The first step when a loved one leaves rehab is to determine if they are serious about sobriety. Worrying or constant monitoring doesn’t help. But, pretending everything is OK, because you want it to be OK, is even more harmful.
Walk the thin line of being supportive, yet aware and ready to speak up. A relapse doesn’t mean failure, but it can’t go unaddressed.
The Five Most Common Warning Signs to Look For
1) Are they asking for money?
Part of the recovery process is stepping up to take responsibility. This includes maintaining a job or committing to school (or both).
It’s not uncommon for family members to be manipulated in additive addiction. Putting an end to manipulation is a huge part of their (and your) healing.
Things like paying for the first few months of sober living can be helpful, but don’t be afraid to verify where the money is going. You can ask for account passwords, call the company, get copies of the bill or pay directly without completely taking over their finances for them.
Ultimately, giving your loved one money shouldn’t be the norm.
2) Are they reverting back to their old schedule?
You’ll almost always notice suspicious behaviors before you confirm a relapse.
If they’re staying out late, sleeping in, not coming home or avoiding family dinners, it’s time to reach out.
These types of behaviors show the person is letting their healthy lifestyle slip.
They may even be back in addiction and it’s controlling their life and dictating their schedule.
3) Are they hanging around the same people and places?
Avoiding old drug-using networks and friends is one of the best strategies to prevent relapse. (“The Recovery from Dependent Drug Use: Addicts’ Strategies for Reducing the Risk of Relapse,” 2022) If someone is hanging around the same people and going to the same places, they’ll be constantly reminded and tempted.
Life after rehab should include new friends, meetings, a sponsor and hobbies.
If you don’t see them changing where they spend their time, they may not be serious about recovery. And, you should act accordingly.
4) Do they change the subject when you ask about their recovery?
Addiction is often a source of shame, but recovery should come with pride and accomplishment.
While recovery doesn’t have to define them, they should be happy to tell you they’re still on the right path.
If they’ve slipped back into addiction, they won’t want to talk. It’s embarrassing, and they probably feel guilty. Most people would rather change the subject or walk away rather than lie.
Don’t stop asking just because they shut you down. In fact, address that specifically.
5) Have they stopped actively working on their recovery?
Recovery is a life-long commitment.
Even people that are 10, 20, 40 years sober go to support meetings and see therapists. (That’s why they’re still sober).
If your loved one isn’t following the recommendations, it’s a sign they’re still stuck in denial.
A general recommendation is:
- 30 support meetings in the first 30 days
- A sponsor by day 45
- Outpatient treatment for at least 3 months
- Sober living for at least 1 month, ideally 6-12 months
- Continuing all medications until stopped by a professional
These aren’t hard rules, but they are good goals. You should see your loved one actively working on their recovery after rehab.
Why is More Treatment Needed After Rehab?
The positive reinforcement of regular therapy allows them to learn to voluntarily abstain from drug or alcohol use without constant supervision — until the risk of relapse decreases.
Try to hold your loved one accountable for outpatient treatment at least weekly, starting immediately after they leave.
Meeting regularly with a therapist is the best way for anyone to remain in a good place mentally and think clearer about their life and issues.
When emotional situations come up — such as a death in the family or marital struggles — they should look to resume outpatient treatment right away.
Therapy can be like going to the gym. It’s something they can do regularly (weekly or bi-weekly) forever as a safety net.
What Should I Do if I Notice a Relapse?
Address any warning signs you see as early as possible but be sure you’re addressing specific behaviors rather than general fears about them relapsing.
- Allow them to open up to you.
- Help them be honest with themselves
- Encourage them to contact their support network.
- Don’t come at them with anger and judgment. They already feel depressed and embarrassed about slipping.
Relapse means gaps exist in your loved one’s recovery that need to be addressed. More treatment is always required — no exceptions or excuses.
However, this doesn’t have to mean going back to inpatient rehab. It could involve things like seeing a therapist weekly or getting back on antidepressants. There are anti-craving mediation options like Vivitrol that may help too.
Don’t let them brush off the topic. Continue to push past denial or excuses even though it’s easier not to.
A relapse can be a temporary setback and learning experience. But, if they refuse further treatment, go back to setting boundaries and require them to take sobriety seriously.
The earlier you can intervene the more likely they will get back on track. Though, your involvement should feel like a loving ally that is also pursuing a healthy lifestyle like going to family support groups and your own therapy sessions when needed.
What Should I Do if They Are Doing Well?
If they are active in their recovery, great! You can work on forgiveness and start re-defining your relationship.
Be willing to participate in family therapy sessions to work on healing and support their efforts. But also find activities to do together unrelated to their addiction story. Maybe you can read the same book, join a softball team or start Friday dinners.
You also should help celebrate their recovery. One month sober might not seem impressive to you, but it’s probably a big deal to them.
Your love and support (without enabling) can continue to play a major part of their recovery journey ongoing.
Dr. Lea McMahon LPC, Ed, is the Chief Clinical Officer at Symetria Recovery, which has 12 outpatient clinics across Illinois and Texas. To learn more about their MAT and IOP treatment options, visit: https://www.symetriarecovery.com/about-us/ or call (866) 719-3813. To read more articles by Dr. Lea McMahon LPC, EdD, visit: https://www.symetriarecovery.com/blog/
The Recovery from Dependent Drug Use: addicts’ strategies for reducing the risk of relapse. (2022). Retrieved December 1, 2022, from Drugs: Education, Prevention and Policy website: https://www.tandfonline.com/doi/abs/10.1080/dep.188.8.131.52