🔄 RPL1T1:Introduction to Relapse

📚 Please refer to the Materials section for additional learning resources and further reading. You may download these materials for future reference.

>more than 75% of patients with alcohol dependence relapsed within a year of treatment

Relapse prevention is vital for individuals with dependence or addiction, as maintaining progress and preventing a return to previous behaviors is challenging. This approach, based on cognitive-behavioral principles, involves developing strategies and skills to sustain positive changes and promote long-term well-being.

Research highlights significant relapse rates in people with SUDs. Miller and Hester’s review of over 500 alcoholism outcome studies found that more than 75% of subjects relapsed within a year of treatment. A study published by Hunt and colleagues demonstrated that nicotine, heroin, and alcohol produced highly similar rates of relapse over a one-year period, in the range of 80-95%. 40-80% of patients treated for alcohol use disorders experience at least one lapse within the first year post-treatment, and 20% revert to pre-treatment levels of alcohol consumption.

The importance of relapse prevention cannot be overstated. It helps sustain positive changes, enhance long-term recovery, improve quality of life, and minimize the economic burden. Additionally, it empowers individuals, supports families and communities, addresses underlying issues, and prevents the cycle of relapse and remission

Under this topic, let us understand the Relapse Process and stages, Determinants and Precipitants of Relapse, Statistics and the Importance of Relapse Prevention.

Process and Stages of Relapse: Relapse is a gradual process that takes place over a period of time. It may differ from weeks to months before an individual picks up the drink or drug.

Relapse

A relapse is when someone returns to previous patterns of using a substance. This is not a once off occurrence or several uses of a substance, but continual use in a way that looks similar to how they used substances before

Lapse

A lapse can be described as a ‘slip”. It could be just one use or few uses of a substance over a few days. The important thing here is that the he returns to the previous pattern (stopping or decreasing) after few days or weeks of lapse.

Slides download

✍️ Please complete the above practice activity. One needs to score above 50% correct to proceed to the next topic. One may attempt this as many times as needed

Let us recap!

✍️ Please complete the above practice activity. One needs to score above 50% correct to proceed to the next topic. One may attempt this as many times as needed

Interpersonal
  • Positive social support
  • Relationships
Intrapersonal
  • Self-efficacy
  • Outcome Expectancy
  • Emotional state
  • Coping
  • Craving
  • Motivation

Mood

Positive: Happiness

Negative: Sadness

Behavior

Impulsivity

Poor coping skills

Physical

Craving

Withdrawal

Environment

Peer Pressure

Loneliness

Lack of support

Cognitive

Overconfidence

Distortions

Psychiatric Disorders

Anxiety disorder

Mood disorder

Psychosis

Murthy et al., 2007

Prevent

To prevent the lapse and maintain sobriety or harm reduction .

Manage

In case person lapsed, provide effective management to go to full blown relapse

1. Miller W, Hester R. Treating the problem drinker: modern approaches. In: Miller WR, editor. The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking and Obesity. New York, NY: Pergamon Press; 1980.

2. Kirshenbaum A, Olsen DM, Bickel WK. Quantitative review of the ubiquitous relapse curve. J Subst Abuse Treat. 2009 Jan;36(1):8–17. [PMCID: PMC3151675] [PubMed: 18571890] 

3. Menon J, Kandasamy A. Relapse prevention. Indian journal of psychiatry. 2018 Feb 1;60(Suppl 4):S473-8.

We read every comment personally — your feedback helps us refine and improve the content with every update. Thank you for being part of this journey.
Doubt clearing form

Feedback/Questions/Doubts for Clinical Faculty

We would be glad to hear from you about any questions or suggestions to improve the content or flow of this topic. Fill in the form below and submit. 


📝 Tip: Make use of the Notes section at the bottom of each lesson to save key points—it will make revision much easier before taking the quiz.

🔒 If “Mark Complete” is not visible, complete the practice activity above and score above 50% to unlock it and proceed to the next; you may retry as many times as needed.

Further reading

  1. Relapse Prevention by Dr Jayakrishnan and Dr Arun
36 Comments

Clear and simplified topic

Prabhat CAM VKN Nimhans January 25, 2025 at 6:50 pm

Thanks. It is one of the topics that is least discussed in detail during regular clinical training or care. Hence, we tried to break it into simple steps so that it became easy to grasp. regards Prabhat

Precise and most relevant points,easy understanding

nimhansdigital (Administrator) January 19, 2025 at 5:46 pm

Thanks

Really the methodology used to learning is very innovative and simple to understand

Shiv Kumar sherikar pursuing PhD in clinical psychology

Short, simple and to the point. Learned more than I did watching hours of ‘educative materials on You tube’. Thank you.

Prabhat CAM VKN Nimhans January 22, 2025 at 5:18 am

Thanks. Relapse is a process that is inevitable in the journey of recovery. On the one hand, a dopamine surge gives pleasure. In this current world of the overwhelming abundance of drugs,food, news, gambling, gaming, social media …all are highly rewarding, and having addictive potential. Prof Anna Lembke mentioned that “Smartphone is like a hypodermic needle, delivering digital dopamine 24/7 for wired generation” Thanks

important and basic concepts handled very well

Concise,informative and very easy to understand.

Easy to understand.

Very succinct

The concept of relapse is simplified. Recapitulation of the subject and feedback through drag-and-drop are good, which helps to remember better.

liked the presentations on the concept of relapse

very creative way of learning and well organized content…

Thank you team, for this content, this is very helpful in understanding the different terminologies well in a simple way.

Simple and lucid session with clarity

It’s a very nice way of representation, sub-categorization of symptoms helps to look at the management in more detail.

Dr Sampratya Pathak February 6, 2025 at 12:04 pm

I am really enjoying and loving these primers. Nimhans has given so much of useful information.

Very nicely explained

Very well organized learning content.

The module is very simplified

VERY INFORMATIVE

Simplified and easy to understand

Very well learning contains

No comment

Simple and brief and hope it helps us to tackle the most challenging issues these days that’s very high relapse case in substance users

The presentation was simple and effective .

Very well explained. The important aspect is that the drag and drop with interesting examples.

very much informative and interesting

models of relapse relates with our daily life

very much informative

very informative

it is helfful for school teachers,school councellors

Leave a Comment

Your email address will not be published. Required fields are marked *