Alcohol Addiction Relapse
Alcohol addiction relapse is not inevitable, but it is also not uncommon. Relapse is a part of recovery for many people struggling to stay sober. Relapses occur because of withdrawal, stressful situations, drinking triggers and cues, lack of positive support, poor coping mechanisms, and untreated or under-treated mental illness. Relapse is much more common in people who do not seek professional support for treatment. Engaging in long-term treatment with a focus on developing and practicing relapse prevention skills and treating underlying co-occurring disorders are important ways to prevent or minimize drinking relapses.
Relapse is often considered a necessary part of treatment for alcohol addiction, but the goal of treatment is always to avoid this outcome. Treatment is considered effective when a person can successfully avoid drinking again. Unfortunately, though, alcohol addiction is a chronic disease, and that means relapsing does happen for many people.
There are known risk factors and contributing causes for alcohol relapse, such as activating triggers, stress, withdrawal, and others. Knowing what causes relapse and having strategies to eliminate or minimize those causes increases the chance that an individual will be able to remain sober and have fewer or no relapses. Very important to this process is a good treatment plan led by experienced professionals with a focus on relapse prevention.
What Is Relapse?
Relapse is a term used in addiction to describe when a person who has been abstaining from drugs or alcohol for a period of time, who is in remission, begins drinking and/or using again. Even if it is just one drink, if that person was sober and had been abstaining from alcohol for any period of time, it is considered a relapse. The term can also be used to describe other behaviors and health conditions. For instance, someone managing hypertension who experiences high blood pressure can be said to have had a relapse of their chronic condition.
For drug and alcohol addiction, relapse can be a part of the recovery process. Although maintaining abstinence and avoiding relapse is a goal of treatment, experiencing one or more such events is not uncommon. It is important to try to avoid relapsing for the sake of staying sober but also for safety. Relapsing can be dangerous, as it may lead to a binge and a harmful or even life-threatening overdose.
Addiction to alcohol or drugs is considered to be a chronic illness, and with any chronic illness relapse is a possibility. The longer a person commits to professional treatment and ongoing commitment to sobriety, the less likely he or she is to relapse.
- A study that followed more than 1,100 people struggling with addiction for eight years found that only one-third of those that stayed sober for less than one year remained sober for the duration of the study. This means that two-thirds relapsed.
- The same study found that when people were able to stay sober for a year, less than half of them experienced a later relapse.
- For those who made it to five years of sobriety, only 15 percent relapsed.
- The longer a person can maintain sobriety, the less likely they are to relapse in the future.
- Relapse rates for addiction are similar to those for chronic physical conditions, including asthma and type I diabetes.
Factors that Cause Alcohol Addiction Relapse
Relapse can occur for a number of reasons that may vary by individual, but there are some common factors that make it more likely. For instance, anyone trying to get sober without professional assistance or even support from family and friends is facing a long uphill battle and is much more likely to experience relapses after periods of remission. Here are some other factors that cause or contribute to drinking relapses:
- Withdrawal is a very common and immediate trigger for relapse. When someone addicted to alcohol stops drinking they experience unpleasant symptoms that can easily lead to a relapse just to get relief.
- Anxiety and stress related to withdrawal has been studied in people trying to abstain from alcohol. A heightened stress response may be triggered by changes to the brain caused by heavy and prolonged drinking, and it has been found to be an important factor in relapse.
- Exposure to alcohol is an important contributor to relapse. Addiction conditions the brain to see alcohol as a cue to drink more. Seeing, smelling, or tasting a small amount can lead to a relapse for this reason.
- Individual triggers also act as cues that lead to relapse. These could include a certain friend, a specific bar, or even an emotion or feeling that cues the drinking behavior.
- Going through multiple cycles of remission, withdrawal, and relapse actually makes a person more susceptible to relapsing again, proving what a terrible cycle addiction is.
- Experiencing stressful life situations or having symptoms or flare-ups of a mental illness can provoke a relapse or contribute to a tendency to start drinking again.
Integrated Treatment for Alcoholism & Co‑Occurring Disorders
Relapse prevention is a strategy and a component of alcohol addiction treatment. Knowing the facts about relapse and how common it is, including specific strategies to actively try to prevent, it is a crucial part of overall treatment as well as ongoing treatment after a period of intense care in a rehab facility. Relapse prevention is so important to long-term effectiveness that it is often considered a treatment model in itself, with much of treatment revolving around this one goal. There are a number of important strategies used in relapse prevention:
- Identifying an individual’s triggers for drinking
- Planning how to best avoid triggers
- Learning to recognize and be aware of the signs that a relapse may be coming, and practicing strategies to head it off
- Learning healthy coping mechanisms for when encountering a trigger or when a high-risk situation is unavoidable
- Improving a person’s attitude and belief in his or her ability to succeed at preventing relapse, or in other words building self-confidence
- Developing an overall healthy lifestyle with changes that minimize the risk of relapsing, including Learning and using stress-management techniques for coping with stressful situations and negative emotions
- Learning and practicing techniques for managing the urge to drink
- Developing and cultivating healthy new hobbies and activities to replace drinking
- Making a concrete plan for what to do if a relapse occurs
- Putting the relapse plan into action when needed
- Planning for treatment and support after a stay in a residential treatment facility
- Participating in support groups and relying on friends and family for support
- Instituting positive rewards for resisting cravings and preventing relapses successfully
Managing Co-Occurring Disorders to Prevent Alcohol Relapse
Co-occurring disorders refers to when a person has both a mental illness and a substance use disorder. This is not uncommon because of several reasons: substance abuse and mental illness have risk factors in common; an underlying mental illness can trigger drinking or drug use as a coping mechanism or a way to self-medicate; and excessive drinking or drug use can trigger or worsen symptoms of mental illness.
One important factor in effectively treating any type of addiction is to address any co-occurring disorders. When underlying mental illnesses are not addressed, a patient is at risk for repeating unhealthy behaviors to cope, including drinking or using drugs. Being screened for, treating, and managing mental illness over the long-term is one of the best things anyone can do to prevent or reduce the risk of relapsing.
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Treatment Is the Key to Preventing Relapse
By far the most important factor in preventing relapses, or cycles of abstinence and drinking, is to engage in long-term, effective alcohol rehab and treatment. People who struggle with alcohol use disorder and go through a treatment program are much more likely to avoid relapsing than those who try to quit using alcohol independently. Treatment by professionals, including therapy, support groups, medications if appropriate, and other strategies, gives a patient access to a wealth of knowledge and experience that can guide them to successful recovery.