From the Guidelines
The relapse risk for Substance Use Disorder (SUD) after 2 years of sobriety is approximately 40-60%, though this varies significantly based on individual factors. After maintaining sobriety for 2 years, a person has substantially reduced their relapse risk compared to earlier recovery stages, but vulnerability persists. Several factors influence this risk, including the specific substance used, presence of co-occurring mental health conditions, strength of recovery support systems, and exposure to environmental triggers.
Key Factors Influencing Relapse Risk
- The specific substance used (opioids and alcohol typically having higher relapse rates than cannabis)
- Presence of co-occurring mental health conditions
- Strength of recovery support systems
- Exposure to environmental triggers Continued engagement with recovery supports remains important even after achieving this milestone. Medications like naltrexone, acamprosate, or buprenorphine may still be beneficial for some individuals beyond the 2-year mark, particularly for alcohol and opioid use disorders, as shown in studies such as 1. The neurobiological changes from substance use can persist for years, explaining why vulnerability to relapse continues even after extended sobriety.
Ongoing Recovery Process
Recovery should be viewed as an ongoing process requiring maintenance rather than a destination reached after a specific timeframe. This perspective is crucial for managing expectations and ensuring that individuals remain vigilant and proactive in their recovery journey. Given the information from 1, it's clear that relapse is a significant risk at any point following abstinence, with estimates suggesting that over the course of 1 year, relapse rates can range from 67%-81%, highlighting the need for sustained support and intervention.
From the Research
Relapse Risk for Substance Use Disorder (SUD) after 2 Years of Sobriety
- The available evidence does not provide a direct answer to the question of relapse risk for SUD after 2 years of sobriety.
- However, a study by 2 found that relapse occurred among 37% of the sample by three-month follow-up, and factors such as younger age, having a psychiatric diagnosis, and receiving treatment at a short-term clinic were associated with an elevated relapse risk.
- Another study by 3 found that higher acquired resilience was significantly associated with a lower relapse risk, and reduced relapse risk was significantly associated with current employment.
- Studies by 4, 5, and 6 discuss the effectiveness of medications for the treatment of substance use disorders, but do not provide information on relapse risk after 2 years of sobriety.
Factors Associated with Relapse Risk
- Younger age 2
- Having a psychiatric diagnosis 2
- Receiving treatment at a short-term clinic 2
- Lower acquired resilience 3
- Unemployment 3