Understanding Alcohol Relapse & Drug Relapse

By now the term "relapse" is both widely used and engrained into the minds of most who are lucky enough to enter some form of treatment in the US for chemical dependency. The "treated" person is informed that with chemical dependency, relapse can occur at any time. That from moment to moment one must be alert to the "triggers" that may cause a regrettable fall back to the clutches of addiction.

"One day at a time" and "you are only an arms length away from your next drink" are the clichés that echo through most AA halls and treatment offices.

Although well intentioned, the concept of drug relapse or alcohol relapse is associated with the idea that addiction is a disease. This concept teaches that those unfortunate enough to have this biological/chemical abnormality will forever have to be conscious of their struggle to maintain sobriety. There is no escape. The disease of chemical dependency never leaves, and in fact it is waiting in the background for its chance to reclaim its victim. Drug relapse or alcohol relapse is viewed as something outside the realm of the person's control. Sure, no one forces them to pick up a drink, but if they succumb to the temptation, it is blamed on the disease. Once the alcohol or drugs enter the body the disease takes over. The disease won, you relapse and become just another statistic in the inevitable cycle of addiction. Once the alcohol or drugs enter the body you are no longer a person with free choice and will. You become a puppet and slave to the desires and demands of this disease of addiction.

The disease of addiction could even be called a "disease of thinking errors". When alcohol or drugs are present the addict will lose all independent decision making capabilities, choices and free will. The disease will take over and sabotage all thinking until you succumb to its ever present need to drink or use drugs. So, in essence the disease not only controls you internally, but externally as well. Where is the hope in this!?

It is not until the addict surrenders his will and admits complete defeat that any hope of abstinence from chemical dependency can be obtained, or so we hope. Remember the disease is powerful and no one is off the hook, ever!

I feel the above information is unfortunate. Our current outlook and use of the term "drug relapse" or "alcohol relapse" needs a more honest investigation.

First of all, there is no study or medical literature that absolutely proves there to be any biological disease with chemical dependency or addiction. There is none! Believe it or not, the disease idea is used purely because no one has a clue why someone would continue to destroy his or her lives through an addiction. If we believe people would not consciously choose chemical dependency or addiction as a way of life, we conclude it must be a disease. With no scientific literature to support this, the concept of relapse is absurd. We cannot relapse if there is no disease.

Telling people addiction is a disease, and relapse is part of that disease, is setting them up for failure. The disease concept may discourage the addict from choosing and controlling what they can to improve their lives. The addict is already beaten down emotionally from alcohol or drug use. They have already lost much and will feel alone. The addicts' self-confidence will be low and emotional vulnerability high.

The disease model may further victimize the addict by telling them they will never be cured and need to become even more powerless. The disease concept strips the addict of free will and puts them under the control of an imaginary disease.

Again, no one and nothing can force them to pick up a drink. But if they do take the drink, it is the disease, not the man.

Try this; think of someone you know who doesn't drink. Now think of them as an alcoholic. What did you just add to them? How did the person change in your mind? You got it, a disease. By labeling them an alcoholic, in your mind, you may have just separated them as being "different" from the normal person because of some internal biological craving. You may have pictured them as inadequate, to be avoided, helpless, or unable to choose or change. In this example the label of alcoholic is dangerous and limiting to the person who wants to change. If they are viewed by others as inadequate and helpless, what might they already think about themselves? Will this type of thinking help them? Or will it just reinforce an already present negative view they have of themselves? They are not different. They are just choosing a form of behavior you would not.

To give dignity to the addict is to allow them their consequences and choices. To give dignity conveys the underlying message that you believe the addict is capable of choosing their own life course. That they are capable of resolving their own life struggles.

Secondly, the majority of those who admit they once had a problem with an addiction no longer have the addiction. They "recovered" on their own. The importance here is that these people are not struggling with a day-to-day battle of the wills to abstain from drug or alcohol use. They did not need 90 meetings in 90 days, or intensive outpatient therapy with relapse plans. They simply quit. They can do this because there is no disease. Their values and focus changed and they decided drugs and alcohol no longer held the power and significance it once had. People normally change when they realize they have something to gain by doing so. Those who continue to use alcohol or drugs have not yet been convinced that life would be better lived if they quit.

Some would then ask if those who continue to use alcohol or drugs need to "hit bottom" in order to change. Or will the addict continue to relapse until they "hit bottom"? The answer to that is simple, No. The addict will continue to use until they are convinced that they can successfully live life without the use of alcohol or drugs.

This can come at any time and for some, it is never. There is no "bottom". It is relative, and has more to do with why people think they can't quit, than why people continue to drink or use drugs. In other words, I am not going to quit until I think I can.

Thinking errors play a role in the persons continuing return to drug relapse or alcohol relapse. Also, what the addict perceive they can handle is essential. What most people would view as a simple resolution to a problem, the addict can often complicate. When the addict is faced with a problem to resolve, often their fears and insecurities will arise. They may doubt their abilities to

make it through their struggle. Whether they will actually make it through the problem is irrelevant. The addicts' perception is all that matters. If the addict perceives their ability to get through a problem is inadequate, they will often error on the side of caution. They will drink or use drugs - relapse. This is why it is important for the person who just quit alcohol or drugs, or continues to "relapse", to develop alternative coping skills.

So knowing that addiction is not a disease, drug relapse or alcohol relapse cannot exist. And, knowing that the majority of people quit on their own, personal perception and choice is important. Why? Because it is human nature to choose what we perceive will give us the most happiness at any given moment.

But what does happiness have to do with drinking or using drugs? Anyone can tell that the addict isn't happy. That's right, those who drink or drug aren't happy but that doesn't mean they can't perceive it to bring happiness. Addicts are full of fear, like many people who live life. The only difference is that the addict consistently chooses not to productively deal with that fear. The addict hides, and with this hiding comes the illusion of control. They numb themselves to the pain or hurt. This numb feeling that is produced from the alcohol or drugs can be seen as a distraction or a kind of warped peace or happiness. Now are they actually experiencing peace and happiness? Of course not, but if you have a splinter in your foot and you knock yourself on the head with a baseball bat, you won't be thinking about the foot!

But this still does not answer the question of why some can't seem to quit alcohol or drugs even though they portray a real desire to do so? The obvious answer would be because they are told they cannot. The same people who want to help them are at the same time telling them they can never escape their addiction completely.

This is not acceptable to me. Let's look at the process:

Someone struggling with an addiction goes to counseling or AA. They are given all the above and more standard information. They buy into "One day at a time" and the disease concept and get "sober". They are excited about this and jump into the "recovery" process full force. But something starts to happen when they are told "recovery" is a life long process and they can never escape their disease. They find only two choices; remain in AA (treatment), or fail. They remain in AA and periodic counseling for a while. But shortly they start realizing that the mistakes they have made are coming back to haunt them. Their finances are in trouble, friends are hesitant to call, family distrusts them, they still are not happy, etc. Things are a mess.

What happens? Well when you take away the addiction, the person becomes like everyone else (probably with a bit more mess to clean up though). There is no more hiding or excuses and the person is hit with the realization that the position he is now in is from his own past choices. He knows he can refrain from drinking or drugging, because he is doing it now. But, he feels alone and has difficulty understanding and controlling his feelings. For the first time in a while he feels fear. What does he do? He holds on to his "recovery". It is his saving grace. It becomes his identity and image.

His self-esteem seems to hinder on his progress of the 12 steps and how other members view him. But this wears thin and he soon finds out that people don't care. The world goes on. His progress in the steps does not land him a job or get his family back. His image falls. He remembers his disease. At least he has that fight. It becomes harder to deny the usefulness his old addiction could give him now. It's a disease remember. He feels out of control and needs to regain it. He uses and the cycle starts again. Until he realizes that addiction is a choice, he cannot regain control and ownership of his life.

He must come to realize that his individual worth is not because he is "sober" but because he is alive. If he does "relapse" it is not because he has a disease, but because he chose to deal with his fear by avoidance.

So why do some continue to experience alcohol relapse or drug relapse?  Why can't people quit drugs or alcohol when everything they say indicates they want to? Simply, they feel they cannot live life without it. They have made the wrong choices for so long and depended on alcohol or drugs as a crutch. To stop drinking or using drugs would strip them of the only constant they know:

The ability to control their fear and helplessness with alcohol or drugs is the way they perceive as most effective for their particular situation. This is drug relapse or alcohol relapse,  this is addiction.

 

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