Addiction recovery and relapse prevention gears with text: Rehab 101 Why It Happens and What to Do Next.

Rehab 101: Relapse, Why It Happens and What to Do Next

Editorial TeamGeneral, Services, treatment

Natasha Lyonne was recently in the news talking about her relapse after a decade of sobriety. This brings up a common, but often ignored and misunderstood, setback in drug and alcohol rehab. Relapse happens on a spectrum, and that means recovery has to be individualized and a personal relapse plan put in place in order to maintain sobriety. Even after a relapse, long-term sobriety is still possible. It is not a moral failure. Read one to learn more about the statistics of relapse, the plans that need to be put in place, and how you can recognize and support a loved one in recovery.

Is relapse a normal part of recovery?

Yes. Relapse is extremely common in addiction recovery and is often described as part of a chronic, relapsing medical condition. NIDA notes that relapse rates for substance use disorders are similar to other chronic illnesses like diabetes, hypertension, and asthma.

Relapse can mean several things:

  • A one-time “slip” or brief return to use
  • A return to previous levels of drinking or drug use
  • A gradual slide that starts with old behaviors, not just substances

The key clinical takeaway: relapse signals that your current plan needs adjustment, not that you are incapable of recovery.

How common is relapse after treatment?

Research from NIDA and other major organizations estimates that about 40 to 60 percent of people treated for a substance use disorder will relapse at some point. These rates are comparable to long-term illnesses like hypertension and asthma, where flare-ups are also common.

A few important points about relapse statistics:

  • Roughly 40–60 percent of people in recovery experience relapse.
  • Risk is highest in the first year after treatment and then drops over time.
  • After about five years of continuous recovery, relapse risk can fall to around 15 percent, similar to the general population.

For families and loved ones, these numbers show that relapse is common, but long-term stability is possible with ongoing support and care.

Natasha Lyonne’s relapse: why her story matters

Actress Natasha Lyonne, known from “Orange Is the New Black” and “Poker Face,” has spoken openly for years about her heroin addiction and past legal and health consequences. She achieved long-term sobriety after court-ordered rehab in 2006 and has been public about the medical damage her drug use caused, including serious heart issues.

In January 2026, she shared that she had relapsed after many years in recovery, posting that she had “took my relapse public” and reminding others that recovery is a lifelong process. Her decision to speak up does several helpful things:

  • Normalizes relapse as something that can happen even after long sobriety
  • Shows that people can be honest about relapse without giving up on recovery
  • Highlights that support, not shame, is crucial when someone slips

For readers, her story illustrates that relapse does not erase years of progress and that returning to treatment or support is a sign of strength, not failure.

Why do people relapse?

Relapse usually has multiple causes, and many are medical and environmental rather than purely “willpower” problems. Common contributors include:

  • Unmanaged stress, grief, or anger
  • Mental health conditions like depression, anxiety, or PTSD
  • Sudden life changes (relationship conflict, job loss, moves)
  • Returning to people, places, and routines linked with use
  • Not following a treatment or medication plan consistently

Because addiction is a chronic brain-based illness, symptoms often return when treatment or support is reduced. In that sense, relapse functions like a flare-up that signals the need to adjust medication, therapy, or level of care.

What should I do if I relapse?

If you or a loved one relapses, the priority is safety and a quick return to support. Relapse, especially after a period of abstinence, can raise the risk of overdose because tolerance has dropped.

Steps that often help:

  • Reach out immediately: call a trusted friend, sponsor, therapist, or treatment program
  • Be honest with your provider so they can reassess medications, triggers, and supports
  • Consider stepping up your level of care, such as moving from weekly therapy to IOP, PHP, or residential, depending on severity
  • Rebuild routines that support recovery: sleep, nutrition, meetings, coping skills

For many people, relapse becomes a turning point where they learn more about their triggers and strengthen their long-term plan, rather than the end of the story.

How can relapse be prevented in the future?

Relapse can never be completely “ruled out,” but the risk can be reduced with a solid, personalized plan. Helpful pieces of a relapse-prevention strategy include:

  • Consistent treatment: therapy, medications for addiction treatment (MAT), and support groups
  • Clear relapse warning signs: changes in sleep, mood, cravings, or thinking
  • A written coping plan: for high-risk situations (holidays, stress, travel, conflict)
  • Supportive connections: family, peers in recovery, sponsors or mentors

Over time, many people find that slips become less frequent and less severe as they build skills, insight, and support. If relapse is part of your story, it does not have to be the last chapter.

Dr. Jeffrey A. Berman, MD, DFASAM
Medically Reviewed by

Dr. Jeffrey A. Berman, MD, DFASAM

Board-Certified Addiction Medicine Physician

Dr. Jeffrey A. Berman, M.D., DFASAM, is a board-certified Addiction Medicine and Psychiatry physician with over 30 years of experience. At Milestone, he leads a compassionate team providing patient-centered care for substance use and co-occurring disorders.

✔ Verified Credentials
📄 Published Expert
🏥 Clinical Practitioner

Sources & References