Why Do Addicts Relapse When Things Are Good & Going Well?

Why would someone, who seems to be doing well with their recovery, start drinking again? This scenario often puzzles family and friends. Especially when they have witnessed a loved one successfully detox, maintain sobriety, and appear happy to reconnect with important aspects of their life.

Why begin drinking again when the link between alcohol and the consequences suffered are so clear? The answer is complex, illustrating how powerful the disease of addiction really is. What would motivate a person to relapse when recovery seems to be going well?

Here are 8 answers to why someone may reignite their addiction, even when recovery is going well.

1.  Medication to deter alcohol use may have helped prevent relapse.

For some, the extra support of prescribed medications can prevent relapse. Medications can be prescribed to discourage the physiological craving and use of alcohol. Medications, such as Disulfiram (approved by the FDA in 1951), are specifically prescribed to deter alcohol use and prevent relapse. Disulfiram, also known as Antabuse, blocks aldehyde dehydrogenase, an enzyme that helps metabolize alcohol. If an individual consumes even the smallest amount of alcohol while taking Disulfiram, they will feel sick with nausea, vomiting, cold chills, and sweat.

Medication is not a cure for alcoholism, but rather a deterrent. Knowing you may become sick to your stomach if you drink alcohol while on medication often prevents relapse.

2. Physical damage one’s body has endured due to drinking can lead to relapse.

Even when recovery seems to be going well, many individuals begin to notice and focus on the physical damage their body has endured due to drinking. They may begin to dwell on this damage and feel defeated due to daily aches, pain, swelling, and fatigue. Although it is discouraging to know that some damage to the body cannot be repaired, giving up recovery and drinking again will not help.

Dwelling on physical damage often causes the recovering individual to ask, “Is it too late?” or “Is sobriety really worth it?” Many individuals who experience the physical consequences of a ‘broken body’ have learned ways to cope and begin to heal. Dwelling on damage rather than healing can cause relapse.

3. GABA depletion and dysregulation of the nervous system can cause one to be prone to relapse.

GABA, or gamma-aminobutyric acid is an inhibitory neurotransmitter in the brain that allows the nervous system to communicate and regulate. The job of the nervous system is to balance the five senses, thoughts, and alertness to danger. Research has identified the connection between excessive drinking and GABA depletion.

Excessive alcohol consumption depletes the production of GABA. The depletion of GABA throws the nervous system off balance, causing the individual to react inappropriately. When the nervous system is not working properly, one cannot function. Instead, their behavior reflects an over-reaction or an under-reaction to the world around them.  

For example, when GABA levels are off-balance, the nervous system may respond with alarm, resulting in the individual perceiving danger in a situation where there is no danger. When one perceives a harmless situation as dangerous, they may experience significant stress, panic, anxiety, and fear. Mis-perceiving a situation can result in behavior problems and mental health symptoms such as paranoia.

Excessive drinking can also lead to GABA withdrawal because alcohol consumption reduces GABA production. Severe GABA withdrawal can produce symptoms of intrusive and/or perseverated thoughts, psychosis, paranoia, and persistent worries. In addition, a decrease in GABA may also worsen a pre-existing mental health illness, causing the individual to relapse and ‘self-medicate’ with alcohol or other substances. Severe symptoms may require inpatient hospitalization for mental health treatment.

Some people take GABA supplements. Although there is not enough research to support that GABA supplements are effective to replenish this neurotransmitter, discussing this option with a physician is a good starting point. In most cases when an individual stops drinking alcohol, the body will recover and begin producing GABA, allowing the nervous system to become balanced. GABA depletion can lead to relapse.

4. Now what? Fear of the future becomes overwhelming, leading to relapse.

Many individuals are proud of their ability to establish a sober lifestyle, connect with others in recovery and live a healthier life. However, as they reconnect with family and friends, they begin to realize all the opportunities and time they have lost. While they were drinking and living life as an addict, their family and friends were moving forward establishing families, homes, employment, and financial stability.

An individual who has embraced recovery may see more clearly and begin to compare themselves to others. They may feel disappointed in themselves and their lives because of how they measure up to their peers. They may feel discouraged and judged. When these thoughts of “not measuring up” are ignored, the individual may begin to dwell about what “could have been.” Negative thoughts may provoke fear and prevent one from developing the skills they need to stay sober. Fear about the future may become overwhelming and distract one from recovery, contributing to relapse.

5. Ruminative thoughts and self-blame can lead to depression and relapse.

Trying to ignore emotions is exhausting. Instead of sharing negative thoughts with supportive others, the individual tries to ignore and push thoughts away, hoping they disappear. They don’t. Negative thoughts, self-blame, and dwelling on the consequences of your addiction may result in feeling shame and guilt. Some individuals feel so bad about the consequences their addiction has caused others, that they start to believe they do not deserve anything, including recovery. This negative thinking can erode at one’s recovery until they give up with defeat, resulting in relapse.

6.  Craving the “Good Ole Days” can lead to relapse.

Craving the “good ole days” of drinking during holidays, parties, sporting events, fishing, camping, weddings, and birthdays can build resentment. The thought of not being “allowed” to drink and enjoy events like you once did, can cause one to become unmotivated for recovery.  Resentment against sobriety can build since sobriety is preventing the individual from experiencing more of the “good ole days”. When craving the “good ole days” is not addressed, bitterness builds. Eventually, there is not enough mental energy left to control cravings. This can cause relapse.

7. Getting cocky about sobriety can erode one’s recovery, leading to relapse.

After a while, the individual may become overconfident, believing that they can stay sober without “recovery activities”. Alcoholics Anonymous meetings (AA), contact with an AA sponsor, AA home groups, and participating in sober social events may become a thing of the past. Triggers may be ignored as well as exit strategies that worked to avoid triggers.

The over-confident individual no longer works to avoid people, places, and things that trigger cravings. They are no longer mindful of becoming HALT (Hungry, Angry, Lonely, and Tired). Becoming overconfident or cocky leads to more exposure to triggers. This gradual erosion of one’s recovery can lead to relapse.

8. Non-supportive people and environments can result in relapse.

Not everyone supports recovery. Some may outright reject the recovering individual. Others may express their non-support in more subtle ways. Obvious non-supporters may ask a person in recovery to go out for a drink, despite knowing that they are addicted and trying to remain sober. The non-supportive individual may become angry if the recovering individual refuses their invitation. They may refer to the recovering individual as a loser, weak and boring.

Other non-supporters are more subtle. They may behave in passive-aggressive ways by constantly reminding the recovering person of the consequences their drinking has caused others. This may cause the recovering individual to dwell on negative thoughts about themselves. When the negative energy of non-supporters penetrates one’s recovery, they can become weak, resulting in relapse.

What can prevent relapse and keep recovery going well?

Like any disease, relapse is common. Preventing relapse requires an active daily process. Don’t ignore triggers and cravings. Talk about the challenges you have, even if they are invisible to others. You are not the only one who may need extra support.

To discuss your unique recovery situation, schedule a consultation with Dr. Musarra. Supportive family and friends are welcome to accompany you to the appointment to support your recovery and prevent relapse.

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