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Staying Strong:  Recognizing Relapse Warning Signs

For the person who has worked hard to reach recovery, the prospect of relapsing can be troubling. The best defense against relapse is to understand the causes and warning signs. The notion that relapse means a return to alcohol or drug use is false. Actually, relapse is a process whereby a series of events render people more likely to return to active addiction. The relapse process is a chain reaction of problems known as relapse warning signs. The events that cause or complicate the problems are called high-risk situations. Terence T. Gorski, a leader in the field of relapse prevention, describes the relapse process as a line of dominoes. In relapse, each problem is like a domino hitting from behind, with each one heavier than the one before.

The Relapse Process

Gorski identified 11 steps in the relapse process:

Step One: Getting Stuck in Recovery – The person recognizes that using alcohol or drugs is a problem and gets treatment, but sobriety is disrupted when a problem arises that is difficult to handle. The person reaches a stuck point in recovery and doesn’t know what to do about it.

Step Two: Denying the Problem – The person denies there’s a problem and doesn’t seek help. Pain and stress begin to mount.

Step Three: Using Other Compulsions – In an effort to deal with the pain and stress, the person turns to other activities for distraction. Alternative compulsions include overworking, overeating, gambling, shopping or addictive relationships. Each has the hallmark of all addictive behaviors-feel good now, hurt later.

Step Four: Experiencing a Trigger Event – Something happens that under normal circumstances wouldn’t be difficult to handle, but this time it triggers stress, and emotions take over.

Step Five: Becoming Dysfunctional on the Inside – As emotions take control, the ability to think intelligently fades. Everything the person learned about who he or she is (an addicted person), what can’t be done (use alcohol or drugs), and what must be done (stay focused on the recovery program) is abandoned. The pain is so severe that feeling good at all costs becomes the goal. The person may suffer mood swings, forgetfulness or insomnia, or become more accident-prone.

Step Six: Becoming Dysfunctional on the Outside – The person knows there’s something wrong but tries to ignore it. Internal dysfunction gets so bad that problems start occurring on the outside, such as mistakes at work, pushing away family and friends, or neglecting the recovery program.

Step Seven: Losing Control – The person tries to handle each problem as it happens, but does not recognize the growing pattern of difficulties. One problem may get solved, but others soon replace it. The person gets scared and angry, and begins to wonder if sobriety is really any better than addiction.

Step Eight: Using Addictive Thinking – The person reverts to addictive thinking, rationalizing that sobriety may not be right for him or her. He or she may not plan to drink or use drugs, but wants to get away by reconnecting with using friends. The person may begin doubting whether he or she was ever truly addicted at all.

Step Nine: Going Back to Addictive People, Places, and Things – Convincing him/herself he or she won’t drink or use drugs, the person seeks escape by returning to toxic people, places, and things.

Step Ten: Using Addictive Substances – As a result of the pain the person is feeling, he or she believes there are only three choices: emotional collapse, suicide, or a return to active use, and active addiction seems to be the best option.

Step Eleven: Losing Control over Use – The person usually follows one of two paths:

Short-term, low-consequence relapse: The person realizes he or she is in serious trouble and seeks help.

Refusal to seek help: Feeling immense shame and guilt, the person does not reach out for help but continues to drink or use drugs. Progressive health and life problems develop which may lead to severe consequences, such as suicide.

Avoiding Relapse

Avoiding relapse requires diligence and self-awareness. At Ashley, we focus on helping people in recovery think and behave as the sober, healthy people they have become. We aid in identifying warning signs of relapse, and then collaborate to develop a personalized action plan for managing these signs. A clear sign of trouble is when people in recovery behave as they did when using drugs or alcohol. If you feel you or a loved one is experiencing any warning signs of relapse, don’t try to handle it on your own. Contact your sponsor or ask others for help immediately.

– By Sheila Matricciani and Stacy Brumage

Sheila Matricciani is assistant program director of Ashley’s Relapse Program and was trained by Terence T.Gorski. She is an advanced certified relapse prevention specialist, a certified associate counselor-alcohol and drug, and a certified chemical dependency counselor. Stacy Brumage, relapse counselor, is an advanced certified relapse prevention specialist, a certified associate counselor-alcohol and drug, and holds an MA in counseling psychology. She was also trained by Terence T. Gorski.

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