Why Is Relapse Common?

Addiction is defined as a “chronic relapsing disease,” because experts say long-term drug use alters the brain’s structure and function.1 (Click here for more on the definition of addiction.) These brain changes remain “months and years after the last use of drugs.”2 The long-lasting nature of the changes in addicts’ brains leaves them vulnerable to relapse long after they’ve detoxed.Q & A

Remember that sobriety requires significant behavioral changes that are extremely difficult to make. It also requires a wholesale change in attitude — from viewing drugs as the solution to recognizing that they’re one’s deadliest problem. It’s very hard to be 100% successful at changing one’s long-held beliefs and years of habit all of the time. It’s easy to slip back into old patterns of thought and behavior.

Many things that can contribute to relapse. Anger, resentment, hopelessness or other types of emotional stress, for example, can precipitate a cry for relief, which to an addict means alcohol or drugs to medicate away those intolerable feelings. Furthermore, “cues” or “triggers” associated with drug or alcohol use, like the sight of a syringe for a sober heroin addict or a beer commercial for a recovering alcoholic, can prompt intense cravings which can seem instinctive and nearly impossible to resist. Many addicts, myself among them, have to go through relapses as part of learning how to stay sober.

As Dr. Alan Leshner, then the Director of the National Institute on Drug Abuse, wrote in a 1977 issue of Science Magazine, “Viewing addiction as a chronic, relapsing disorder means that a good treatment outcome, and the most reasonable expectation, is a significant decrease in drug use and long periods of abstinence, with only occasional relapses.”3

Dr. Leshner also told Time Magazine, “The occasional relapse is normal, and just an indication that more treatment is needed.”4

For more, click on Relapse Triggers.

Click here to return to the Questions About Addiction Menu.


1. Addiction is a Brain Disease, and It Matters, Science, Oct. 3, 1997.

2 A Range of Research-Based Pharmacotherapies for Addiction, Science, Oct. 3, 1997.

3. Addiction is a Brain Disease, and It Matters, Science, Oct. 3, 1997.

4. Addicted, Time Magazine, May 5, 1997. 


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