It’s not uncommon to have a client who successfully completes treatment, but still relapses without any obvious warning signs. Often, what preceded the relapse was quiet withdrawal from the people and structure that supported their recovery. Loneliness rarely shows up on a chart the way a missed appointment or a positive test does, which is exactly why it's worth measuring on purpose rather than waiting to notice it.
For treatment professionals and sober coaches, that means treating isolation is something to screen for at intake and track over time proactively. Below is what the research shows about loneliness and relapse risk, four validated tools for measuring it, and how tools like Soberlink can help keep clients connected in between.
A study of adults in outpatient treatment for substance use disorder found that nearly three-quarters of women and roughly two-thirds of men reported moderate to severe loneliness (PMC, 2022). A narrative systematic review of 41 studies on loneliness among people with substance use problems described loneliness as deeply embedded in this population, tied closely to mental health, physical health, and the quality of relationships around them (Ingram et al., 2020, Drug and Alcohol Review).
The connection to relapse specifically shows up across substance types. A one-year study of methamphetamine use disorder treatment found loneliness was associated with both higher craving levels and more positive urine tests as treatment progressed (PMC, 2022). A 2025 longitudinal study of young adults found loneliness predicted hazardous alcohol use and cannabis use disorder over time (Journal of Adolescent Health, 2025). And a review of long-term relapse risk factors in alcohol use disorder, summarized by Mass General Brigham, found psychosocial factors, including loneliness and social isolation, were more strongly associated with relapse than most of the biological markers researchers tracked (Mass General Brigham).
Taken together, this research points to loneliness as a measurable, trackable risk factor, on par with the kinds of things treatment teams already screen for at intake.
You don't need to build a new instrument to start screening for isolation. A few validated tools already exist, and most take only a few minutes to add to an intake packet or periodic check-in.
UCLA Loneliness Scale. The most widely used measure of subjective loneliness was developed by Russell (1996). The full version has 20 items, and there's also a short 3-item form (the UCLA-3) that asks how often someone feels they lack companionship, feels left out, and feels isolated from others.
Download the UCLA Loneliness Scale, Version 3 (PDF)
Lubben Social Network Scale (LSNS-6). A 6-item scale that measures the size, closeness, and frequency of contact in someone's family and friend networks. It's a good complement to the UCLA scale: the UCLA scale captures how isolated someone feels, and the LSNS-6 captures how thin their actual support network is.
Download the Lubben Social Network Scale (LSNS-6) (PDF)
PROMIS Social Isolation Short Form. Available in 4-, 6-, and 8-item versions, this scale measures perceived exclusion, detachment, and feeling unknown by others. It wasn't built for addiction treatment specifically, but it's brief, well-validated, and easy to drop into an existing EHR workflow.
Download the PROMIS Social Isolation Survey (PDF)
Brief Assessment of Recovery Capital (BARC-10). A 10-item self-report tool that places social support alongside nine other domains, including sobriety, psychological health, housing, and meaningful activity. If your program already uses a recovery capital framework, this one folds in without adding a separate assessment.
None of these tools were designed to predict relapse on their own, and none replace clinical judgment. What they do is turn a hunch that a client seems to be pulling away into something you can score, track, and compare across check-ins.
Why this matters in practice:
Screening tools like the ones above rely on a client reporting how isolated they feel, which is useful, but it's a snapshot, not something happening in real time between check-ins. A second, complementary approach is using tools that actively keep people connected to their support system day to day, not just tools that ask them to reflect on their isolation after the fact.
One thread that shows up across the loneliness research above is the role of secrecy: hiding or lying about drinking tends to deepen isolation, since the lying itself pulls someone away from the people they'd otherwise lean on. That's part of what makes Soberlink relevant here. Instead of a client having to keep telling a spouse, sponsor, or family member "I'm sober," verified results are shared automatically, and because facial recognition and tamper detection keep the results from being faked, both sides can trust the data the same way.
Many people who've shared their experience describe this shift directly: one Soberlink user described how tracking, sharing, and being honest about drinking helped them maintain lasting sobriety. “You cannot do it alone,” they share.
Another user shares how early recovery “was lonely and hard,” but after Soberlink, “It feels wonderful to finally be dependable, honest, and authentic. It feels right and powerful to be able to show up for my loved ones and for my life… Having people trust me is part of the whole deal.”
The effect worth naming for this audience: sharing results replaces a question that gets asked over and over, "are you sober?", with something that doesn't need to be asked at all. That's one less moment of friction a day, and one more reason for a client to stay in touch rather than avoid the people who love and support them.
Connection tools don't have to be limited to the people already in a client's life, either. Peer communities like In The Rooms, a free online recovery community with meetings, forums, and peer support, give clients a way to build new relationships with people who understand recovery, which matters most in the early months when a client's old social circle may not be a safe or sober one to lean on.
Screening catches isolation before it becomes a pattern. Tools that keep people connected, whether that's verified sharing through Soberlink or a peer community online, give clients something to do about it in between check-ins. Together, they give treatment professionals and sober coaches a more complete way to act on isolation before it turns into a relapse.
Disclaimer: While Soberlink strives to keep all resources accurate and up to date, some information from external tools and studies may be updated over time.
