Slip vs. Relapse: What’s the Difference?

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Alcohol addiction is considered a chronic, relapsing condition.¹ The majority of people diagnosed with alcohol use disorder need long-term clinical help to find recovery and the journey is characterized by slips and potential relapse. But “slip” vs. “relapse” are not interchangeable terms, and these setbacks require different responses.

In this article:

• How Do You Define Recovery?
• What is a Slip?
• What is Relapse?
• How Do You Deal With a Slip vs. Relapse?
• How Do You Prevent Slips and Relapse?
• Does a Slip or Relapse Mean You Need to Reenter Addiction Treatment?

How Do You Define Recovery?

The idea of “slip vs. relapse” is typically grounded in a definition of recovery that equates “full recovery” with strict abstinence. Many addiction recovery organizations, such as Alcoholics Anonymous (AA), endorse this definition of recovery.

In this definition of recovery, either complete abstinence from all mind-altering substances or strict abstinence from your “drug of choice” is required.

Using either alcohol or another mind-altering drug would be a slip or relapse.

The Substance Abuse and Mental Health Administration (SAMHSA) has a broader working definition of recovery:²

This definition of recovery allows for relapse to be seen as part of the process of recovery.

Research appears to support this idea as major epidemiological studies report that 57%-83% of individuals with addiction experience relapse.¹

One study of adults who reported recovery from significant alcohol or other drug problems showed that they had made an average of five recovery attempts.¹

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What is a Slip?

A slip, or “lapse,” is a single event, even if more than one drink is consumed in that event. A common definition of a slip is:³

A reported 40-80% of individuals who have received treatment for alcohol use disorder have at least one drink within a year of treatment completion.³ This single drinking event qualifies as a slip.

What makes this a slip vs. relapse is removing yourself from high-risk circumstances, returning your focus to recovery-focused activities, admitting the lapse to another person, and continuing to make positive changes.
This potential outcome of a lapse is sometimes called a “prolapse.” A recovery prolapse happens when a lapse reinvigorates your motivation and focus.

What is Relapse?

A relapse vs. slip is a gradual process rather than a single event. The process of relapse could start weeks or months before you take the first drink.

Mental health professionals are taught to recognize as many as 11 phases of addiction relapse. But there are 3 primary stages you can recognize in yourself.⁴

1. Emotional Relapse

During the emotional stage of relapse, you likely remember your last negative drinking experience vividly. You know why you sought sobriety. However, your emotional state shifts away from being hopeful, open, and future-focused.
Emotional relapse can happen due to poor self-care, specifically prioritizing other things over your personal needs (e.g., sleep, food, and companionship) and wants.

Signs of emotional relapse include:⁴

• Suppressing or “bottling up” your emotions
• Isolating yourself from others
• No longer attending recovery activities, like AA meetings
• Attending recovery activities but not participating actively
• Putting others’ needs before your own
• Often being hungry, tired, or agitated due to poor eating or sleeping habits

2. Mental Relapse

When negative emotions stay intense and pervasive over a period of time, you may transition into the second phase of relapse: mental relapse.

During mental relapse, alcohol starts to feel like a potential escape from the mounting negative emotions. This idea becomes preoccupying or even obsessive, creating an internal battle that may distract from everyday activities.

Even if you have not felt cravings for a long period of time, they could return. You may also experience:⁴

• Persistently thinking about people, places, or things that were part of your life before you entered recovery
• Minimizing negative things you experienced or did when using alcohol
• Glamorizing or idealizing alcohol use
• Internal bargaining about how you could use alcohol without consequences
• Strategizing rules you could use to “better control” your alcohol use this time
• Lying about your thoughts or feelings, including in recovery settings
• Looking for opportunities to use alcohol
• Planning a relapse

During this stage, you may think that you can have a “slip” and get right back to recovery, but a lapse that occurs while in this emotional and mental state is likely to produce “continued [behavior] to a level that is similar to before quitting.”³

3. Physical Relapse

The majority of relapses occur during a window of time when a person believes they can “get away with it” without anyone else knowing. This secrecy can make you believe that you can force a slip vs. relapse.

However, the obsessiveness created in the mental relapse stage can cause make you go think over the incident constantly, even if you only bought a drink and didn’t touch it or only had a sip.

These circumstances can lead to a relapse of drinking at the level before you entered treatment. Relapse can affect your recovery journey, but returning to a problematic level of alcohol use suddenly is also dangerous because your body may have lost tolerance. You may be at significantly higher risk of alcohol poisoning and other acute health issues.

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How Do You Deal With a Slip vs. Relapse?

Because a slip can turn into a relapse and a relapse can potentially undermine the work you have done in recovery, react as soon as you are able.

First, take yourself out of any situations you know are of highest risk for you to use alcohol. This may include leaving your home to take a walk or sit in a coffee shop if being alone with access to alcohol is a trigger for you.

Like addiction itself, slips and relapse thrive in secret. Admitting to a person or people who you know can provide support–especially clinical support–is one of the first steps.

You can:

• Contact your therapist or addiction treatment team
• Go to a crisis clinic
• Call a helpline, such as the AA hotline
• Attend a peer support meeting, either in person or online
• Reach out to your AA sponsor

How Do You Prevent Slips and Relapse?

Relapse prevention is a primary concern in addiction treatment and addiction recovery. You can take steps to prevent both slips and the progression toward potential relapse both with the help of professionals and on your own.

Formal Relapse Prevention

Relapse prevention is part of an entire addiction treatment program. Your treatment team can assist with:^3,4

• Learning new coping skills that assist with replacing alcohol use
• Lapse prevention and management through the cognitive-behavioral Relapse Prevention technique
• Training on seemingly irrelevant decisions (SIDs)–choices that support or undermine long-term recovery

Personal Relapse Prevention

You can empower yourself by:

• Employing self-care techniques such as HALT, which encourages you to evaluate if you are Hungry, Angry, Lonely, or Tired before you make recovery decisions
• Prioritizing activities that help you feel purposeful and connected to your community
• Changing your housing, job, or social groups if they place you in compromising positions

Does a Slip or Relapse Mean You Need to Reenter Addiction Treatment?

A slip or relapse does not mean that treatment has failed. These setbacks do not even necessarily mean that you need to reenter intensive addiction treatment. However, a slip or relapse does indicate that something is missing in your recovery plan or resources.

Discuss the circumstances under which the slip vs. relapse occurred with an addiction professional to understand your next steps, which may include formal addiction treatment. A slip may also mean that you need to update your relapse prevention plan, pay close attention to a specific aspect of self-care, or engage with a new treatment resource.

Need help knowing how to respond to a slip vs. relapse or alcohol addiction treatment to start your recovery journey? Call 800-948-8417 Who Answers? to get help today.

Resources

1. MacKillop, J. (2019, November 22). Is Addiction Really a Chronic Relapsing Disorder?. Alcoholism Clinical & Experimental Research, (44)1, 41-44.
2. Substance Abuse and Mental Health Administration. (2022, March 08). Recovery and Recovery Support.
3. Kandasamy, A. & Menon, J. (2018). Relapse prevention. Indian Journal of Psychiatry, 60(Supp 4), S473–S478.
4. Melemis, S. M. (2015, September 03). Relapse Prevention and the Five Rules of Recovery. Yale Journal of Biology and Medicine, 88(3), 325–332.