Relapse & Its Prevention
Alcoholism has so influenced our thinking about addiction that most other addicts assume they have to come up with some equivalent of the ﬁrst drink to identify relapse. Since alcohol is not necessary for survival, even a single drink of it indicates that relapse has progressed to the danger point. Actually, this line of thinking has limitations even for alcoholics, because an alcoholic who focuses only on not taking the ﬁrst drink will not experience the joy and freedom of recovery, and is constantly in peril.
Stages of Relapse
Rather than looking at relapse as an event, we can separate relapse into three stages. This tends to shape our thinking more in the direction of a process. These stages can be called lapse, relapse, and collapse.
If the early signs of relapse are not heeded, relapse will come along in short order. Some examples of a lapse might be (depending on your concept of sobriety or abstinence or moderation and your Program):
- Alcoholics and drug addicts: Reestablishing relationships with drinking or using buddies, or increased frequenting of drinking or drug-oriented events or environments.
- Eating addicts: Eating a meal that was really too large, but not really a binge, skipping a meal, or eating a food not normally included in your food plan. If you are underweight, ignoring a signiﬁcant weight loss; for others, taking no action in response to a gain of more than a few pounds, or overreacting to a weight gain.
- Compulsive gambler: You ﬁnd yourself picking up the phone and dialing your bookie’s number, or looking at the racing forms.
- Sex addict: Wandering into the adult section of the video store or ﬁnding yourself with an explicit magazine in your hands.
- Excitement addict: Finding yourself beginning to take risks that others might consider unusual or unnecessary. Failure to talk over a potentially exciting event or enterprise with a sponsor or others in the Program.
- Any addict: Going longer than about a week without a Twelve-Step group meeting, without having a very good reason, and perhaps not doing anything to compensate for that (like calling others, meeting online, or reading literature).
- Overall: Obsessive or compulsive behavior about alcohol, drugs, body image, eating, weight, or other signs of the physical, emotional, mental, or spiritual aspects of the addiction.
Recovery has suffered a signiﬁcant setback, and immediate action is required to get back on track. This is what many would consider breaking sobriety or abstinence. Again, the speciﬁc determination of which of these might be lapse or relapse depends on your own ideas; these are simply examples that you might include as relapse rather than lapse:
- Alcoholics: Taking a drink.
- Nicotine addicts: Smoking a cigarette.
- Compulsive gamblers: Placing a bet or entering a game for money.
- Drug addicts: Talking a physician into prescribing a moodiﬁer (mood-altering drug) that is not clearly necessary. ° Eating addicts: Eating between meals (not including a planned snack or “metabolic adjustment” if allowed on your eating plan). Eating a quantity of food that clearly cannot be called a moderate meal, whether it is overeating or undereating. Eating a signiﬁcant quantity of a food you know is a sensitivity for you and you have speciﬁcally excluded from your food plan, like sugary desserts. A purge, like vomiting or laxative use. This does not include legitimate illness or medical necessity.
- Compulsive spenders: Purchasing something you do not need, you have vowed not to buy, and you know is an emotional purchase.
- Sex addict: Buying a pornographic magazine or having “casual sex” with a stranger or acquaintance.
The disease has become ﬁrmly entrenched and the whole process of recovery, from detox through early recovery must begin again as quickly as possible. This happens when lapses become relapses, and relapses do not result in immediately getting back into recovery. This may include:
- Alcoholism: Drinking continues and gets worse. Legal or medical consequences return or increase.
- Eating addicts: Binges that go on for days, weeks, months, or years. Return to regular purging, starving, dieting, or excessive exercise.
- Compulsive spending: Spending binges result in severe ﬁnancial problems, shoplifting, or other advanced consequences of the addiction.
- Compulsive gambling: Active involvement in gambling, borrowing, deceit, and shame and guilt.
- Sex addict: The acting-out cycle of compulsive sexual behavior that is beyond your control continues.
- All addicts: Suspension of all, or most, recovery efforts, perhaps with avoiding Twelve-Step program friends. Lying and deceitful behavior, including lying about your recovery, or not talking openly about your relapse.
Reverse of Recovery
Relapse, like recovery, is a process, not an event. Remember that usually lapse gradually turns into relapse, and that relapse over time becomes collapse. It is far more important to stop the relapse process wherever you are, rather than to split hairs over whether a given development is a lapse, relapse, or collapse.
If you have any question about whether you have broken your addiction abstinence, we recommend that you avoid making that determination until after you reverse the relapse trend. Often, your sponsor and friends in the Twelve-Step programs can give you valuable input, and the ﬁnal determination can be between you and your Higher Power or Program.
Some warning signs you should look for might include:
- Increased obsession with the substance or behavior of your addiction
- A deﬁant attitude about your recovery plan
- Skipping or slacking off on meetings
- Decreased contact with others in the Program, especially your sponsor
- Increased contact with those who do not support your recovery
- Placing yourself in situations dangerous to your sobriety, abstinence, or moderation
- Rigid control, like dieting behavior
- Obsession with shortcomings, like weight or body shape
- Getting overextended in daily living
- Increased fear, anxiety, or hopelessness
- Reduced contact with your Higher Power or Program
- Increasing resentments toward others
- Isolating from everyone
- Care about yourself at least as much as you would someone you sponsor.
- Learn from your mistakes.
- Use your Higher Power or the Program.
Relapse prevention, see also: Abstinence, Aftercare, Anger, Assertiveness, Celebrations, Chronic pain, Control, Counseling, Craving, Crisis, Dichotomous thinking, Family, Feelings, Habit & structure, Halfway house, Honesty, Intervention, Moderation, Prayer & meditation, Premenstrual syndrome, Pregnancy, Priorities, Relaxation, Resentments, Sabotage of recovery, Sanity, Sex, Sleep, Slogans, Steps of AA, Stinking thinking, Tools of recovery, Willingness.
Updated 12 Sep 2015
Addictionary 2 by Jan & Judy Wilson
is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.