Substance use disorder is a chronic disease that can be managed. After treatment, many struggle to cope with relapse triggers such as social, environmental, or emotional situations that reminds them of their drug or alcohol use. Although everyone’s triggers are unique to their experience, the National Institute on Drug Abuse estimates that 40 to 60 percent of individuals will relapse after recovery treatment. While not all triggers are the same, this statistic indicates that some categories of triggers are common to many people in recovery.

External Triggers

External triggers are things around an individual. This can include specific people, places, activities, and objects. It is often a mix of conscious or subconscious cues that reinforce thoughts or cravings to use substances. With subconscious triggers, one is unaware of a desire to begin using once again. External triggers can be easily avoided as individuals can choose not to be around them.

The following categories and subcategories are common external triggers:

People

  • Former drug dealers

  • Friends

  • Co-workers

  • Employers

  • Family members

  • Spouses or partners

  • Neighbors 

Places

  • Neighborhoods

  • A particular friend’s home

  • Bars and/or clubs

  • Hotels

  • Worksites

  • Concerts

  • Freeway exits

  • Bathrooms

  • Former drug-stash locations

  • Schools

  • Downtown 

  • Places they used to meet a dealer or meet friends to smoke or drink

Objects

  • Paraphernalia 

  • Furniture 

  • Silverware 

  • Magazines

  • Movies

  • Television

  • Cash

  • Credit cards

  • ATMs

  • Empty pill bottles

Situations

  • Parties

  • Meeting new people

  • Recovery group meetings

  • Going out

  • Before, during, and after sex

  • Anniversaries

  • Family gatherings

  • Holidays 

  • Long drives/road trips 

  • Arguments 

  • Listening to particular music 

  • Going out to dance or eat

  • Any time of isolation

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Internal Relapse Triggers

Internal triggers are what many psychological and behavioral therapies try to address, either in- or out-patient. These triggers have to do with the thoughts of the individual, how they see themselves and others. These are much more difficult to manage because managing them is entirely dependent on the individual.

Many emotions can re-ignite unhealthy behavior in individuals, and it is vital to learn how to cope with emotions. These subconscious and sometimes neurological triggers will signal the brain to act in a certain way, usually signaling cravings, without the individual's knowledge. These feelings are placed into three categories, but nearly every emotion possible can be the cause of a relapse for any given individual depending on their experiences.

Negative Feelings

  • Fear

  • Anxiety

  • Guilt

  • Irritation

  • Overconfidence

  • Anger

  • Hate

  • Jealousy

  • Shame

  • Depression

  • Loneliness

  • Feeling inadequate or overwhelmed

Uncomfortable Feelings

  • Boredom

  • Insecurity

  • Nervousness

  • Sadness

  • Embarrassment

  • Loneliness

  • Pressure

  • Tiredness

  • Frustration

  • Neglect

Relaxation

  • Positive Feelings

  • Celebratory feelings

  • Excitement

  • Happiness

  • Passion

  • Strength

  • Confidence

  • Exhaustion

  • Feeling "normal"

  • Sexual arousal

Recognizing Relapse Triggers

Relapse prevention begins in treatment, whether that be an in-patient or out-patient recovery program. Addiction recovery teaches the individual to recognize triggering situations once they are out of treatment to develop a long-term sober life.