Posted by: RealisticRecovery | May 31, 2009

Warning Signs of an Alcohol or Drug Relapse

Warning Signs of an Alcohol or Drug Relapse
Recognizing the Steps Leading to a Relapse
By Buddy T,

Relapse is so common in the alcohol and drug recovery process that it is estimated more than 90 percent of those trying to remain abstinent have at least one relapse before they achieve lasting sobriety. But a relapse, sometimes called a “slip,” doesn’t begin when you pick up a drink or a drug. It is a slow process that begins long before you actually use.

The steps to a relapse are actually changes in attitudes, feelings and behaviors that gradually lead to the final step, picking up a drink or a drug.

Attitudes, Feelings and Behaviors
In 1982, researchers Terence T. Gorski and Merlene Miller identified a set of warning signs or steps that typically lead up to a relapse. Over the years, additional research has confirmed that the steps described in the Gorski and Miller study are “reliable and valid” predictors of alcohol and drug relapses.

If you are trying to obtain long-term sobriety and avoid having a relapse along the way, it is important to recognize the following warning signs and take action to keep them from progressing into a full-blown relapse.

11 Steps to a Relapse
Change in Attitude – For some reason you decide that participating in your recovery program is just not as important as it was. You may begin to return to what some call “stinking thinking” or unhealthy or addictive thinking. Basically, you are not working your program as you did previously. You feel something is wrong, but can’t identify exactly what it is.

Elevated Stress – An increase in stress in your life can be due to a major change in circumstances or just little things building up. Returning to the “real world” after a stint in residential treatment can present many stressful situations. The danger is if you begin over-reacting to those situations. Be careful if you begin to have mood swings and exaggerated positive or negative feelings.

Reactivation of Denial – This is not denial that you have a drug or alcohol problem, it’s denial that the stress is getting to you. You try to convince yourself that everything is OK, but it’s not. You may be scared or worried, but you dismiss those feelings and you stop sharing those feelings with others. This is dangerous because this denial is very similar to denial of drug addiction or abuse.

Recurrence of Postacute Withdrawal Symptoms – Anxiety, depression, sleeplessness and memory loss can continue long after you quit drinking or doing drugs. Known as postacute withdrawal symptoms these symptoms can return during times of stress. They are dangerous because you may be tempted to self-medicate them with alcohol or drugs.

Behavior Change – You may begin to change the daily routine that you developed in early sobriety that helped you replace your compulsive behaviors with healthy alternatives. You might begin to practice avoidance or become defensive in situations that call for an honest evaluation of your behavior. You could begin using poor judgment and causing yourself problems due to impulsive behavior without thinking things through.

Social Breakdown – You may begin feeling uncomfortable around others and making excuses not to socialize. You stop hanging around sober friends or you withdraw from family members. You stop going to your support group meetings or you cut way back on the number of meetings you attend. You begin to isolate yourself.

Loss of Structure – You begin to completely abandon the daily routine or schedule that you developed in early sobriety. You may begin sleeping late, or ignoring personal hygiene or skipping meals. You stop making constructive plans and when the plans you do make don’t work out, you overreact. You begin focusing on one small part of life to the exclusion of everything else.

Loss of Judgment – You begin to have trouble making decisions or you make unhealthy decisions. You may experience difficulty in managing your feelings and emotions. It may be hard to think clearly and you become confused easily. You may feel overwhelmed for no apparent reason or not being able to relax. You may become annoyed or angry easily.

Loss of Control – You make irrational choices and are unable to interrupt or alter those choices. You begin to actively cut off people who can help you. You begin to think that you can return to social drinking and recreational drug use and you can control it. You may begin to believe there is no hope. You lose confidence in your ability to manage your life.

Loss of Options – You begin to limit your options. You stop attending all meetings with counselors and your support groups and discontinue any pharmacotherapy treatments. You may feel loneliness, frustration, anger, resentment and tension. You might feel helpless and desperate. You come to believe that there are only three ways out: insanity, suicide, or self-medication with alcohol or drugs.

Relapse – You attempt controlled, “social” or short-term alcohol or drug use, but you are disappointed at the results and immediately experience shame and guilt. You quickly lose control and your alcohol and drug use spirals further out of control. This causes you increasing problems with relationships, jobs, money, mental and physical health. You need help getting sober again.

Relapse Is Preventable
Relapse following treatment for drug and alcohol addiction is common and predictable, but it is also preventable. Knowing the warning signs and steps that lead up to a relapse can help you make healthy choices and take alternative action.

If a relapse does happen, it is not the end of the world. If it happens, it is important that you get back up, dust yourself off and get back on the path to recovery.




  1. RR….

    It is said of Telemark Skiing (a down-hill technique using cross-country styl equipment) that it is a “sport of 1,000 falls”.

    In other words, most people need to fall 1,000 times before they are any good at it.

    Telemark is a complex skill with lots of moving parts. Mastered though, it is a sight of beauty.

    I have often thought of recovery in somewhat the same way…. with dsitinction made clearly on the number of mishaps required as few could ever survive 1,000 relapses.

    For me at least, I do not see any other way that I could finally “get it” other than by the painful process of trial and failure.

    I wonder if there was any other way for me to find lasting sobriety and recovery had I not got beaten so badly and completely in my many attempts to get and stay sober in ways that did not work.

    Most of us start with the resolve of our will. Most of us fail. In fact, those who can quit on sheer will power … I wonder if they would really be considered alcoholics.

    When will power fails, we tend to turn it up a notch. Maybe we talk to our doctor or ‘try out’ an AA meeting or two. For me, neither of these were sufficient.

    For me, it was not until I ‘went out’ agian completely unexpectedly to me after having been medicated in the hospital.

    Prescription sedatives triggered some sort of euphoria in me when I was about a year clean/sober…. whatever it was…. judgement went out the window and I went out to use one last time.

    I can honestly say, I was out of control and I do not know what would have stopped me other than physical restraint.

    Having done this and suffered the consequences which were severe, I was finally ready to start listening to those who had travelled the path before me.

    I had listened before, but always filtered sufficiently to miss all I needed to get and remain sober.

    I remember the feelings of how I felt that my mind had to open and I had to hear like I never heard before. I had to try new things no matter how much my old thinking balked.

    It was agonizing but it yielded the desired result.

    So the process of relapses, although we never know which one will kill us and hurt those we love, they do seem to be a part of the process that can help us get and remain sober.

    I just do not see that it can be avoided entirely.



  2. Hey Chaz, thanks for dropping by again and commenting (I really enjoyed your post :Thinkers think, talkers talk, provers prove.)

    I just checked out telemark skiing on youtube.
    For me, just “regular skiing” is still the sport of a thousand falls.
    This one would be a little more difficult for me.

    I heard a great quote once that we can apply to relapse and recovery (and skiing):

    “The measure of a person, is not in how many times you fall, but in how many times you get back up. -Anonymous”

    Words to live by, for sure.
    Unless you’re fighting Mike Tyson of course, then I would suggest just staying down.;)


  3. Yo… RR….

    Thanks…. the post was written after having engaged a few debates with some people who do not appear to have any genuine or first-hand understanding of addiction and some other issues.

    I have discovered that the fact that opinions are free to have and speak, that many people speak them freely.

    Testing these opinions in the real world does not seem to be a requirement.

    Anyway… I dont mean to go on about this.

    Back to subj at hand…. like many things in life, relapses can be the best thing or the worst thing ever to happen to us.

    On the bad side, we die or harm others. One the good side, our last relapse may have been what it took for the penny to drop so we could be desparate enough to open our minds and ears to receive what we need to get sober/clean and begin recovering.

    I wish relapses on nobody. I know many who went out one more time and never came back… in fact they died horrible deaths. It is a high risk every time, especially in the drug world.

    But if we do survive one, we had doggone better well learn from it. We may not have another chance.



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