Relapse is the number one problem that drug addicts and alcoholics face in the early years of their struggle for long term recovery. This phenomenon is baffling not only to addicts and alcoholics themselves, but to their family and friends as well. When they are clean and sober their lives improve physically, mentally, emotionally, and financially. It is tragic to watch it crumble when they pick up or drink again. The haunting question is this: Why does it happen?
For those not in the field of addiction, the answer has historically been that the sufferer has some type of character deficiency; a lack of self control, low moral standards and/or not loving the family enough to stay clean and sober. Although these characteristics are present in most addicts and alcoholics to some degree, they actually play a very small role in relapse. The major causes of relapse are physical, mental, emotional and behavioral complications that surface after the detoxification process and the initial period of treatment have been completed.
Physical Components of Relapse
When a person stops using drugs or drinking alcohol, the body goes into withdrawal. This can be extremely uncomfortable. Withdrawal symptoms can include but are not limited to: sweating, shaking, dehydration, seizures, fever, stomach pain, muscle cramps, chills, disorientation, and hallucinations. These symptoms can be so bad that the person drinks or uses drugs again to stop them, which puts the person right back where they started.
The physical discomfort of withdrawal can be eased by medical detoxification. This procedure reduces the discomfort and allows the person to get the majority of the substances out of their system. What is not common knowledge is that it can take as much as 3 - 6 months (and in some cases a number of years) for all of the substances to be flushed from the body through its natural cleansing process. As the substances are exiting the organs and intramuscular hiding places, they trigger a physical craving for the substance. This is called Post Acute Withdrawal Syndrome (P.A.W.S.), and is one of the primary contributors to and causes of relapse.
Mental Components of Relapse
After years of use and abuse, the brain has taken a beating, and the thought processes of the addict or alcoholic have become severely compromised. It can take up to 18 - 24 months for the neurotransmitters to stabilize and the brain to have normal functioning. Short term memory loss, inability to handle stress, poor judgment and depression are just a few of the mental side effects of long term substance abuse.
The way alcoholics and addicts think about things is difficult for the average person to understand. The fact that their lives have been damaged by their drinking and using seems to elude them. Common sense and good decision making do not exist; spending their paycheck on drugs or alcohol instead of paying the rent actually makes sense to the addict or alcoholic.
Emotional Components of Relapse
Alcoholics and Addicts generally have extreme difficulty processing and coping with strong emotions of any kind. They have developed over time a set of emotional reactions to everyday events that are filled with feelings of insecurity, resentment, fear, hopelessness, helplessness and the like. They love to play the victim, and have difficulty taking responsibility for their actions.
Most substance abusers have the emotional age and skills of a child or teenager, and their go-to coping mechanism is to pick up a drink or a drug. Therefore, it is not surprising that when these feelings surface, the first thing that the Addict or Alcoholic thinks about is picking up a drink or a drug to make the bad feelings go away.
Relapse can be precipitated by any strong emotion, and without an effective strategy for dealing with those emotions, the Addict or Alcoholic is vulnerable to it.
Behavioral Components of Relapse
Over the course of time, Alcoholics and Addicts develop behavior patterns that center around drinking and using. They tend to associate with people that are like them, and spend most of their leisure time drinking and using. Their work suffers; they are late, miss work, don't complete tasks, and are fired regularly for their inability to perform. They spend money that they don't have, and commonly put themselves in dire financial positions because they are buying alcohol and drugs instead of food.
The answer to the question is this: physical cravings that surface as a result of Post Acute Withdrawal Syndrome, combined with poor thinking and an inability to deal effectively with excessive emotions lead to the old behavior of drinking or using drugs to feel better. These elements, in combination or alone, are the cause of every relapse.
