Understanding Relapse in Substance Abuse Recovery
Relapse is often part of the journey to recovery from substance abuse. Step 1 in the Alcoholics Anonymous (AA) 12-Step program is a huge and often not a slam dunk. Getting to the point of admitting complete powerlessness over alcohol or drugs is a process that, for some, continues into early attempts at recovery.
In AA, there is a concept called “hitting bottom” that describes reaching a point of profound personal and emotional low due to alcoholism. Another way to look at hitting bottom is when we run out of excuses and are unable to further rationalize that we are not an alcoholic. Some individuals have not reached their true bottom when entering recovery and need additional experiences to come to terms with their disease.
The Stoics acknowledged that mistakes are part of being human. Marcus Aurelius often reminded himself that people, including us and others, are fallible by nature. He encouraged viewing mistakes with a balanced, understanding perspective rather than harsh judgment.
In Chapter 3 of the AA Big Book, we are told: “We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself. Step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long to decide if you are honest about it.” As you can see, even in early AA understood it is a process to accept and admit one’s powerlessness.
While relapse can feel like a setback, it’s essential to view it as a learning opportunity and a chance to strengthen one’s commitment to sobriety if one returns to the program. Unfortunately, not all do return and end.
Stoicism teaches us to see every mistake as an opportunity for growth. Seneca wrote, “Errare humanum est,” meaning, “To err is human.” Instead of dwelling on errors, he advised reflecting on what led to the mistake and moving forward with renewed insight and clarity.
In this first of two part on this topic, we will cover the different aspects of relapsing, including warning signs, what to do when we see these signs, and what steps to take if we need to start over in recovery. We’ll also explore other relevant topics to help you or your loved ones navigate the recovery process.
What is Relapse?
Relapse occurs when a person who is in recovery from substance abuse returns to using drugs or alcohol after a period of sobriety. Going back to drinking or drugging is not a premeditated action for most people I have interacted with over the years. There are as many reasons to drink as there are people, but it is usually a personal trigger; the individual has not entirely accepted their powerlessness or maybe sobriety and simply lost priority in their life, which drives one to relapse.
It can happen to anyone, and this is a big drive for focusing on one day at a time in AA. All we have today is to work on our program daily to protect our sobriety. Many alcoholics accept the fact that without their sobriety, nothing else good tends to happen in their lives.
One thing I have heard many times is that a stint of sobriety will ruin one’s drinking in the future. Knowing that there is a different way to live, via recovery, can become a significant motivator for those who return to drinking and see the same patterns of destruction repeating.
Again, this is a process; some individuals need these experiences to break down any lingering denial. Understanding relapse and knowing how to respond to it can make a significant difference in maintaining long-term sobriety.
Warning Signs of Relapse
Relapse often follows a series of warning signs. Recognizing these signs can help prevent a full-blown relapse. Here are some common warning signs:
Mood Swings: Sudden mood changes can indicate underlying issues we must address. Severe mood swings from happy to sad may be expected in early recovery as we adapt to sobriety, but they tend to lessen the longer we stay sober and the more effort we put into working the 12-steps. It is essential to do a regular inventory of one’s actions so we can catch this warning sign early.
Isolation: Avoiding friends, family, and 12-Step support groups can be a considerable sign of impending relapse and might be one of the more accessible signs to recognize. A big red flag should fly if we regularly make excuses to avoid people and prefer to stay at home or engage in solo activities. Of course, we do not need to always be with people; alone time is cherished by many, but regularly and purposefully avoiding people is not good.
Negative Thinking: Frequent negative thoughts about oneself or the recovery process. These can be very subtle, as many of us have a long history of negative thinking and self-talk. Chapter 4 of the Big Book reinforces the following: “Remember that we deal with alcohol—cunning, baffling, powerful! Without Help, it is too much for us.” Through negative thinking, our ego and disease are happy to help us rationalize that a drink won’t hurt anything.
Anxiety and Stress: Increased feelings of anxiety or stress without apparent causes are a big concern and are often at the root of the emotional changes and thinking that can drive one to relapse. Experiencing these feelings is often an opportunity to dig deeper into working the program and figuring out how to live life on life’s terms.
Here is also a key area to practice what the stoics call Dichotomy of Control. The Stoic concept of the “dichotomy of control” refers to the idea that life consists of things we can control and things we cannot. This principle, discussed by the Stoic philosopher Epictetus, encourages us to focus only on what is within our power—our thoughts, actions, attitudes, and reactions.
Things outside our control, such as the actions of others, the outcomes of events, or natural occurrences, should be accepted as they are, without resistance. The Serenity Prayer embraces this same concept. Putting this into practice in our lives can help significantly reduce stress.
Return to Old Habits: Engaging in common behaviors during active substance use. Many of us “ritualized” our drinking by always drinking with the same people, drinking only in certain places, and doing bar crawls around our area. If we find ourselves leaning back into those rituals, it is a red flag that our disease may be creeping up on us. It can be as subtle as telling ourselves we are just going on a walk but happen to take the same path as our bar crawls once did.
Cravings: Strong urges or thoughts about using the substance again. We might find ourselves with nostalgic thoughts or otherwise distracted by thoughts of drinking throughout our day. Or we may be having recurring relapse dreams that get us thinking of drinking. However, these thoughts present themselves and are signs that we may want to double down on our recovery activities.
Glamorizing Past Use: Reminiscing about the good times associated with drinking can be an easy thing to fall into, especially if we are sharing “war stories” that are about the good times vs the bad times. Having these thoughts opens the door to our ego and disease to start rationalizing that it wasn’t all that bad, and maybe we take a shot at recreating some good times.
Lying: Being dishonest with oneself or others about thoughts and behaviors. I have not met a fellow traveler who said they never lied during their periods of substance abuse. Whether they were white lies or big lies, we have been dishonest. As we get into our recovery and work on our shortcomings, we become much more honest with ourselves and others. If we find ourselves slipping lies back into our behavior, we want to recognize this as a sign that something is incorrect.
Planning to drink: Making plans to obtain alcohol and drink again can be dangerous thinking. Our disease needs very little firm ground to gain traction. We might rationalize that just thinking about what we might do is harmless. The reality is that thought often leads to action that can end our sobriety.
The following parable is attributed to Native American Wisdom but may have other origins. It is one of my favorites and applies to this planning and many different signals.
In the story, a grandfather explains to his grandchild that two wolves are constantly fighting within each person. One wolf represents negative emotions like anger, envy, greed, and resentment, while the other embodies positive qualities such as love, kindness, compassion, and peace. The child, curious about which wolf will ultimately win, asks, “Which one wins?” The grandfather replies, “The one you feed.” That story contains powerful wisdom.
Conclusion
In conclusion, understanding relapse as part of the recovery journey helps to remove the stigma often associated with it and allows individuals to approach their sobriety with compassion, humility, resilience, and a readiness to learn. Relapse is not a failure but rather a moment to reassess priorities, recognize warning signs, and deepen one’s commitment to sobriety.
By integrating Stoic principles, such as the dichotomy of control, individuals can develop the emotional tools necessary to confront and navigate the challenges of recovery. Every setback can be reframed as a stepping stone toward greater self-awareness and growth, fortifying one’s path in sobriety. Embracing this perspective fosters resilience, helping each person on this journey move forward with renewed clarity and resolve.
Remember, recovery is a process, not a destination—every day is an opportunity to build a stronger, healthier foundation.
Resources:
How to Create a Successful Relapse Prevention Plan – The Recovery Village
Preventing Relapse – Hazelden Betty Ford
Written By Tony Harte
