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Alcohol Relapse

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Alcohol addiction is one of the most common substance abuse problems in the United States. A 2015 National Survey on Drug Use and Health report shows that among adults, nearly 27% admitted to binge drinking in the past month, and 7% of them said they drank heavily in that same month 1. Problematic drinking behaviors such as these may eventually give way to the compulsive patterns of abuse that underlie an alcohol addiction. Other signs of alcohol addiction are persistent cravings or a powerful desire to use alcohol and drinking despite the negative impact and detrimental consequences. Doctors use the term alcohol use disorder to refer to the condition that occurs when alcohol abuse leads to this kind of distress or harm. Nearly 15.1 million adults ages 18 and older suffered from an alcohol use disorder in 2015 alone 1.

Around 88,000 people die each year due to alcohol-related causes, and the National Institute on Alcohol Abuse and Alcoholism reports that alcohol is the fourth-leading preventable cause of death in the U.S.1 Addiction treatment is an essential component in bringing down these numbers.

However, while treatment is beneficial for your recovery and overall wellbeing, it is not uncommon to relapse after a period of sobriety. In fact, some schools of thought see alcohol relapse as a normal part of the recovery process. So it’s important to understand what a relapse is and how to respond once one has happened.

Drug abuse treatment can usher you safely through all stages of the recovery process.

What Is a Relapse?

In its simplest terms, a relapse is when you start drinking again after a period of abstinence 2. Heavy cravings or obsessive thoughts about drinking can feel impossible to ignore in the early days of recovery, especially if you are experiencing stress or feel unhappy in your day-to-day life. Despite your best efforts to stay clean and sober, you may turn to drinking as a familiar coping mechanism and relapse.

Relapse happens, in part, because of the chronic nature of the disease of addiction. According to the National Institute on Alcohol Abuse and Alcoholism, evidence shows that roughly 90% of people with alcoholism relapse within 4 years after completing treatment 3.

For those who view alcoholism as a chronic, relapsing disease, such as the authors of the book, Relapse and Recovery in Addictions, relapse acts as an impetus for learning more about what a person needs to sustain long-term recovery 4. With the belief that people who suffer from alcoholism are powerless over their disease, then, it makes sense that they may need to attend treatment numerous times before they are truly able to conquer their addiction.

Alcohol relapse rates vary widely in clinical studies, but some studies show that people who receive treatment have a short-term remission rate between 20% and 50% 5. Somewhat discouragingly, other studies indicate that between 20% and 80% of people who receive treatment and experience short-term remission are estimated to relapse in the long-term 5.

Why Do People Relapse on Alcohol?

frustrated business man

The alcoholism relapse process may be the result of a progressive series of problems, according to substance abuse expert Terence T. Gorski 6. In his perspective, relapse is seen as a series of individual problems exacerbated by negative situations. Everything gradually becomes more overwhelming until a person reaches a point where they feel out of control. In such cases, some people tell themselves the only possible source of relief is alcohol.

Another perspective, presented in a 2013 study published in the journal Clinical Psychological Science, involves the possibility that some people relapse because of feelings of shame and embarrassment about their drinking. They feel that they are “bad” people who are unable to change who they inherently are. These feelings are warning signs that may increase their chances of alcohol abuse and relapse 7.

However, alcohol addiction relapse can also be an opportunity to work on the issues and triggers that first led to the development of the addiction. For those who have already been in treatment, it might signal that it’s time to try a different approach. If you are looking to learn more about alcohol addiction, visit our trusted resource library.

Warning Signs

A strong craving to drink may be precipitated by many factors that vary from person to person. People tend to experience several warning signs of alcohol relapse, including 2, 5, 8:

  •  Physical withdrawal symptoms. Withdrawal symptoms include increased heart rate, elevated blood pressure, sweating and tremor that can be so distressing that a person starts drinking again to alleviate their discomfort.
  • Anxiety. People who experience anxiety may begin drinking again as a way of avoiding their feelings of nervousness and panic.
  • Dysphoria. A general feeling of dissatisfaction with life for which drinking can be a form of escape.
  • Anhedonia. An inability to experience pleasure in everyday life, which leads people to relapse to try to obtain some form of pleasure from drinking.
  • Stress. Clinical evidence has demonstrated that people who relapse are more sensitive to the effects of stress and may start drinking as a form of relief.
  • Little or no social or family support. Social support is associated with a higher level of abstinence since positive relationships help alleviate stress, provide emotional support, and offer a sense of belonging. Lack thereof can set the stage for relapse.
  • Failure to engage in recovery aftercare. Clinical research has shown that participating in 12-step groups or individual counseling increases levels of remission and decreases relapse rates.

What to Do When You Relapse on Alcohol

Some of the steps a person may take if they experience a drinking relapse include 5, 6:
  • Reaching out to loved ones, trusted friends, family members, or sponsors.
  •  Attending 12-step meetings and temporarily increasing the frequency of attendance immediately following a relapse, such as going to 90 meetings in 90 days.
  • Beginning individual or family counseling, if they aren’t already regularly attending.
  • Avoiding addictive thinking, such as, “Look how unhappy I am. I’d be so much happier if I started drinking again.” Recall all the negative ways that alcohol abuse has impacted your life and remember the positive aspects of being sober.
  • Avoiding self-criticism and judgment. Though a person might be tempted to mentally beat themselves up, it’s especially crucial during relapse to demonstrate self-compassion.
  • Remaining objective and avoiding all-or-nothing thought patterns, such as “I’m 100% bad and there’s nothing good about me.” It’s not uncommon for people to experience alcohol relapse shame and regret in association with relapse, but it’s also important for them to realize that they are not the first people in the world to relapse.

Going to Treatment After a Relapse

After a relapse, a person’s support system—which might include their therapist, psychiatrist, family, friends, or sponsor—may advise them to enter a treatment program again. This is not a sign of weakness but a sign that they are ready to stand up again despite having stumbled. It’s not uncommon for people to experience repeated relapses—it can take numerous attempts to remain abstinent for life.

Some of the mental and emotional symptoms that may follow an alcohol relapse can make it difficult for a person to admit to a renewed need for treatment, including 6:

  • Denial. A person tries to convince themselves that they’re not stuck and in need of help. But admitting the need for help and getting it can reduce the stress and anxiety that tends to make the problem worse.
  • Thinking that treatment won’t work because they’re hopeless. They think thoughts such as, “What’s the point? Treatment obviously didn’t work last time or I wouldn’t have relapsed.” The skills learned in treatment are still valid, but a different approach might be needed.
  • Making excuses. This includes saying they don’t have the time or money even though they know nothing is more important than sobriety.
  • Giving in to feelings of depression. If a person berates themselves so much that they feel like everything is pointless, it’s the perfect time to go to treatment. There, they can gain a healthier perspective on the relapse and long-term recovery.

If you’re not sure where to turn for help, call to speak to a treatment support professional about your rehab options.

How to Create an Effective Relapse Prevention Plan

Implementing a relapse prevention plan is one of the most important ways to safeguard against further relapse. According to Gorski, a comprehensive alcohol relapse prevention plans consists of 9:

woman and man planning relapse prevention
  • Stabilization. This means being sober and in control, something a person can’t do if they’re drunk. Focus on one day at a time. Ask, “What do I need to do to not drink today?”
  • Assessment. This component happens during treatment and involves taking a detailed family history and examining any history of drug and alcohol use.
  • Relapse education. Another part of treatment that teaches different concepts about relapse, including the idea that they are normal and nothing to be ashamed of.
  • Warning sign identification. It’s important for a person to know their relapse triggers to help prevent them from drinking again because it’s rarely just one problem that causes a relapse, but an accumulative process.
  • Recovery planning. This includes increasing AA attendance or getting in touch with a sponsor.
  • Inventory training. Every morning, take a mental inventory to prepare to recognize warning signs throughout the day, and review their progress every evening.
  • Family involvement. Ask family members to attend Al-Anon meetings, or if a person doesn’t have a supportive family, lean on trusted friends or members of your 12-step group.
  • Follow up. Update the alcohol relapse prevention plan on a periodic basis: every month for the first 3 months of recovery; quarterly for the first 2 years; and then on an annual basis. This is important because every stage of recovery has different warning signs—what was a trigger for a person 12 months ago may no longer be a trigger today.

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Meredith Watkins, MA, MFT is a licensed Marriage and Family Therapist with specialities in eating disorders and dual diagnoses. As a seasoned editor and writer, she has also worked as a clinical editor for online addictions journals and websites, and ghostwritten for numerous medical and addictions professionals.

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