“Why did they relapse?” This question burns in the minds of just about any friend or loved one of someone who is struggling with addiction.
From the outside looking in (at addiction or alcoholism) it is so easy to see that the person is so much better off when they are clean and sober. But obviously the addict does not see things that way and for whatever reasons they decide to go back to their pattern of self medicating.
So what is the answer, ultimately? Why does a person relapse?
There are a couple of possible reasons:
1) They are not ready to get sober yet.
2) They are not done having fun yet.
3) They have failed to deal with issues that caused them to use in the first place.
4) They are too young to “get” recovery.
5) They have pain or some other issue that they believe must be medicated.
6) They have used a major life event as an excuse to relapse.
Let’s look at these possible relapse causes one at a time.
They just were not ready to be clean and sober
Some people are just not ready to get clean and sober yet. This is typical if the person has not yet experienced a lot of consequences as a result of their addiction. If you look at people who are in rehab centers and ask them what they have lost due to their addiction, they can usually go around the room and everyone who is there has a long story about all of the things that they have lost in life as a result of their using. It would be quite rare to be sitting in rehab and have someone say “oh, I haven’t really lost anything due to my drug or alcohol use.” This would never happen because if it did, why would the person be sitting there in rehab? You don’t go to rehab when things are going good! You go when things are really, really bad–and you don’t know what else to do with yourself.
Change is motivated by pain. A change like recovery is not a minor change, it is a major change, and going through with it takes a lot of guts. No one makes this change lightly. You may be thinking that some people just have an easier time than others sobering up, or that some people find it natural and easy to grasp recovery. This is never the case. No one enters recovery lightly and easily, because it is so crushing to the ego to do so. You have to admit that you don’t know how to live, and that you need directions on how to conduct yourself on a day to day basis. Really, this is the depth of surrender that is needed and most people are not willing to do this until they are practically dead. This is why overdose and fatalities with addiction are so common–no one wants to admit to their faults, sober up, and do the work necessary to change their life. Recovery is hard work and just getting to the point of surrender takes nothing short of miracle.
It is pain that causes people to change. If someone has not endured much pain because of their addiction then they are not going to embrace recovery. The cost is too high. Going through with the entire process of surrender is just too tough. No one wants to do it unless they have no other options, and even then some addicts will refuse to surrender and just end up self medicating themselves to death.
If someone is “just not ready to get sober yet” then it almost always means that they have not reached that magical threshold of pain yet. If they do get enough pain in their life then they will become willing to surrender and examine a new way of living. After enough pain has been achieved the person will become humble enough to take direction and advice from others as to how they should be living. But if they have not experienced huge amounts of pain then they are not likely to embrace recovery. The cost of surrender, of being humble, of taking advice from others is just too high. Our ego cries out against these ideas in protest. The only thing that can overcome this ego reaction is if we are so miserable that we are willing to stomp on our own ego anyway.
There is a point at which the person abandons the ego and becomes willing to turn their life over completely, to take direction and advice and stop struggling for control all the time. That point is reached through pain and misery, unfortunately. If someone is “just not ready for recovery” then what they really need is more pain and misery in their life (not more hope!). It seems a bit unfair and almost counter-intuitive but pain is the real motivator. Just look at the Al-anon philosophy and how they instruct families to detach and allow the addict to suffer the natural consequences of their disease. You don’t have to go out of your way in order to be malicious with the addict, but just get out of their way and let them do their own damage. So long as you are not enabling the addict they will create all of the pain and misery that they need, all on their own. This pain and misery will eventually be the thing that motivates them to get clean and sober (for real), such that they will not relapse.
They were not done having fun yet
If someone is very early in their disease (such as the first few months to the first few years) then they are probably still having lots of fun using drugs and/or alcohol. If this is the case then you can pretty much forget it, they are nowhere near the point where they would willingly surrender to their addiction.
In the beginning addiction is always fun. How else would people get addicted, if it was not fun and beneficial at first? Of course it is fun in the early days and so this is how people get trapped in denial. Their denial is based on the fact that the person remembers what it was like to get high in the beginning. They cling to that perfect memory of an earlier time, when they could use their drug of choice freely without having to worry about consequences. A time when they could use their drug of choice and both control it AND enjoy it.
So basically if an addict or an alcoholic is still in these fairly early stages (where they are having lots of fun) then they are not about to surrender to their disease. Remember that change is motivated by pain and misery. Ask yourself: “What consequences has the addict endured? What has their disease cost them?” Then the second part of that question is really about their awareness and their ability to see past their own denial. Not only are you asking what their disease has cost them, but what are the willing to admit that their disease has cost them? If they are still stuck in denial then they are not necessarily going to see the same “costs” of their disease that you are seeing. The addict who is stuck in denial will be pointing the finger at everyone except for themselves, blaming others, blaming society, blaming the system, but never realizing that their drug or alcohol use is what is screwing their life up.
Sometimes when a person in early recovery relapses it is because they are not done having fun yet. This can be especially common when the person is younger, and they see their peers still going out and having a good time self medicating. They think that maybe they are different, that they can go have fun again and somehow learn to control it this time. The only thing that leads them back to surrender is more pain and misery, which their addiction will eventually produce for them.
They failed to tackle the issues that led them self medicate
Another possibility is that the addict or alcoholic is not dealing with some of their underlying issues, the same ones that may have led them to self medicate in the first place. The 12 step program attempts to lead a person through this process of healing, such that each addict will examine their past and then deal with it accordingly, such that it can no longer hold power over them and cause them to relapse.
Even if a person does not formally work the steps of AA, they still need to find a way to deal with any issues that helped to fuel their addiction. If they were self medicating in order to cover something up or deal with emotional problems, then those problems need to be dealt with in recovery. Of course, it can take real guts to face your deepest issues in recovery, and no one said it would be easy. But if you fail to deal with such issues then eventually they could come back to haunt you during your sobriety, even if it is several years down the road. These are the kinds of issues that sometimes cause people to relapse.
They are too young to embrace recovery because peer influence is still too strong on them
Some young people do recover from addiction and alcoholism, but it is fairly rare compared to older adults. For example, consider that the average age in AA is 47 years old! This should be a strong indicator right there that the young are not as likely to embrace recovery. Even though many kids in their teen years certainly need help and could benefit from the 12 step program, not many youths are willing to take such drastic steps.
Consider too that for a younger person, embracing recovery is an especially drastic and radical step. Why? Because they are still young, and the idea that they are a hopeless lifelong addict has not even been established yet. It can’t be because they are too young. For all we know they might be in a “phase.” Perhaps they will settle down soon and grow out of their crazy behavior, right? Of course when an addict or alcoholic is in their twenties, thirties, forties, or beyond it is much more obvious that their problem is no longer just a “phase,” and that they are going to have to take real action in order to do something about it.
It all goes back to the ego and taking massive action. The problem is that overcoming a real addiction requires the complete obliteration of the ego whereby the individual must take massive action. For example, a person who goes through the detox process and then starts attending 12 step meetings every single day of their life is taking massive action. If they get a sponsor and work the steps and spend the time to go to another meeting each day then they are taking massive action. This is not a trivial commitment. Now imagine that you are expecting someone who is quite young to make this enormous commitment and take massive action. Hey, they are still having fun with their drug of choice, you think they are going to sober up permanently and dedicate their life to these boring meetings? You are asking quite a bit there.
So it is not as realistic to expect younger people to be able to recover or to embrace recovery programs. The problems are just too numerous for them to overcome, in most cases:
1) They are still young and having fun with their addiction.
2) They have not faced tons of major consequences yet in their life (maybe only some minor ones at this point).
3) Their friends are still having fun with drugs and alcohol.
4) They have time in the future to get clean and sober if they want to (or so they tell themselves….”I can always recover later on”).
That said, it is still possible to recover when you are young, and there are many specialty groups within AA and NA that focus on younger people in recovery. It is possible. Just realize that this can be a major excuse/cause of relapse, because there are so many arguments for the young to want to go back to self medicating.
They believe that they cannot deal with physical pain or some other situation without self medicating
There are some people who are addicted to drugs because they were originally prescribed them in the medical world. This happens quite a bit with painkillers but also at times with anxiety medications as well.
Physical pain is unfortunately subjective so there is no real way to tell just how badly someone is hurting inside. But once someone has become addicted to opiates then the whole game changes quite a bit and the way that their mind responds to pain is quite different. In fact, we now know that the mind can manufacture pain out of thin air simply based on opiate withdrawal. And if there is any actual pain present, the mind can amplify that pain to the point that the person is craving the painkillers.
Many people who are addicted opiates in this manner are terrified of physical pain. They may become completely unreasonable when asked about finding alternative ways to medicate their pain. They may just shut down and cover their ears with their hands and say that there is nothing that can possible help them other than opiate drugs. If such a person is addicted then their chronic pain becomes nothing but a big excuse for them to stay stuck in their disease.
The reality is that opiates do not actually medicate pain at all. All they do is to dull the brain from being able to register those pain signals, but opiates do not actually reduce the pain signals. It is like sticking a rag in an alarm clock–you can dull the pain signals that get to the brain but you have not actually reduced the pain at all. There are other medications that actually can reduce pain right at the source (such as nsaids) but this is not how opiates work at all.
So some people who have chronic pain may have tried a few alternatives but not really had much success with it. So they give up and just resign themselves to a lifetime of opiate use. They have effectively talked themselves out of recovery before they even had a chance. Such a person does not believe that recovery is even a possibility for them, and they think that it would be completely impossible for them to ever be happy without their drug of choice.
In my own personal example I never had any chronic pain, and yet I still had the mindset and belief that I could never possibly be happy without self medicating. I was convinced that I was unique and different from everyone else because for some reason I just had to be drunk or high in order to be happy. I was not open to the possibility that I could find a new way of life, that I might some day become happy without having to self medicate all the time. I did not believe this to be possible, at all.
They have used a major life event as an excuse to relapse
If you need an excuse to relapse, don’t worry–you will get a good one eventually. Life is full of twists and turns and even if you are perfectly clean and sober you are going to have some ups and downs in your life. This just goes without saying and is part of the random nature of the universe. If anyone in recovery needs an excuse to relapse, they will probably stumble on one soon enough.
Part of dealing with this possibility is in looking at possible reservations. Maybe you get clean and sober but you decide that if your spouse ever were to pass away suddenly then you would definitely not hesitate to go get loaded again. If this is your thought process then what you are dealing with is a reservation, and that can obviously trip you up some day. You have a predetermined excuse as to why you can get wasted again some day. This is not good and so therefore you must get honest with yourself and work through such reservations. In the end there are no excuses for any relapse and you have to get really clear on that while you are still of sound mind (not much use figuring this out after you drink or use!).
In short, there is no excuse for a relapse. No matter what happens in your life, no matter how bad things get in the short run, relapse will only make it worse in the end. You may get a temporary relief from the pain or misery in the short term, but after you sober up, the cause of that pain or misery will still be there, only now you will have TWO problems (the second one being your relapse!).
There is no problem in life that a relapse cannot make worse. No matter what the reason is for self medicating, the relapse itself will only make your life worse in the end. The relief that you get from self medicating is only temporary at best. The pain and misery that you get from the relapse will endure for weeks, months, or years. Depending on how far off the deep end you go, it could take a whole lifetime to patch up this particular mistake. And of course, there is always the possibility that a relapse will kill you outright (or land you in prison or the psych ward).
There is no VALID excuse for a relapse, but there are plenty of reasons that an addict will try to grab hold of anyway. If you are vigilant about staying sober then you have to realize in advance that all of these potential excuses are garbage.
In short, they relapsed because they were not finished using drugs or alcohol yet. They will be done as soon as they have had enough pain and misery. We don’t always get to choose when that is.