“Let us not look back in anger or forward in fear, but around in awareness.” – James Thurber
According to the National Institute on Drug Abuse, “Relapse rates … for people with addiction and other substance use disorders are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components.” And while these relapse statistics appear dishearteningly high, they do not imply that treatment has failed. Rather, they serve as indicators that key components of long-term sobriety are amiss in an addict’s treatment and/or aftercare plan.
Whether you or a loved one has a history of addiction, familiarizing yourself with these ten signs of an impending relapse can signal a need for immediate changes in the recovery regime.
You Abandon Your Social Supports
You Revert to Your Previous Behaviors
You Discontinue Your Mindfulness Routine
You Romanticize Your Drug and/or Alcohol Days
You Withdraw from Healthy Hobbies and Recreational Outlets
You Fail to Address Stressors As They Surface
You Reach Out to Friends from Your Substance Abuse Day
You Begin To Tell Yourself That You Can Moderate Your Use
You Lose Hope That Sobriety Can Be Long-Term
You Have a Slip-Up
In his book Chasing the Scream, author Johann Hari states, “ [T]he opposite of addiction isn’t sobriety; it is connection.” And, indeed, there is mounting evidence that supports this assertion. The individualistic nature of Western culture carries an undercurrent of loneliness and isolation. Recovery programs emphasize the importance of establishing a healthy, sober support system and nurturing it continually. Be it a traditional 12-step group, a secular organization, a digital support community, or simply a group of like-minded individuals who participate in healthy activities–diminished participation is a red flag.
In addition to social isolation, addiction is also associated with volatility, mood swings, increased risk taking behaviors, and dishonesty. When these behaviors emerge following a period of improvement, it is often an indicator that the emotional aspects of treatment are not being attended to adequately. “Dry Drunk Syndrome” is a common term in alcohol recovery programs and refers to those participants that are abstaining from drinking, but are failing to embrace the psychological and social implications of treatment. As a result, behaviors and attitudes mirror those that were exhibited while the addict was actively using.
As treatment programs grow more individualized, a greater emphasis is being placed on the mind/body connection. Elements like meditation, yoga, and journaling are often incorporated in the treatment planning process. Many addicts struggle to reconcile past behaviors, and a mindfulness routine reinforces the importance of living more fully in the present. When a recovering addict discontinues these healthy practices, it can quickly lead to previous patterns of self-medication and numbing.
An important piece of treatment involves shifts to the addict’s internal dialogue. After years of drug or alcohol abuse, many addicts establish a belief system that not only justifies their unhealthy behaviors. For drug and alcohol abusers, however, the physical and emotional toll has long since outweighed any of the perceived social benefits of using. Relapse often occurs when a recovering addict allows those romantic misperceptions to resume.
In recovery, addicts not only reintroduce previous passions and hobbies, but often explore new ones. Activities that were once “off the table” because of the physical and emotional toll of drug or alcohol abuse are suddenly viable. Oftentimes, it’s participation in these hobbies that lead addicts to form some of their most meaningful social connections. Withdrawing from these healthy outlets often indicates a shift toward potential relapse.
Comprehensive treatment programs heavily emphasize coping skills. The majority of addicts will site drug and alcohol use as a means of escaping or numbing negative feelings like anxiety and sadness. In recovery, addicts are exposed to countless healthy strategies that address (rather than mask) these types of feelings. Everything from breathing techniques to cognitive/behavioral interventions are introduced in the treatment process. When an addict abandons these techniques, she may be tempted to resume her previous means of coping.
In general, people seek peer groups comprised of like-minded individuals. Similarly, addicts gravitate toward other addicts or others that use. Not only do these associations enable the unhealthy behaviors to continue, but also provide judgement-free access to drugs and alcohol. Treatment professionals encourage addicts to eliminate these connections and to replace them with healthier peer groups. Whether an addict is pondering using again or simply growing complacent in their recovery, reaching out to past negative influences can quickly lead to relapse.
“One drink won’t hurt,” is an internal message that alcoholics often employ. After a period of successful abstinence, many addicts begin to question whether they ever truly had a problem. Perhaps, they had simply strayed into some unhealthy habits or were leaning on substances due to a lack of healthy coping skills. Regardless of the source, these thoughts of future moderation can prove quite damaging and lead many down the road to relapse.
Recovery is challenging and carries its fair share of ups and downs. Without adequate supports in place, the process can be overwhelming. When an addict fails to take advantage of available social and emotional support, they are at risk for feelings of depression or hopelessness. And when challenges like divorce, financial strain, illness, or death arise – the prospect of numbing with drugs and alcohol can prove quite alluring. Again – human connection becomes key and can play a large role in preventing a relapse triggered by negative life events.
Many addicts mistake slip-ups for relapses. And once that first drink or pill is swallowed, defeatist thoughts like, I’ve lost my sobriety streak so I should keep using take hold. While slip-ups do indicate the need for immediate attention, they are often reflective of a one-time lapse in judgement. The addict regrets the decision and is able to resume recovery immediately.
However, these instances lead some recovering substance abusers to feel like they are “back at square one.” It’s important that the addict realize that the coping strategies and supports established prior to the slip-up are still accessible and that a full relapse occurs only when the pattern of previous behaviors is resumed.
If you note any of the above relapse indicators in yourself or a loved one, please reach out. Your sobriety is hard-won and you deserve to maintain it.
Jen Anderson is a Licensed Clinical Social Worker (LCSW), Sobriety Coach, and former alcohol enthusiast living in Florida with her husband and son.