Keeping the Rough Course: Chronic Relapse and The Need To Keep Moving Forward

The great absurdist comedian Mitch Hedberg has a line where he says “Alcoholism is a disease, but it’s the only one you can get yelled at for having.” Like all great jokes, there is a lot of truth in this. We all know that the person suffering from alcohol or drug addiction isn’t doing it on purpose, but because we see it as a behavioral issue, society too often tends to blame them. We don’t usually come down hard on the cancer patient for their lifestyle choices, or blame someone with Alzheimer’s for their condition. But substance abuse seems to be in its own category.

This is even more the case when the sufferer gets treatment, and then relapses. Chronic relapse is seen not as a sign of advanced problems, but of moral weakness. It is unfair, insulting, and entirely counterproductive. The science behind relapse is established, and society’s attitude needs to catch up.

Why Relapse Happens


We’ve talked before about the science behind addiction. Substances like drugs or alcohol provide a dopamine stimulus to the limbic system of your brain, essentially giving it a pleasurable reward. The brain grows to crave this. Its chemistry is altered, and starts to demand more and more to get the same satisfaction. Whereas before a couple of drinks could do it, the addicted brain wants several, and then many. No other positive stimulus compares. The brain demands the substance to which it is addicted, and the crashing lows when it doesn’t get it can be unbearable.

That’s the key to understanding this: the chemistry of your brain is altered, in the same way that the physical nature of your body is altered if you have any other disease. The process of recovery is not just to retrain your brain, but to allow you the ability to handle the pressure and the need that comes with altered chemistry. That isn’t always a smooth process, and it’s understandable, then, when the person suffers a relapse. The need is just too strong, because the chemistry is just too altered.

It’s here that people tend to start judging, even though it is unfair. 70-90% of addicts suffer at least one relapse, with many suffering multiple ones. This is actually normal when compared to other diseases–think of cancer being in remission and then coming back. Indeed, the rate of relapse for addiction is very comparable to diseases like diabetes, hypertension, and asthma. You get better, you take a step back, and you keep moving forward. That’s what we mean when we say someone is fighting a disease.

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Overcoming the Stigma In Yourself and Others


As Mitch Hedberg said, very few people get yelled at for something like asthma. But for an addict suffering from chronic relapse, the sense of shame can be overwhelming. It can come at them from others, who think they are helping. It comes from inside the addict–that feeling of hopelessness, of despair, and of not having any answers for these feelings except what caused them in the first place–the temporary soothing numb of the high. The issue is that the need for the substance, for the short-term drug-induced relief, overwhelms the cognitive recognition of long-term benefits of sobriety. So they take a step backwards.

Each step backwards can push them further and further into this spiral, especially if they are met with a lack of understanding from outside. When you believe you are wrong, and other people are telling you you’re a failure, that becomes the default mode. Expectations are erased, allowing old and bad habits to flood back in. This is a terrible and destructive way to look at it. When someone doesn’t react well to a specific treatment for cancer, we don’t tell them that they need to straighten up and accept that this is the only treatment, so it better start working. We try to find another. That acceptance of the process too often doesn’t happen with addiction.

That needs to be overcome. Treatment from a compassionate staff of licensed professionals in a residential rehab clinic might be just the step you need. If outpatient programs or support groups weren’t enough, don’t give up. Alta Mira offers an intensive, comprehensive 90-day treatment program that can give you the time and the focus to overcome your addiction once and for all. We also provide continued care once you leave, to support you in your journey, and keep you from the relapse spiral. Understanding that you have a disease, and that the cure to it lies both within you and in other people, can help pull you up again. The only yelling should be shouts of joy.