The Psychology of Relapse in Addiction Recovery

Abstract

Relapse remains one of the most significant challenges in addiction recovery, with rates ranging from 40% to 60% across substance use disorders. The present study investigated the psychological mechanisms underlying relapse vulnerability, with a specific focus on the roles of trigger exposure, perceived stress, craving intensity, environmental risk factors, and coping strategy utilization. A cross-sectional survey design was employed with a purposive sample of 150 adults (M age = 32.7 years, SD = 9.4) currently enrolled in outpatient addiction treatment programs across Karachi, Pakistan. Participants completed the Perceived Stress Scale (PSS), the Craving Intensity Scale (CIS), the Trigger Exposure Index (TEI), the Environmental Risk Score (ERS), and the Brief COPE inventory. Results of a hierarchical multiple regression analysis revealed that craving intensity (β = .39, p < .001), perceived stress (β = .32, p < .001), and trigger exposure (β = .26, p < .001) were the strongest predictors of relapse risk. Adaptive coping strategies were identified as a significant protective factor (β = −.27, p < .001). Environmental risk also independently predicted relapse vulnerability (β = .21, p = .002). The model accounted for 61.4% of variance in relapse risk scores (R² = .614, F(6, 143) = 37.82, p < .001). Findings underscore the importance of integrated, multi-component relapse prevention interventions that simultaneously target cognitive, affective, and environmental domains of recovery.