Recovering from alcohol abuse is not a linear process. Just like other chronic diseases, there might be periods of remission followed by a short lapse where the person might get back to using alcohol.
These periods are usually temporary and are followed by returning to the person’s treatment goals of staying off alcohol and maintaining sobriety.
If the lapsing period is prolonged or the person no longer has the intention to stay sober, they’re considered to be in alcohol relapse.
Although frequent alcohol consumption after a period of abstinence might jeopardize someone’s recovery from alcohol use disorder, some consider it an inevitable part of the recovery journey.
Here are some of the causes, stages, and symptoms of alcoholic relapse. We’ll also discuss relapse prevention methods used by mental health professionals working closely with substance abuse disorder patients.
Stages of Alcohol Relapse
Alcohol addiction treatment requires a considerable amount of effort, which means that relapse doesn’t come easily or suddenly to those who experience it.
It’s often said that relapse begins weeks or even months before the recovering person decides to forgo their sobriety and start drinking frequently again.
This happens because relapse occurs in three stages, which might overlap at first, but usually happen in the following order:
1. Emotional Relapse
Healthily dealing with emotions is one of the positive outcomes of any addiction treatment plan for alcohol or drug abuse. When recovering alcoholics start struggling with their emotional well-being, this can spell trouble for their sobriety.
The warning signs of emotional relapse include living in isolation, bottling up feelings, avoiding healthy outlets for negative emotions like stress, anger, and shame, and being in denial about real-life issues the person might be facing.
Having trouble with self-care and keeping up with daily tasks can also be a catalyst in creating the emotional backdrop for a relapse.
2. Mental Relapse
The brain of someone who lives with alcohol or drug addiction changes in many ways. Aside from the changes in the reward-seeking behavior centers, they might also have trouble recalling all the facets of their addiction days due to memory lapses.
Failing to remember the ugly sides of alcohol abuse could be the reason why many recovering alcoholics fondly reminisce on their alcoholic days in the mental stage of relapse.
Alongside alcohol cravings and emotional turmoil after a short lapse into alcohol use, this sets the stage for the next phase.
3. Physical Relapse
The final stage of relapse is returning to the frequent use of alcohol. It’s characterized by a lack of desire to stop drinking because it quiets the cravings and reignites the brain’s reward centers after a period of sobriety.
It can also be led by the belief that one’s alcohol use has spiraled out of control and can’t be stopped. Many people tend to think that once they’ve returned to the same volume of drinking they were used to before becoming sober there is no hope of recovery, which is untrue.
External Causes of Alcohol Addiction Relapse
Relapse doesn’t happen in a vacuum. Although intrinsic risk factors highly affect its likelihood, external issues can expedite the process and make the person fall into a relapse more deeply, quickly, or both.
These risk factors include, but aren’t limited to:
- Stress: Everyday life can be stressful, making escapism a necessary part of most people’s daily activities. However, in highly stressful circumstances, like the loss of a job or housing insecurity, some people break under the pressure and return to drinking instead of finding a healthy coping mechanism.
- Triggers: Exposure to a similar environment as the one where a person used to drink can trigger intense alcohol cravings for some people. This can include visiting the same places (bars, clubs, etc.), reconnecting with drinking companions, or even the sight, smell, and taste of alcoholic beverages.
The effect of triggers can be especially potent in the first stage of recovery.
- Conflict: Relationships can be messy, even without the negative effects of alcohol use. Getting into fights with significant others, family members, or even co-workers can push the person to drink alcohol to ease the stress and anxiety caused by the conflict.
- Peer Pressure: Some people choose to keep their struggle with alcohol use disorder private, which often means the people around them don’t know of their recovery journey or sobriety goals. This can lead to events where social drinking is encouraged, and can, unfortunately, cause relapse in certain cases.
- Poor Support Network: In other instances, the person recovering from alcohol abuse might be surrounded by people who don’t care or support their recovery journey. These cases are highly unfortunate, as most people in a fragile state fail to recognize the negative influence of their peers.
Support groups can also bring a sense of belonging, camaraderie, and accountability to other people who are also recovering from the same disease. If people pull away from these groups too early or fail to establish bonds with them, this can lead to isolation and loneliness that can lead to relapse.
Internal Factors That Put You at a Higher Risk of Relapse
Sometimes, unresolved personal struggles can lead a person down a path that makes it more difficult to remain sober. These internal risk factors include:
Undiagnosed Mental Illness
There’s a strong link between alcohol use disorder and mental health issues.
Mood disorders, like anxiety and depression, may encourage people to use alcohol to ease their symptoms due to its ability to “calm down” the brain’s frontal cortex.
People with post-traumatic stress disorder (PTSD), especially war veterans and survivors of abuse, are also at higher risk of using alcohol to self-medicate.
When someone goes through alcohol addiction recovery on their own without receiving proper mental healthcare, they’re more likely to relapse if the underlying cause for their drinking goes unaddressed.
Physical Pain
This factor is more prevalent in cases of drug addiction, especially opioid painkillers. That said, some people use alcohol to medicate acute physical pain after an injury or medical procedure, such as surgery, or chronic pain from back problems or other illnesses.
It’s important to note that using alcohol with opioids (prescription or otherwise) is incredibly dangerous, as it can cause respiratory and central nervous system (CNS) depression, which can lead to coma and death.
But that’s not all. There are other factors at play, including:
- Low Self-Efficacy: The belief in one’s ability to succeed at a certain task is called self-efficacy. Unfortunately, not everyone has this kind of trust in their own abilities, which leads to a self-fulfilling prophecy of failure.
- Being HALT (hungry, angry, lonely, or tired): 12-step programs coined this acronym to alert people to their most vulnerable states, which can lead to lapsing into alcohol use after sobriety.
- Boredom can also be added to the list as a potential internal risk factor, which stems from a lack of enriching activities that can kill time in a meaningful way.
Signs and Symptoms of Alcohol Relapse
If you’re suspecting someone you care about is heading toward alcoholic relapse, these are some of the warning signs you should look out for:
Denial About Pre-Recovery Days
Before someone gets back to drinking, they go through a period of negotiation between the sides of their personality that want to remain sober and the others that want to use alcohol again.
A huge sign that the latter side is winning the argument is that they start exhibiting signs of denial about how bad their problems were.
This can show in the form of fond reminiscence, underplaying their former state, or reconnecting with “old friends” who were part of their drinking days.
Missing Support Meetings
Peer support is a pillar of recovery from alcohol and other forms of addiction, whether it’s a 12-step program, like Alcoholics Anonymous, or a more evidence-based program, like SMART recovery.
These spaces offer a chance to connect with others who have the same goal, share experiences, and offer mutual support in a judgment-free environment.
If a person’s interest and investment in the attendance of meetings wanes with no direct reason, they might be distancing themselves from a source of accountability.
Once someone entertains thoughts of returning to alcohol use, they feel the need to hide this information for fear of appearing like a failure.
Stopping Alcohol Addiction Medication
Some addiction recovery programs offer medication-assisted treatment using prescription drugs like acamprosate, disulfiram, and naltrexone.
They have different mechanisms of action depending on which stage in alcohol recovery the person is going through, but they all aim to reduce the incentive to consume alcohol.
This can happen by either nullifying its euphoric effect or creating unpleasant symptoms whenever it’s consumed.
When someone abruptly stops taking their prescription medication without consulting a healthcare professional first, they might be considering getting back to drinking.
Self-Imposed Isolation
Creating a strong support network is one of the positive outcomes of proper alcohol addiction treatment. Family members, friends, neighbors, and coworkers can be a beneficial asset in navigating recovery and maintaining sobriety.
Pulling away from this support system can provide a cover of secrecy to relapsing individuals.
They might view any potential intervention as unwelcome interference with their personal choices, so they distance themselves from the people who might want them to stop.
Physical Signs of Alcohol Use
Lastly, if someone shows obvious signs of excessive alcohol consumption, like slurred speech, an unsteady gait, and a distinct smell of alcohol on their breath, they have obviously relapsed.
Keep in mind that a temporary lapse that doesn’t affect recovery outcomes usually involves 3 drinks in one setting or less than 7 drinks in one week. Any more than that, alongside signs of intoxication, is a red flag for a relapsing
Prevent Relapse into Alcoholism Today…
If you’re a recovering alcoholic facing a stressful life situation, it can be tempting to get back to drinking.
Creating a relapse prevention plan with a healthcare provider can be incredibly beneficial in keeping your recovery goals. It can include:
- Contact information for your support network
- Healthy coping mechanisms
- Therapy talking points to bring to a mental health professional for your next session.
Similarly, if you find out that a loved one has relapsed, then it’s important to intervene by asking for help from a trusted professional.
Curednation offers telemedicine services to people living with the chronic disease of addiction. Book an appointment today to discuss your recovery journey and sobriety maintenance plan.
Frequently Asked Questions
What is the Relapse Rate for Alcohol Dependence?
Alcohol dependence has one of the highest relapse rates at almost 70%. That’s mainly due to the cultural acceptance and ubiquity of alcohol, unlike other substances that are more controlled.
Is Relapse a Necessary Part of the Addiction Recovery Process?
While relapse is a normal part of addiction recovery, many people spend years in complete sobriety without relapsing, so it’s not necessary. That said, paying attention to what causes relapse can offer valuable insight into personal triggers and the quality of a person’s support network.
