Understanding relapse risk, holiday pressures, and how families can protect recovery rather than pull away during the hardest season of the year.
Why Relapse Is Often Part of Recovery
Relapse does not mean a person does not care about their recovery. It is a clinically recognized part of the healing process for many chronic illnesses, including substance use disorders. According to the National Institute on Drug Abuse, an estimated 40 to 60 percent of individuals experience at least one relapse during the recovery process (NIDA, 2020).
Addiction fundamentally changes the brain regions responsible for executive function, stress tolerance, impulse control, and reward. Even when someone is committed to sobriety, healing takes time. Emotional regulation, decision making, and stress response pathways do not fully stabilize overnight.
The holiday season can be especially challenging due to multiple risk factors:
• Increased social drinking and alcohol exposure
• Disrupted daily routines
• Heightened financial or family pressures
• Loneliness or grief that intensifies during holidays
These conditions temporarily magnify vulnerability to relapse (SAMHSA, 2022). At Ascend Health in Charlotte, our focus is helping individuals and families understand relapse as information rather than failure. Recovery requires structure, clinical support, and understanding, especially during high risk periods.
Why Relapse Happens Even When Someone Is Trying
• The brain is still healing and rebuilding regulation pathways (NIDA, 2020)
• Emotional stress is responsible for more than 70 percent of relapse events (Hendershot et al., 2011)
• Relapse identifies unaddressed triggers or unmet needs that can strengthen long term recovery when addressed (Melemis, 2015)
• Recovery is cyclical rather than linear and sometimes requires adjustments to the treatment plan (Witkiewitz and Marlatt, 2007)
Relapse is not a sign to abandon someone. It is a signal that more support is needed.
How Relapse Can Affect Family Relationships
Relapse can reopen emotional wounds for families. Many loved ones experience fear, disappointment, exhaustion, or anger when someone slips. These emotional reactions are normal, but if expressed through blame, shame, or criticism, the outcome can be damaging.
Research in family systems shows that negative responses increase relapse risk and escalate substance use (Family Recovery Institute, 2021). Supportive and nonjudgmental communication strengthens readiness to re-engage in meetings, therapy, or medication assisted treatment (Miller and Rollnick, 2013).
Relapse and Shame
Shame is one of the strongest predictors of continued use. It increases secrecy, emotional pain, and avoidance of treatment (Hendershot et al., 2011).
Relapse and Compassionate Support
Compassionate responses reduce relapse duration, rebuild trust, and support early re-entry into treatment (Melemis, 2015).
At Ascend Health, we work closely with families to reduce shame and build supportive engagement strategies. Learn more about our approach at https://ascendhealthcharlotte.com.
Why Giving Up on a Loved One Often Makes the Problem Worse
Isolation makes addiction significantly more dangerous. Without the presence of supportive family members, individuals may feel hopeless, disconnected, or overwhelmed. These emotional states increase cravings and worsen relapse severity (Witkiewitz and Marlatt, 2007).
What Happens When Families Withdraw
- Isolation increases substance use
Loss of connection and accountability often accelerates relapse (SAMHSA, 2022). - Shame intensifies cravings
Feeling like a burden reinforces the emotional patterns that fuel addiction. - Safety nets disappear
Families are often the first to notice subtle risk behaviors. Without that support, consequences escalate quickly (McCrady and Epstein, 2013). - Self worth collapses
People in recovery already struggle with identity and self esteem. Withdrawal communicates abandonment and deepens despair.
Healthy boundaries are essential. Giving up is not.
Warning Signs of Crisis or Imminent Relapse
Early intervention is powerful. These signs are often missed during the holidays.
Behavioral Signs
• Withdrawal from family or friends
• Skipping therapy or MAT appointments
• Secretive behavior
• Increased irritability
Emotional Signs
• Hopelessness
• Shame and guilt
• Heightened anxiety
• Depressive symptoms
Cognitive Signs
• Minimizing the seriousness of past use
• Believing a single drink will not cause harm
• Romanticizing past substances or environments
Crisis Indicators
• Suicidal thoughts
• Self harm
• Severe confusion
• Medical distress
Crisis signs require immediate medical or emergency help. Ascend Health encourages families to contact treatment providers promptly when these warning signs appear.
Holiday Triggers Families Often Overlook
Nearly 80 percent of individuals in recovery say family dynamics have triggered cravings or emotional distress during holidays (Family Recovery Institute, 2021).
Misunderstandings That Trigger Use
• Encouraging a single drink
• Suggesting they are ruining the holiday
• Implying recovery is purely willpower
• Treating them like a burden
Relational and Environmental Triggers
• Alcohol centered traditions
• Chaotic or overstimulating gatherings
• Judgmental comments
• Bringing up past mistakes
• Family conflict or unresolved grief
• Loneliness within a crowded setting
Understanding these triggers helps families create safer, more supportive environments.
Healthy Ways Families Can Support a Loved One in Recovery
1. Communicate with Compassion
Motivational interviewing research shows empathy increases motivation for change (Miller and Rollnick, 2013).
Examples:
• I am proud of your progress.
• I want to support you. Tell me what you need today.
2. Reduce Alcohol Centered Traditions
Removing alcohol from gatherings lowers relapse risk.
Examples:
• Serve mocktails
• Keep alcohol out of shared spaces
• Offer alternative activities
3. Encourage Recovery Tools Without Pressure
Peer support, therapy, and MAT reduce relapse risk.
Examples:
• Offer a ride
• Help create time for meetings
• Check in after stressful events
4. Set Loving Boundaries
Boundaries protect everyone without withdrawing support.
Examples:
• I can talk when you are sober and safe.
• I do not argue when substances are involved.
5. Validate Their Effort
Positive reinforcement strengthens resilience (Melemis, 2015).
Examples:
• Struggling is not failing.
• You are doing incredibly difficult work, and I believe in you.
6. Address Warning Signs Early
Gentle early intervention can prevent escalation.
7. Stay Connected
Small gestures like calls and texts reduce isolation. Connection is one of the most powerful relapse prevention tools.
What Families Need to Remember
Your loved one is fighting a difficult and often invisible battle. Relapse can be part of the process, and with structured support, recovery remains possible.
You cannot cure addiction alone. You can create the environment that supports healing. Ascend Health can provide the clinical framework, accountability, medication support, and therapeutic structure your family needs during the holidays and throughout the year.
Personalized Call to Action for Ascend Health
If your loved one is struggling during the holiday season or showing early signs of relapse, Ascend Health can help. Our Charlotte based team provides confidential, evidence based treatment, medication assisted therapy, and compassionate support that empowers long term healing. Visit https://ascendhealthcharlotte.com or contact our team for immediate guidance and next steps.
APA References
[Complete reference list retained exactly as provided by the user]
American Society of Addiction Medicine. (2019). The ASAM national practice guideline for the treatment of opioid use disorder: 2020 focused update. American Society of Addiction Medicine.
Centers for Disease Control and Prevention. (2022). Alcohol and public health: Frequently asked questions. https://www.cdc.gov/alcohol/faqs.htm
Connors, G. J., DiClemente, C. C., Velasquez, M. M., and Donovan, D. M. (2013). Substance abuse treatment and the stages of change: Selecting and planning interventions. Guilford Press.
DiClemente, C. C. (2018). Addiction and change: How addictions develop and addicted people recover. Guilford Press.
Family Recovery Institute. (2021). Family systems and addiction recovery.
Hendershot, C. S., Witkiewitz, K., George, W. H., and Marlatt, G. A. (2011). Relapse prevention for addictive behaviors. Substance Abuse Treatment, Prevention, and Policy, 6, 1 to 17.
McCrady, B. S., and Epstein, E. E. (2013). Addictions: A comprehensive guidebook. Oxford University Press.
Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. Yale Journal of Biology and Medicine, 88, 325 to 332.
Miller, W. R., and Rollnick, S. (2013). Motivational interviewing. Guilford Press.
National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol facts and statistics.
National Institute on Drug Abuse. (2020). Drugs, brains, and behavior: The science of addiction.
National Institute on Drug Abuse. (2020). Relapse rates and addiction.
SAMHSA. (2022). Substance use disorder treatment and family involvement: A guide for families.
Witkiewitz, K., and Marlatt, G. A. (2007). Modeling the complexity of post treatment drinking. Clinical Psychology Review, 27, 724 to 738.
