Knowing what to do when an alcoholic relapses has never been more important.
The government performs an annual survey to obtain information on alcohol use and substance use in the United States. Reported by SAMHSA in the form of the NSDUH (National Survey of Drug Use and Health), the most recent data from NSDUH 2020 shows alcoholism dramatically increased over the past year in the US.
Alcohol use disorder (AUD) is the clinical descriptor for alcoholism, diagnosed according to the criteria set out in DSM-5 (the fifth and latest edition of APA’s Statistical and Diagnostic Manual of Mental Disorders).
According to NSDUH 2019, 14.5 million people in the US had AUD. The most recent data shows 28 million adults now have AUD. Not only have rates of alcoholism practically doubled, but only 2 million received any form of treatment, just 7% of those requiring professional treatment.
NIDA (the National Institute on Drug Abuse) defines addiction as a chronic and relapsing brain disorder. Research shows that between 40% and 60% of all those engaging with treatment for AUD will relapse at least once.
With the appropriate treatment, aftercare, and relapse management plan, you can embrace sober living, even if your recovery journey is not always strictly linear.
Alcohol Relapse 101
Not everyone who engages with inpatient or outpatient treatment for alcohol use disorder manages to transition seamlessly from addiction to recovery.
The clinical definition of relapse involves someone returning to an addictive substance or behavior.
Although the terms lapse and relapse are used interchangeably, these are not synonymous.
If an alcoholic lapses in their recovery, this is a short slip into drinking alcohol that is rapidly self-corrected.
With relapse, the person dives headlong back into abusive patterns of drinking while abandoning treatment and therapies.
A lapse, then, is associated with a fleeting return to consuming alcohol, whereas a relapse can often mean starting again from scratch on your recovery journey, beginning at detox even if you have just completed a stint in residential rehab.
Those who experience frequent lapses are more likely to end up relapsing fully at a later stage.
If you have a loved one abusing alcohol, it pays to know what to look out for in terms of relapse warning signs.
What Are the Most Common Signs of Relapse?
If you or a loved one are grappling with alcohol use disorder, watch out for the following red flags for relapse:
- Increasing feelings of anxiety
- Withdrawal from social activities
- Feelings of self-pity
- Being overly positive
- Regularly missing therapy sessions or peer-support group meetings
- Spending time among those who encourage drinking
- Doubts about maintaining sobriety
- Overconfidence about addiction
- Minimizing addiction
- Changes to normal routine
- Appetite changes
- Problems coping with stress
- Use of other addictive substances
How does alcohol relapse unfold, then?
The Three Stages Of Relapse
Relapsing into alcohol abuse, like any addictive behavior, doesn’t usually happen overnight. Before learning what to do when an alcoholic relapses, you must first understand the stages of relapse.
Alcohol relapse is characterized by the following stages:
- Emotional alcohol relapse
- Mental alcohol relapse
- Physical alcohol relapse
These stages of relapse were outlined in this study published in the Yale Journal of Biology and Medicine.
- Emotional alcohol relapse: The emotional phase of alcohol relapse is characterized by emotional and psychological withdrawal symptoms rather than physical withdrawal symptoms. During this precursor to relapse, you may become defensive about your recovery. You are also likely to experience dramatic mood swings, anger, anxiety, intolerance, and isolation. Poor eating habits and disrupted sleep patterns can ensue. At this early stage of relapse, you may stop engaging with treatment or peer support group meetings.
- Mental alcohol relapse: This phase of alcohol relapse often involves a fierce internal battle. You may start reminiscing about the time you spent drinking alcohol. You may downplay all the adverse consequences that sent you in search of addiction treatment, at the same time glamorizing the experience. Some people undergoing mental relapse start thinking about the idea of drinking again, while others actively plan a return to alcohol.
- Physical alcohol relapse: When physical relapse occurs, some people rapidly realize the mistake they have made, correcting it and re-engaging with recovery. For others, relapse means months burdened by alcoholism once more followed by the need to detox again and start recovery from scratch.
Causes of Alcohol Relapse
There is no universal reason explaining why people in recovery from alcoholism relapse.
Alcoholism, like drug addiction, was once viewed as a moral failing or a sign of weakness. The disease model of addiction currently prevails, with researchers understanding that the abuse of addictive substances triggers structural and functional brain changes.
Untreated, though, alcoholism can become life-threatening.
Once someone is on the road to recovery, many different elements can trigger relapse.
Alcohol Relapse Triggers
The following can all trigger relapse into alcoholism:
- Withdrawal symptoms
- Troubling emotions
- Peer pressure
- Testing limits and self-control
If you develop a physical dependence on alcohol, your body and mind will crave the substance during withdrawal and detox.
Alcohol detox brings about the following adverse withdrawal symptoms:
- Extreme fatigue
Some symptoms of alcohol withdrawal can be intense, sometimes driving the individual detoxing to relapse to alleviate these symptoms of alcohol withdrawal.
Many people abuse alcohol in an attempt to self-medicate life’s everyday stressors. When alcohol is removed from the equation and the stress remains, those in recovery without robust and healthy coping mechanisms may end up relapsing when the going gets tough.
Many people in recovery find social situations with alcohol present to be extremely challenging.
Others find themselves becoming more isolated if they fail to replace drinking buddies with a sober network.
To minimize your chances of being triggered to relapse by peer pressure, stay away from tempting environments like bars until you feel confident in your recovery and confident in your ability to say no to alcohol.
Testing limits and self-control
If you feel your recovery is going so well that you can test your limits by having “just one drink”, ask yourself how well that went for you in the past.
Alcohol use disorder is characterized by a compulsive desire to drink, making it futile for anyone addicted to alcohol to try to moderate consumption. It may work in the short-term, but will almost certainly lead to relapse.
What To Do When an Alcoholic Relapses
If you find your recovery is suddenly derailed by relapse, what can you do to get back on track? It’s important to know what to do when an alcoholic relapses.
Firstly, accept that relapse is often a part of the recovery process. Resist any feelings of guilt or shame, and double down on your sobriety rather than slipping back into active alcoholism.
You should reach out to your loved ones, allaying their concerns about this roadblock and getting the help you need to recalibrate.
Take this opportunity to connect with your sober network, whether that is a counselor, a recovery coach, a psychologist, or a sponsor, meet face-to-face with someone you can speak with openly about your relapse and its implications for your recovery.
Whatever stage of your recovery journey you are at, always remain vigilant for the possibility of relapse. If it occurs, how you handle it could mean the difference between months more of chaos and a rapid return to sobriety with renewed focus.