Warning Signs & Stages of an Impending Relapse

Warning Signs of an Impending Alcohol Relapse

Alcoholics – whether they have been sober for months or years – are always at risk of suffering from a relapse. This may be attributed to the chronic nature of alcohol addiction. Even though they try their hardest to keep away from liquor, they eventually get back to drinking – even though they have managed to quit before. 

Alcohol relapse is a bothersome event, but it is relatively common. According to the National Institute on Alcoholism and Alcohol Abuse, about 90% of drinkers experience at least one episode of relapse in 4 years. 

Warning Signs of an Impending Relapse

If you know somebody who might be battling some alcoholic demons, the best thing you could do is to be on the lookout for these warning signs of an impending relapse:

Emotional Relapse Stage 

In this initial stage, Melemis states that alcoholics are not thinking about drinking again. However, the behaviors and emotions that they are exhibiting may be setting them up for eventual relapse.

1. He keeps to himself.

He may be going to Alcoholics Anonymous meetings but he’s just quietly sitting there, not sharing anything. If he seems to be bottled up with emotions and isolating himself, then he might just be on the way to relapse. 

No man is an island, after all.

How isolation may lead to relapse is explained by Johann Hari in his book, “Chasing the Scream.” According to the author, addiction is not just about the chemicals. It can also be triggered by the social isolation that comes with the habit. 

2. He has poor eating and sleeping habits.

Poor self-care can bring about relapse. Such activities can be described by a simple acronym: HALT. This stands for hungry, angry, lonely, and tired. 

A state of hunger will not only prod the alcoholic to eat, it may coax him to drink as well. That’s because hunger brings about the release of ghrelin, a hormone that can increase the reward value of alcohol (like it does with food.) Because of this, it is important to keep the alcoholic happily satiated, so that his tendency of relapsing is decreased. 

Anger can also bring about stresses that may lead to relapse, according to a study by Kelly et al. With that being said, anger management is one of the pillars of Alcoholics Anonymous (AA). The AA manual even goes on to say that “Resentment is the number one offender. It destroys more alcoholics than anything else. … If we were to live we had to be free of anger.” 

The same can be said with loneliness. Willinger et al have shown that loneliness and depression can increase the risk of relapse in previously abstinent alcoholics.

Lack of sleep (and its resulting tiredness) is another one of the biggest risk factors behind relapse – not only with alcohol but with other substances as well. According to Brower and Perron, recovering alcoholics who have sleep problems are more likely to relapse – compared to those without slumber difficulties. They may resolve to liquor simply because it can make them sleepy. 

In summation, being hungry, angry, lonely, and tired can make the person uncomfortable. And when he feels that way, he may become restless and irritable – emotions that may prod the person to relapse.

3. He is emotionally vulnerable.

While seeking out relationships is a healthy thing to do, single alcoholics should refrain from having one.  According to a US News interview with psychologist Anne Lewis, a relationship may become a replacement addiction for alcohol. This is all good until the honeymoon phase is over – or when a break-up occurs. The result? The alcoholic may revert to drinking to replace the failed relationship. 

With that being said, experts advise newly-sober alcoholics to avoid dating for a while – even just for a year after treatment. This may help them avoid an emotionally-induced relapse. 

Mental Relapse Stage

In this stage, the alcoholic continues to fight the demons inside his head. He feels the need to use – but he knows that he should not. As this stage persists, self-control diminishes, leading to eventual relapse in the future.

1. He’s now craving for alcohol.

Craving is defined as a motivational state to consume something. For alcoholics, it is, of course, a drink or two. A Tufts University article has shown that cravings are governed by the addiction center of the brain – the hippocampus, caudate, and insula. 

More than possessing addictive behaviors, alcoholics have poor impulse as well. When these cravings hit, they are more likely to act on it. 

2. He thinks his past use is not a big deal.

He may have had an accident due to alcohol – maybe he was even institutionalized for his addiction. Despite the gravity of the said situations, he’s quick to shrug it off. He thinks of his past alcohol use as not much of a big deal – and that if he managed to get through that, he could drink again. 

3. He’s thinking of ways to control his alcoholism. 

An alcoholic who’s on the brink of relapse will be thinking of ways to better control his drinking problems – simply because he’s about to do it. 

4. He’s looking for an opportunity to relapse. 

He may put himself in situations where alcohol is easy to reach. He may invite himself to a social event where drinks are free-flowing – heck, he may even fly out to catch a drink at an airport bar. An alcoholic who’s thinking a lot about drinking may put himself in situations where he can relapse. Instead of blaming himself, he may blame the circumstances that he was in.

Physical Relapse Stage

This denotes the stage wherein the alcoholic has begun to drink again. According to Melemis, it can be divided into two phases: lapse, the moment of the initial drink; and relapse, or the return to excessive alcohol consumption. 

This is the culmination of emotional and mental relapse. When the signs above are not spotted right away, actual physical relapse can take place. 

Wrapping it up

Relapse may be common, but it can be avoided. By being able to recognize these warning signs, you may just be able to help another drinker steer clear from the dangerous path that is alcoholism.

Latest posts by Raychel Ria Agramon, BSN, RN, MPM (see all)

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