By Patrick O’Neil
The term relapse, simply put, means “to slip or fall back into a former worse state.” With that in mind it’s safe to say that no one relapses into a better state. Although some addicts and alcoholics that relapse will tell you they are happier to be back in their addiction. Only if that were true, then why did they seek help in the first place? No one that is recreationally using drugs and alcohol suddenly thinks, “I’m in trouble, I should get help,” if their addiction isn’t detrimentally damaging to themselves or those around them. When the addict and alcoholic honestly admits that they are powerless over alcohol, and that their lives had become unmanageable, they are literally taking the first step to getting sober.
But just admitting they’re powerless won’t keep the addict or alcoholic sober. Getting and staying sober isn’t easy. Addiction treatment requires hard work. Addicts and alcoholics have to become rigorously honest, admitting that they’re addicted, and accepting and surrendering to the idea that their way isn’t working. As it says in the Big Book of Alcoholics Anonymous, “Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves”—and that’s where relapse comes in.
According to addiction researcher and author Dr. Steven Melemis there are three stages to relapse:
By using Dr. Melemis’ stages it’s apparent that the actual relapse of using happens way before the addict picks up a drug or the alcoholic gets drunk. So one would think that the behaviors that lead up to a relapse would be fairly easy to recognize. But that isn’t always so. Here are few of the issues that addicts and alcoholics have historically struggled with regarding honesty in their recovery.
Working A Program: Some addicts that have relapsed have been known to say, “I did everything my sponsor told me to do, but I still relapsed”—as if just going through the motions without really putting in the work would keep them sober. Unfortunately an addict can go to all the meetings that are available but if they don’t talk about the negative stuff going on in their head, tell their support system they have thoughts of using, continue to carry resentments, or engage in the same unhealthy behaviors as when they were using drugs and drinking—then it doesn’t matter how many steps they do, or how many meetings they attend—they’re not being honest in their recovery. Addicts and alcoholics that thoroughly immerse themselves into their program of recovery, are honest with their sponsor, and talk about their cravings at meetings, don’t just suddenly relapse.
Resentments: Looking good in recovery isn’t a requirement. In fact it’s not even listed in any program’s literature. Sometimes the addict has to let their defenses down and kick their ego to the curb. If they’re afraid of what others think of them, worried about being liked, and angry if they’re unnoticed—then maybe that’s a sign they need to put in the needed internal work and find some forgiveness and acceptance. Blaming others for everything is old behavior. If the addict wants to stay sober then they have to admit that people, places, and things are not the problem. The problem is how they respond to them. As the actor and writer Malachy McCourt once said, “Resentment is like taking poison and waiting for the other person to die.”
Self-Sabotage: There are addicts and alcoholics in treatment that resist every suggestion and opportunity that could help them to get recovery and stay sober. Many of them say they resent the god in the AA program, but when presented with the alternative; find a support group, start a spiritual practice, see a therapist, and be of service to others—they do nothing and expect to stay sober by just not drinking. With this type of thinking they’ve probably relapse numerous times, but that doesn’t stop them from refusing to put in the needed work. The definition of insanity is doing the same thing over and over again and expecting different results. But self-sabotage isn’t insanity, it’s the alcoholic not being honest, with themselves and others, and admitting that the real reason they’re not engaging in recovery is that they really just want to go drink.
Cross Addiction: When an addict replaces one addiction with another then they are cross-addicted. There are heroin addicts that stop using but now are alcoholics. Meth addicts who are fearful of gaining weight and become anorexic. People who are sober are suddenly shopaholics, sex addicts, gamblers, workaholics, or they abuse prescription drugs because a doctor prescribed them and the pills aren’t their drug of choice. They tell themselves that this is better than using but its really just substituting one substance for another. They don’t consider it a relapse but eventually that substance or behavior will become just as problematic as the original addiction.
Becoming Complacent: Perhaps the biggest factor for relapse is the addict and alcoholic becoming complacent in their program. Their lives become better and they start putting more effort and time into their work, or a relationship, or any other activity besides recovery. Eventually they stop calling their sponsor. When they lose a sponsor they don’t bother to get a new one. They stop going to meetings. The next thing they’re doing is visiting a friend that is in their active addiction just to say hello. It’s not that they want to relapse, it’s just that they stop doing everything that has kept them sober, and now they’re defenseless to their addiction.
“Addiction requires lying,” says Dr. Melemis. “Addicts must lie about getting their drug, hiding the drug, denying the consequences, and planning their next relapse. Eventually, addicted individuals end up lying to themselves. Clinical experience shows that when [addicts] feel they cannot be completely honest, it is a sign of emotional relapse. It is often said that recovering individuals are as sick as their secrets. When people don’t understand relapse prevention, they think it involves saying no just before they are about to use. But that is the final and most difficult stage to stop, which is why people relapse. If an individual remains in mental relapse long enough without the necessary coping skills, clinical experience has shown they are more likely to turn to drugs or alcohol just to escape their turmoil.”