A Closer Look at Relapse in Alcoholism and Drug Addiction

A Closer Look at Relapse in Alcoholism and Drug Addiction


Why do some alcoholics continuously relapse? It’s a question that baffles me, because I work with many newcomers in recovery, and I am constantly finding new hope with them, watching them progress, seeing them “get recovery,” and I eventually tend to forget just how lousy the success rates are in recovery. And then it hits me–just like it did today–and I hear about yet another good friend of mine who has gone back to the bottle.

I’ve been watching this happen, over and over again, for the last 7 and half years, and I can assure you that I have been doing all that I can to learn from these examples. And these are not just people who have a few weeks of clean time….I’m talking about fellow addicts and alcoholics with a year or more of sobriety. Why do they keep relapsing? “There but for the grace of God go I,” we always say, but I think it is worth it to try and look deeper at things, to see why some people have failed, even after enjoying a significant period of time in sobriety.

For analysis sake, let’s flip the thing around and consider success stories for a minute. Let’s think about 3 possible explanations for those who actually do manage to remain sober over the long haul. What makes some people more successful at staying sober than others? In each case, when considering a success story, we are asking who to give the credit to:

1) Credit to God or a higher power – Those who stay sober do so only through their higher power. This is the tidiest explanation, and I am starting to believe that some of us are just simply blessed, that we are “chosen.” But on an intuitive level, this feels wrong, even though the simplicity of it is appealing. I have to believe that at least part of success is up to the individual, not just to their higher power.

2) Credit to self – Some might surmise that certain individuals are simply better at maintaining long term sobriety than others, regardless of which program they are working or how spiritual they might be. This feels wrong too, and seems like dangerous territory to boot. (We’ve seen plenty of people who got cocky about sobriety, only to end up drunk).

3) Credit to the program – This has got to be wrong. Some of those who seem to work the best 12 step program (heavy step work, heavy sponsorship involvement, dedicated meeting attendance, etc.) seem to be constantly relapsing. And of course, those who try to explain the relapse will inevitably fault the individual (see point number 2 above), and say that “they just did not want it enough,” or something similar. Also, there are many people who have achieved long term sobriety in a variety of different programs, some of which seem to have conflicting methods and techniques.

Well, you might say, what if it is all three factors that converge to create a successful life in recovery? Perhaps it takes a motivated individual who “works a serious program” and is earnestly seeking their higher power or pursuing a spiritual life in some way. Maybe it is the balance between these 3 factors that creates the optimum conditions for long term success.

That explanation feels wrong as well, because we constantly see examples to the contrary: people who are working a perfect program and seem to have it all, only to relapse. It seems to all boil down to conviction, and this is a theme that you hear over and over again in recovery programs such as AA or NA. People always say: “You have to want this thing. You have to want to be clean and sober more than you want to get high. You have to want it more than anything in the world.” Desire. Conviction. Passion.

So the only real measure of success in recovery seems to be the level of conviction. How bad does a person really want to stay sober? Unfortunately, conviction and desire is ridiculously easy to fake, (and often is), especially in early recovery.

In fact, many of us start out in early recovery, trying to convince ourselves that we have the conviction needed to stay clean and sober. We might feel overwhelmed and a bit hopeless, so we try to be positive and end up faking our level of sincerity and conviction–simply in an effort to motivate ourselves into possibly staying clean. The phrase “fake it ’till you make it” is even thrown around, and this applies both to faith as well as to conviction and motivation. And there’s nothing wrong with this, necessarily, we should try to be positive.

Conviction equals success in recovery, but only in retrospect. So even this becomes a useless, circular definition: we can look at the success stories, and say “yep, they were serious about wanting recovery.” But we seem to have no power to make accurate predictions in this regard. We can’t make predictions about others or about our own success. Relapse remains a mystery.

Action items – What you can do:

1) If you’re a struggling alcoholic, find some ways to motivate yourself to quit drinking.

2) If you know a struggling addict or alcoholic, find some ways to help them.

3) You might also take a look at how to break through denial.

If you happen to have any wisdom about relapse, please share it with others in the comments.


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