Relapse is most likely in the first 90 days to a year after starting recovery, especially during stressful periods or when encountering old triggers (people, places, things, emotions). Key risk times include immediately following intensive treatment, when coping skills are weak, and during emotional distress (anger, anxiety) or isolation, often preceded by "emotional relapse" signs like mood swings and erratic sleep/eating, according to American Addiction Centers and Psychology Today.
Some of the most common relapse triggers include:
In ALL, early relapse is often defined as occurring in the first 1.5 years from diagnosis whereas late relapse is defined as occurring after 3 years from diagnosis and these patients may represent a subset of patients with a distinct biology that follows a more quiescent course [3, 7].
Studies have shown that people with low self-efficacy in their abilities to stay sober have a higher risk of relapsing, while those with a sense of mastery over their sobriety are more likely to cope effectively.
Research shows that alcohol and opioids have the highest rates of relapse, with some studies indicating a relapse rate for alcohol as high as 80 percent during the first year after treatment. Similarly, some studies suggest a relapse rate for opioids as high as 80 to 95 percent during the first year after treatment.
By far, alcohol is the most commonly abused substance in the United States.
The relapse rate amongst drug addicts varies depending on the type of drug they are addicted to but is generally between 40 and 60 percent. Smoking, alcohol, and marijuana have a considerably lower relapse rate than drugs like cocaine and heroin.
Alcohol. Alcohol is the most regularly used addictive substance in America, with nearly 29 million people aged 12 or older having a past year alcohol use disorder in 2023.
People can relapse when things are going well if they become overconfident in their ability to manage every kind of situation that can trigger even a momentary desire to use. Or they may be caught by surprise in a situation where others around them are using and not have immediate recourse to recovery support.
However, studies place the number at around 70%. The first year is the tenderest period for relapse risks. Research shows that less than 35% of people were abstinent from alcohol over the course of a one-year period following completion of a rehab program.
Several studies have shown relapse rates as high as 65% to 70% in the 90-day period following treatment. Laboratory-based assessments of provoked drug craving and EMA methods of drug craving and stress have shown high accuracy for predicting lapse to drug use in the real world [5, 29, 30••, 31•, 94].
The symptoms of relapsed ALL are the same as those for newly diagnosed ALL, including: Anemia. Bone and joint pain. Bruising or petechiae (small red spots on the skin)
In general, the term “early relapse” refers to the first, second, or third time the myeloma stops responding to treatment. Early relapse signifies disease progression that occurs during treatment or shortly after stopping therapy.
Research shows that some of the most addictive substances include:
Despite an 85 to 90 percent cure rate after first treatment for children, adolescents and young adults with acute lymphoblastic leukemia (ALL), 10 to 15 percent of patients with pediatric ALL will experience relapse. ALL relapse can happen months or years following remission.
The truth about recovery rates depends on the type of substance, the approach to addiction treatment, and the support a person receives along the way. According to research, long-term recovery is widespread, with relapse rates around 40% to 60% early on, dropping to less than 15% after 5 years of continuous sobriety.
Stress – Stress is often cited as the number one trigger for a relapse. It's a normal part of life, but when it becomes overwhelming and unmanageable, it can push someone back to using substances as a coping mechanism.
According to Narconon.org, the relapse rate for drugs and alcohol spikes at least 150% during the holiday season.
The Highest Drug Relapse Rates
There is a consensus that the drugs with the highest relapse rates — rates over 60% — are the following: Opiates. Alcohol. Cocaine/Crack.
Anxiety, depression, and stress levels among Gen Z are at an all-time high. Many turn to substances like prescription drugs and psychedelics as a form of self-medication. Stimulants like Adderall and Xanax are often misused to cope with academic and social pressures.
Modafinil: A prescription medicine used for narcolepsy and sleep disorders without significant addiction liability. Caffeine: Found in coffee and teas, providing mild stimulating effects without the severe addictive potential of illicit drugs.
Cocaine. It's helpful to understand the long-term effects of crack cocaine, but the most immediate aspect to know is that it's a top-ranking substance for overdose deaths. It's super unpredictable too, especially when mixed with fentanyl.
A relapse happens when a person stops maintaining their goal of reducing or avoiding use of alcohol or other drugs and returns to their previous levels of use. 3,4. This is different to a lapse, which is a temporary departure from a person's alcohol and other drug goals followed by a return to their original goals.
According to a survey of members of AA, 75 percent experience a relapse during their first year of recovery. For those who are sober five years, the rate drops to 7 percent.
Interestingly, cannabis was ranked as the least harmful drug by the Scottish addiction experts.