By Patrick O’Neil
It can be scary getting honest about relapsing. The term relapse, simply put, means “to slip or fall back into a former worse state.” With that in mind it’s safe to say that no one relapses into a better state. With that being said, some relapsing alcoholic and addict individuals will tell you they are happier to be back in their addiction. But if that were true, then why did they seek help in the first place? No one that is recreationally using drugs and alcohol suddenly thinks, “I’m in trouble, I should get help,” if their addiction isn’t detrimentally damaging to themselves or those around them. When the addict and alcoholic honestly admits that they are powerless over alcohol, and that their lives have become unmanageable, they are literally taking the first step to getting sober.
How Do Relapses Happen?
Just admitting they’re powerless won’t keep the addict or alcoholic sober. Getting and staying sober isn’t easy. Addiction treatment requires hard work. Addicts and alcoholics have to become rigorously honest, admitting that they’re addicted, and accepting and surrendering to the idea that their way isn’t working. As it says in the Big Book of Alcoholics Anonymous, “Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves”—and that’s where relapse comes in.
According to addiction researcher and author Dr. Steven Melemis there are three stages to relapse:
- Emotional Relapse: the addict is suppressing their emotions, becoming more isolated, missing meetings, blaming others, and developing poor recovery habits.
- Mental Relapse: the addict is experiencing cravings, thinking about triggers, glamorizing drugs and alcohol, lying, and planning to relapse.
- Physical Relapse: the addict/alcoholic has relapsed and is now completely back in their addiction.
By using Dr. Melemis’ stages it’s apparent that the actual relapse of using happens way before the addict picks up a drug or the alcoholic gets drunk. So one would think that the behaviors that lead up to a relapse would be fairly easy to recognize. But that isn’t always so.
Signs Of A Relapsing Alcoholic Or Addict
The signs of a relapse can be difficult to spot. Normally, the start of a relapse begins with dishonesty. Here are few of the issues that addicts and alcoholics have historically struggled with regarding honesty in their recovery:
Working A Program:
Some addicts that have relapsed have been known to say, “I did everything my sponsor told me to do, but I still relapsed”—as if just going through the motions without really putting in the work would keep them sober. Unfortunately an addict can go to all the meetings that are available but if they don’t talk about the negative stuff going on in their head, tell their support system they have thoughts of using, continue to carry resentments, or engage in the same unhealthy behaviors as when they were using drugs and drinking—then it doesn’t matter how many steps they do, or how many meetings they attend—they’re not being honest in their recovery. Addicts and alcoholics that thoroughly immerse themselves into their program of recovery, are honest with their sponsor, and talk about their cravings at meetings, don’t just suddenly relapse.
Resentments:
Looking good in recovery isn’t a requirement. In fact it’s not even listed in any program’s literature. Sometimes the addict has to let their defenses down and kick their ego to the curb. If they’re afraid of what others think of them, worried about being liked, and angry if they’re unnoticed—then maybe that’s a sign they need to put in the needed internal work and find some forgiveness and acceptance. Blaming others for everything is old behavior. If the addict wants to stay sober then they have to admit that people, places, and things are not the problem. The problem is how they respond to them. As the actor and writer Malachy McCourt once said, “Resentment is like taking poison and waiting for the other person to die.”
Self-Sabotage:
There are addicts and alcoholics in treatment that resist every suggestion and opportunity that could help them to get recovery and stay sober. Many of them say they resent the god in the AA program, but when presented with the alternative; find a support group, start a spiritual practice, see a therapist, and be of service to others—they do nothing and expect to stay sober by just not drinking. With this type of thinking they’ve probably relapse numerous times, but that doesn’t stop them from refusing to put in the needed work. The definition of insanity is doing the same thing over and over again and expecting different results. But self-sabotage isn’t insanity, it’s the alcoholic not being honest, with themselves and others, and admitting that the real reason they’re not engaging in recovery is that they really just want to go drink.
Cross Addiction:
When an addict replaces one addiction with another then they are cross-addicted. There are heroin addicts that stop using but now are alcoholics. Meth addicts who are fearful of gaining weight and become anorexic. People who are sober are suddenly shopaholics, sex addicts, gamblers, workaholics, or they abuse prescription drugs because a doctor prescribed them and the pills aren’t their drug of choice. They tell themselves that this is better than using but its really just substituting one substance for another. They don’t consider it a relapse but eventually that substance or behavior will become just as problematic as the original addiction.
Becoming Complacent:
Perhaps the biggest factor for relapse is the addict and alcoholic becoming complacent in their program. Their lives become better and they start putting more effort and time into their work, or a relationship, or any other activity besides recovery. Eventually they stop calling their sponsor. When they lose a sponsor they don’t bother to get a new one. They stop going to meetings. The next thing they’re doing is visiting a friend that is in their active addiction just to say hello. It’s not that they want to relapse, it’s just that they stop doing everything that has kept them sober, and now they’re defenseless to their addiction.
“Addiction requires lying,” says Dr. Melemis. “Addicts must lie about getting their drug, hiding the drug, denying the consequences, and planning their next relapse. Eventually, addicted individuals end up lying to themselves. Clinical experience shows that when [addicts] feel they cannot be completely honest, it is a sign of emotional relapse. It is often said that recovering individuals are as sick as their secrets. When people don’t understand relapse prevention, they think it involves saying no just before they are about to use. But that is the final and most difficult stage to stop, which is why people relapse. If an individual remains in mental relapse long enough without the necessary coping skills, clinical experience has shown they are more likely to turn to drugs or alcohol just to escape their turmoil.”
Coming Back To Treatment After A Relapse
Sobriety is rarely a linear progression. There will be ups, and downs, setbacks, achievements, and yes, there will even be relapses sometimes. Yet many people in recovery look at relapse as a failure and they end up berating themselves, or worse, hiding it because they are too embarrassed to ask for help. The latter is especially true for those that had substantial amounts of time and felt they should have known better and suddenly their pride is getting in the way of saying they relapsed.
So much importance is made of clean time—birthdays, chips, and time countdowns—that it often feels shameful to relapse. Nonetheless, “Relapse is common,” writes Dr. David Sack. “Studies suggest that approximately half of all individuals who try to get sober return to heavy use, with 70 to 90 percent experiencing at least one mild to moderate slip. In other words, not many people say, ‘I want to get sober,’ walk into a treatment center, and never use drugs again.”
Another way to look at it is an addict and alcoholic’s natural state is abusing substances.
Their unnatural state is sobriety. Everyday that they are not using and drinking is an incredible gift. But it is very likely that they could possibly slip. However if they do they should get back up, dust themselves off, and jump back into recovery.
For the majority of individuals relapses are a subtle process. “Relapse is a gradual process that begins weeks and sometimes months before an individual picks up a drink or drug,” instructs Dr. Steven M. Melemis. “If individuals do not practice sufficient self-care, eventually they will start to feel uncomfortable in their own skin and look for ways to escape, relax, or reward themselves.” Further stating his position Dr. Melemis suggests that, “recovering individuals need to learn to feel comfortable with being uncomfortable. They often assume that non-addicts don’t have the same problems or experience the same negative emotions. Therefore, they feel it is defensible or necessary to escape their negative feelings. The cognitive challenge is to indicate that negative feelings are not signs of failure, but a normal part of life and opportunities for growth.”
Medical opinion about relapse
Dr. Stephen Taylor, the medical director of the Player Assistance/Anti-Drug Program of the NBA, similarly advises, “even if you know you consciously made a choice that you knew better than to make, bottom line is that you make a mistake and then get past that. Move forward. Learn what you did right, and what mistakes you made leading up to your relapse. That’s valuable time; you don’t throw that away.”
Yet the bottom line is, “Your recovery doesn’t have to end because of a relapse,” writes journalist Elizabeth Brico. “Your value is not defined by your drug use, even if that drug use is ongoing. You are a human being who deserves love, care, and respect. A friend once said this to me and now I’m passing it to you: take a break from being strong if need be, for as long as you need—but remember to get back up and keep fighting when you’re ready. You deserve a life you love.”
Addiction Treatment In Los Angeles
If you have relapsed and need addiction treatment in Los Angeles, then Cast Treatment Centers can help. We provide a wide range of flexible programs that will help you get back on track with your recovery. Our stance is to take an individualized and compassionate approach to drug and alcohol treatment. If you need help, then contact our admissions department today.
References:
- Psychology Today, The Challenge of Cross Addiction
- AA, How It Works
- NCBI, Relapse Prevention and the Five Rules of Recovery
