“What’s the difference between a slip and a relapse?” is a well-discussed question. A slip is one brief time when you drink or use again, often without meaning to, followed by a quick return to your recovery plan. A relapse lasts longer and usually means stepping away from that plan.
If you’ve used again, you can tell slip vs relapse by asking whether it stayed brief or got out of your control. It also helps to ask whether you’re still getting the help that was working for you, like recovery meetings and aftercare therapy.
Doctors and therapists separate a slip from a relapse when they decide how much support to suggest. If you know which one you or someone in your life is dealing with, it’s easier to decide what to do next.
What is the difference between a slip and a relapse?
Both words describe going back to drinking or using drugs after some time in recovery. What separates them is how far it goes and what happens to your recovery plan. A historical review of the relapse prevention model describes a slip, also called a lapse, as the first break from your goal of not using. A relapse is when drinking or using gets out of your control, or when you stop trying to stay off it.
A 2022 review of 276 studies found little agreement on how researchers define relapse, and about a third gave no definition at all. If one drink or one dose is treated as a relapse, slip versus relapse becomes hard to tell apart. However the words are used, neither a lapse nor a relapse means your treatment has failed or that your recovery is over.
What is a slip?
A slip is a single occasion that you didn’t plan, like having a drink at a wedding. You get back to your recovery plan quickly, for example by ringing your therapist the next morning, and the slip shows you where the plan needs more support.
What is a relapse?
A relapse is a lasting return to drinking or using, and it can start with things like cancelling therapy and missing meetings. Within weeks, you can end up drinking or using most days.
For many people, addiction is a chronic condition, and relapse is a common part of living with one.
An old review in the Journal of the American Medical Association found that medication adherence and relapse rates are as similar in drug and alcohol dependence as in other chronic conditions, such as diabetes or asthma.
Why does the difference between a slip and a relapse matter?
A slip and a relapse need different amounts of help:
- After a slip, you can usually take the first steps yourself by going back to your plan and speaking to the people who support you
- After a relapse, usually professional help is needed
A slip makes a relapse more likely, and whether one follows depends partly on how you react to it. Guilt can push people to keep using, and some give up on recovery altogether. But if you understand that a slip is a mistake with a cause, you have something to fix.
Knowing the difference between slip and relapse can put an accurate name to what happened. That alone can take some of the shame out of it and make asking for help feel easier.
"If you drink when you are not one bit thirsty, you may be trying to change the way you feel."
What to do after a slip or relapse
If you or someone with you has a seizure, is very confused and hard to talk to, has slow or shallow breathing, or can’t be woken, call 112 straight away. In the UK and Ireland, you can also call 999. Stay with them, and put them on their side if they’ve passed out.
Start by telling someone you trust, like a friend from your recovery group or your therapist, as soon as you can.
If you feel unable to cope, or you have thoughts of harming yourself, you can call Samaritans free on 116 123, in the UK or Ireland, at any time.
It’s important to note that, in the case of opioids, the risk of overdose is higher than before treatment. The European Union Drugs Agency (EUDA) says that after detox or leaving drug-free treatment, your body can handle less, so the amount you used to take can now be too much. Using alone, or mixing opioids with other drugs or alcohol, raises the risk further.
It’s best to then simply go back to what was already working for you, like your meetings and your therapist. Look at what led up to it. Talk it through with the person you’ve told, and work out what your plan is missing.
Signs that a slip may be turning into a relapse
- Using again after the first time
- Avoiding the people who support you
- Dropping your recovery tools or skipping meetings
- Cravings that keep building, with no way to ease them
- Finding reasons why using again is fine
If you recognise any of these, tell someone who knows your recovery plan.
When should you consider returning to treatment after a slip or relapse?
There’s no single rule, because the right step depends on you and the situation:
- One slip, with your recovery tools still in use, may not call for a return to residential care.
- Repeated slips, or consequences that keep getting worse, are signs you need more professional help.
- With a relapse, the question is usually which kind of professional help to ask for.
You could start with outpatient treatment, add recovery coaching, move on to aftercare support, or go back to residential care. Castle Health offers support at each of these points.
The UK’s clinical guidelines on drug treatment say people who relapse need quick access back to treatment. Relapse prevention and the work done in aftercare are often about stopping a slip from turning into a relapse.
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If someone you know has experienced a slip or relapse
When someone you care about uses again, you may not know what to say, or whether to say anything at all.
How long it’s been going on, and whether they’re still going to meetings or therapy, can give you a clue whether it’s a slip or a relapse. After a slip, it’s often enough to stay calm and ask what would help. After a relapse, ask who’s supporting them now and offer to help them find more.
Avoid asking why it happened. There’s no good answer, and the question adds to the guilt that keeps people quiet.
You can help them stay on track by supporting them without enabling them. A lift to a meeting or a chat over a cup of tea is support. If you make excuses to their boss or lend them money, that’s enabling, because it makes it easier for them to keep using.
If they use opioids, ask your doctor, pharmacist, or local drug service about keeping naloxone at home. Naloxone can reverse an opioid overdose while you wait for emergency help.
It can wear you down to support someone through this. Castle Health’s family support programme helps families understand what’s happened and how to respond to it, because addiction affects more than the person using.
- 75 European studies have indicated relapse rates between 40 and 75% for some llicit drugs.
Frequently asked questions about slip vs relapse
Can therapy help prevent a slip from becoming a relapse?
Yes, it can help. Cognitive Behavioural Therapy (CBT) helps you spot the thoughts and situations that lead to using, and plan for them. Group therapy lets you hear how other people got back on track, and outpatient support keeps you in regular contact with a team. You can find out more about types of therapy.
Is a slip the same as starting over in recovery?
Not necessarily. Many people keep building on the recovery work they’ve already done after a slip. If you go to a 12 Step group, you can talk with your sponsor or members you trust about how your group sees a slip.
Does a slip or relapse mean my treatment didn't work?
Not always. A slip or relapse can show you which skills need more practice, or that your plan needs more support or a different kind of help. Your next step might be a refresher with your therapist, or going back to the support that worked before.
Does relapse mean someone has given up?
Not on its own. What they do next says more than the relapse itself. If they tell someone or get back to their recovery plan, they’re still working at recovery. If they hide it and drop their recovery plan, they’re likely to need more help than they’re getting.
