your stress management skills at the ready. If you identify the beginning of a cascade of thought or feeling that may result in relapse-related behavior, then immediately:
- Apply a stress management tool you know helps you, such as a mindfulness breathing or grounding technique
- Use an outlet you know helps you tolerate distressing emotion: write in your journal, take a walk, exercise, play or listen to music, meditate.
Step 4: Ask for Help
Remember: you are not alone. When you encounter a trigger, you may feel like you can’t handle it, which is why you need a robust social support system, and know who to call when you’re in, or on the verge, of a relapse crisis or emergency. Make a list of the following:
-
- Social support: phone numbers of friends and family that know your situation, know what you need, and know how to help
- Professional support: phone numbers of psychiatrists, therapists, or counselors that know your situation and know how to help
Next, get on the phone and call these people. Arrange to meet face-to-face if you can, but in an emergency or crisis, making positive contact via phone or text can help you find the balance and stability you need to make it through even the most challenging moments.
Preventing Relapse: You Have to Be Proactive
If you follow those four steps, you can significantly reduce your risk of relapse.
There’s something implied here that we’re not really addressing directly – yet. If you want to quit drinking, have tried to quit drinking, and keep relapsing but you haven’t:
- Received support from a therapist or counselor
- Been to alcohol rehab
- Tried a community peer support group like alcoholics anonymous (AA)
It may be time to consider committing to some type of formal treatment. In a treatment program – or if you find a dedicated sponsor at AA – you can develop a relapse prevention plan that includes the components above. In addition, during a formal treatment program, you’ll learn core skills that promote recovery and reduce risk of relapse, such as:
- Stress management
- Distress tolerance
- Relationship/conflict resolution skills
- Addiction education
- Addiction treatment education
We’ll close with a final word on why you may keep relapsing with drinking, and why seeking treatment can help. If you have an undiagnosed mental health disorder such as depression, anxiety, or posttraumatic stress disorder, you may keep relapsing because you’re using alcohol to deal with the difficult, overwhelming, and painful emotions associated with those mental health disorders. If you don’t receive a diagnosis and treatment for a mental health disorder that occurs alongside your alcohol addiction – called a co-occurring disorder – then that will dramatically increase your risk of relapse.
On the other hand, if you seek support, receive a diagnosis – for addiction, a mental health disorder, or both – and commit to evidence-based treatment, that that will dramatically reduce your risk of relapsing with drinking alcohol.
