What Is a Relapse Autopsy?

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No matter where you are in your recovery, relapse is possible. You may relapse once or multiple times. Everyone's recovery journey looks a little different. No matter where you are in your journey, it's always important to practice relapse prevention. Just because you have a history of relapsing doesn't mean you'll continue, and just because you don't have a history of relapsing doesn't mean you never will. Every time you relapse, you'll learn something different about yourself. You'll learn how to manage your symptoms better to continue down your unique path of recovery.

Relapse Is Not a Failure of Treatment

Relapse does not mean that the treatment program you completed was a waste of time and money. It means that your treatment plan needs to be adjusted to match your current wants and needs.

Relapse can happen for any number of reasons. Life is unpredictable and can put you in an uncomfortable, overwhelming situation that you don't have the emotional tools to navigate because you never had to before. However, it does not mean that you failed, and it doesn't mean your treatment failed. All it means is that you've hit a mountain in your recovery journey, and you have yet to acquire the right equipment to climb it.

Relapse Autopsy

When you relapse, a treatment facility may require you to complete a relapse autopsy. Think of a relapse autopsy as retracing your steps after you lose something. It's an exercise that helps you retrace the steps that lead to your relapse. While it may feel like the relapse crept up on you out of nowhere, when you retrace your steps you'll likely realize that there were symptoms of relapse earlier in your recovery that you didn't notice.

Understanding the different stages of relapse will make it easier for you to work backward and identify the root cause. Often relapses begin with resorting to toxic behaviors and coping mechanisms. The goal of a relapse autopsy is to get to the root of the problem and answer the question, “Why did I relapse?”

Stages of Relapse

Relapse happens in gradual stages. The stages that mark the beginning of a relapse can begin weeks or months before the physical relapse of drug or alcohol use occurs. One common breakdown of the stages of relapse is emotional, mental, and physical.


In this stage, you vividly remember the consequences of using drugs or alcohol for both you and your loved ones. You are not considering using substances again. However, you may be sliding back into harmful behaviors and toxic coping mechanisms. This stage of relapse usually involves denial because while the person is strongly against using substances, it may be easy for them to dismiss their behavior.

Emotional relapse usually exposes itself through poor self-care. This may include mismanaging both your mental and physical health. Some signs of emotional relapse include:

  • Bottling up emotions
  • Self-isolating
  • Missing meetings
  • Not sharing at meetings
  • Focusing on other people's problems
  • Poor eating or sleeping habits

If you recognize signs of relapse at this stage, you should be conscientious about using emotional management tools to mitigate your symptoms. You can also work with a therapist to identify what's causing your emotional relapse. Is something specific in your life causing you distress? What changed? Once this is identified, you can develop tools that will better suit you and the place you are in your recovery.


During this stage of relapse, you recognize your desire to use. There is a chaotic interior battle in your mind as you struggle to remember the consequences of using alcohol or drugs. This interior monologue can turn into external turmoil. You might find yourself hyper-sensitive to criticism and picking fights with your friends or family members.

During this stage, you may experience an overwhelming loss of control. You might contribute your desire to use to be caused by outside sources and forget about your responsibility for your actions. Some signs of mental relapse include:

  • Cravings
  • Thinking about things associated with past use
  • Bargaining (I'll only do it this one time because I'm having a bad day)
  • Lying
  • Brainstorming how to better control use of substances
  • Looking for opportunities to relapse
  • Planning a relapse


During this stage of relapse, you give in to your temptation and begin to use substances again. Some people refer to the initial consumption of a substance as a lapse. In this case, the physical relapse stage occurs after repeated use and re-established addiction to the substance. Often this stage occurs when an opportunity presents itself where you think you won't get caught using. This is the final and most difficult stage of relapse.

Relapse Prevention

The earlier you recognize the stages of relapse, the easier it will be for you to manage your symptoms and prevent relapse. Ideally, you'll recognize your relapse symptoms during the emotional stage and can immediately find help. However, there is no stage of relapse where it's too late to receive help.

Relapse may be a part of your recovery journey thus far, but it doesn't have to continue to be. Understanding the steps of relapse that lead to a physical relapse will help you recognize the problem before you travel too far down an unhealthy path. Pathways Recovery Center offers relapse autopsies for clients who have relapsed. We know that the best chance of changing behavior is for you to understand your behavior and the causes of relapse. We invite you to journey through recovery with us one day at a time. If you or someone you know struggles with substance abuse, call (888) 771-0966 and learn how Pathways Recovery Center can help you.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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