According to the findings, only 43 percent of those who go through an alcohol addiction treatment program can abstain from drinking over the subsequent weeks and months. The percentage is even lower (a paltry 21 percent) for those who try to quit drinking but do not undergo a formal treatment process. These statistics prove that relapses among treated and untreated alcohol addicts are very common.
But knowledge is power, and the more one knows about alcoholism, treatment, and recovery, the better the chances of overcoming the drinking problem. Users can win the battle against alcohol and remain sober for life if they learn how to recognize and avoid the triggers that can provoke a relapse.
Table of Contents
What Are Alcohol Use Triggers?
Alcohol use triggers are events, people, places, social interactions, situations, and emotions that make a recovering alcoholic feel a strong urge to drink. For many people who try to quit drinking, yielding to alcohol abuse triggers is what ends their sobriety and puts them back where they started.
To understand how triggers affect a recovering alcoholic, one must realize that his or her brain functions differently from the brain of a person who is not physically and psychologically dependent on alcohol:
- Chronic alcohol consumption rewires the brain’s risk-reward circuitry, giving it undue influence over an alcoholic’s cognitive faculties.
- The recovering addict’s brain is brainwashed into believing that drinking is the most effective way to deal with problems.
- A person with a history of alcohol abuse will form a whole new set of behavioral responses, based on a deeply ingrained instinct that tells them drinking is always a rewarding experience. As a result, his or her automatic behavioral response to the sight of alcohol is to reach out for that familiar comfort.
- The coping mechanisms of a person addicted to alcohol are severely compromised, and even after going through treatment, those old habits remain tenacious. Being in recovery and dealing with the stresses of physical and mental withdrawal symptoms stretches his or her coping mechanisms to the limit, which inevitably creates a high risk for relapse.
The brains of people with substance use disorders perceive and respond to environmental stimuli differently. Consequently, what are merely passing nuisances to others become powerful alcohol abuse triggers for individuals in recovery.
How to Deal with Alcohol Triggers?
To avoid succumbing to alcohol abuse triggers, patients need a plan of action, and they have to execute it thoroughly. They must learn how to anticipate alcohol triggers, recognize them in their early stages, and develop strategies to reduce their power over the behavior.
Identifying the Triggers
Triggers differ from person to person, but they are everywhere around. Often their connection to drinking seems tangential at best, yet the learned behavior with alcohol still makes people vulnerable in a wide variety of circumstances.
Drinking triggers can be classed into three groups:
- Environmental Triggers
- Re-Exposure Triggers
- Stress Triggers
These include people, places, and events that they’ve come to associate with drinking. Environmental triggers may include:
- Encounters with former drinking companions who have yet to embrace sobriety.
- Places where one is used to drink in, like bars, clubs, or even certain private areas at home.
- Social or cultural events where alcohol is served and tends to flow freely, like backyard barbecues, family reunions, holiday celebrations, and concerts or sporting events.
These can occur in any location where others are drinking, or through exposures to alcohol in TV commercials or movie scenes. Re-exposure triggers are impossible to avoid completely since drinking behavior is so open and ubiquitous in our society.
Potential triggers of alcohol abuse include stressful occurrences or developments, such as:
Strong and persistent negative emotions. Emotions like fear, anger, anxiety, guilt, shame, hopelessness, and depression are powerful alcohol triggers that tend to overwhelm the fragile coping mechanisms of problem drinkers. If one has a history of dealing with negative feelings by turning to alcohol, they can easily slip back into those habits if the recovery process is still in a sensitive stage.
Physical pain or stress. Physical stress can be a chronic illness, a painful condition, or unpleasant withdrawal symptoms (or PAWS) that sap the moral strength and leave a person unable to resist the urge to self-medicate with alcohol.
Sleep deprivation. Lack of sleep is stressful and can leave feeling fatigued and low on energy. In this state, the willpower may be weak, tension and anxiety can build, and one may be strongly tempted to turn to drink in an attempt to end insomnia (which won’t work for long).
Sudden or profound life changes. Profound life changes can leave feeling overwhelmed. The loss of a loved one and unemployment are examples of negative life changes that can set off a relapse while getting married, having a baby, or moving to a new city to take a new job are examples of positive developments that can still be stress-inducing (and alcoholism triggers often involve stress, regardless of its source).
Avoiding Triggers to Alcohol Abuse
The best way not to yield to triggers is to stay away from them. One can easily avoid some, but to avoid some others, it may be a bit harder. One might also need to make some fundamental alterations in the patterns of thought and behavior to avoid a few.
Here are some ideas on how to avoid the most common drinking triggers:
- Ask friends and family members not to drink in front of the recovering addict.
- If there are people in the house who drink, request they stock their supplies where the recovering addict won’t find them.
- Avoid old drinking buddies, and ask them respectfully not to visit the recovering addict.
- Avoid going to the places where one used to drink.
- Find a new route to the workplace or school, if the old one takes to pass bars or clubs one used to haunt.
- Avoid going to social events where drinks will be served. Politely explain the reasons for declining invitations to avoid being misunderstood.
- Examine relationships that might be stressing the recovering addict or causing anxiety. Talk with the other person to work out solutions to the problems that trigger arguments, misunderstandings, and accusations.
- End any relationships that are toxic and irredeemable.
- Look closely at the job and living arrangements and identify any emotional and physical stressors they invoke. Be prepared to make some significant changes, if it becomes clear those stressors are unavoidable or too challenging to resolve.
Asking for Help in Recovery
Battling alcoholism is not a solo venture, or at least it shouldn’t be. Since most relapses occur during the initial months of recovery, during that time, they’ll need a network of compassionate, supportive people to help to resist temptation.
The social support network may include:
- Close family members: partners, parents, siblings, children (if they’re adults)
- Loyal, close friends
- Trusted co-workers, teachers and classmates
- Pastors, priests, mentors or other advisors
- Members of support groups one can look to for guidance and understanding
- Professionals therapists and addiction specialists involved in aftercare or outpatient treatment program
- The recovering addicts (during the recovery, they should remain optimistic and resolute in their determination to overcome the substance abuse issues)
How to Prevent Relapse During Recovery
Relapse prevention means continuing treatment during aftercare when the recovery is still new, and the vulnerability to triggers still high.
Outpatient treatment during the first 6-12 months of recovery will consist primarily of individual, group and family psychotherapy, and medication therapy to relieve the intensity of physical and psychological cravings for alcohol.
Depending on the needs of the individual patient, aftercare treatment programs may be extended for as long as necessary, and identifying triggers and avoiding relapse will remain a point of emphasis.
Psychotherapy for Alcohol Addiction
Among their many contributions to healing, experienced addiction counselors can help patients identify, anticipate, and defuse alcohol abuse triggers.
Therapists who work with alcoholics are flexible and versatile, and to some extent, counseling programs are always tailored to meet the unique needs of each patient. Nevertheless, addiction counselors do prefer certain evidence-based approaches to recovery and relapse prevention, including cognitive-behavioral therapy (CBT) and contingency management (CM):
Cognitive Behavioral Therapy (CBT)
During CBT sessions, patients are taught to be mindful of their emotions and to pay close attention to what’s happening in the surrounding environment, so they can learn to identify triggers before they magnify in strength. The individual is also taught coping strategies to deal with triggers (i.e., distracting the mind by reading, going out for a walk, listening to music, meditating, watching a movie, talking with close friends, etc.).
Over time, CBT helps modify behavioral responses in people whose inner resources have been neglected because of their dependence on alcohol.
Contingency Management (CM)
Contingency management is used as both a stand-alone therapy and as a supplement to other therapeutic approaches, including CBT. Under CM protocols, people receive rewards of various types of staying away from alcohol. Typical rewards include vouchers redeemable at retail stores or tickets to a movie or concert.
This relapse prevention technique strives to rewire the brain until it is conditioned to reject alcohol and seek happiness and fulfillment only in healthy, sobriety-enhancing activities.
Medicines are often prescribed as part of an alcohol addiction treatment program. Certain drugs can help counteract the intensity of withdrawal symptoms and cravings, lessening the urge to drink and negating the effects of triggers.
Medications commonly prescribed for alcohol treatment include:
- Disulfiram (Antabuse). This drug produces strong nausea when it mixes with alcohol in the stomach. Eventually, the person using disulfiram learns to associate alcohol with highly unpleasant experiences.
- Naltrexone (ReVia, Vivitrol). By blocking opioid receptors in the brain, naltrexone reduces the intoxicating effects of drinking. In the process, it also reduces the intensity and frequency of cravings.
- Acamprosate (Campral). This medication works by repairing chemical imbalances in the brain associated with alcohol withdrawal symptoms. It thereby negates much of the severity of withdrawal and makes detox go more smoothly, ultimately reducing the urge to drink.
Disulfiram, naltrexone, and acamprosate are the only drugs approved by the FDA for the treatment of alcohol use disorders.
Spotting the Warning Signs of Relapse
A relapse is not a momentary slip of minor significance. It is a dangerous retreat into self-destructive habits that can have severe negative consequences.
Some of the telltale warning signs of an impending relapse include:
- Finding excuses to reconnect with old drinking buddies
- Staying away from people who support and encourage sobriety
- Romanticizing alcohol use or waxing nostalgic about “the good old days.”
- Deliberately tempting fate by attending events where alcohol is being consumed
- Missing appointments with addiction counselors or therapists
- Skipping doses of medications that were prescribed by an addiction specialist
- Not attending support group meetings
- Exhibiting overconfidence or minimizing the depth of the addiction
- Drastic changes in mood, like being overcome by feelings of depression or hopelessness
- Sudden struggles to cope with the common work, family or home life stressors that were supposedly addressed in rehab
- Neglecting personal hygiene
- Abandoning hobbies and activities that were once enjoyable
- Exhibiting strong cravings and talking about them or obsessing over them constantly
When the warning signs of relapse are present, it is vital that recovering alcoholics speak to their therapists and support group sponsors about what has been happening—before it is too late.
Myths About Alcohol Relapse
Relapses are frightening, disappointing, and frustrating. Alcohol triggers seem to come out of nowhere and catch the recovering addict unaware. It difficult to fathom how seemingly innocuous people, places, and events can be triggers, and yet that is exactly what they so often are.
Given the complexity and unpredictability of relapse and its multitude of potential alcohol abuse triggers, it is no wonder myths surround the issue of alcohol relapse. Separating truth from falsehoods in this instance is essential, since understanding the true nature of the challenges one faces as an alcoholic will improve their chances of maintaining the sobriety.
Myth 1: Being treated for alcoholism guarantees lifelong recovery
Sobriety is a lifelong journey. It is not a fixed goal or a final destination, but an ongoing, unfolding process that requires commitment, patience, and focus.
Recovery, in essence, is like a second full-time job. It will test one’s mettle and rewards only if the effort remains consistent from the initial time in inpatient rehab through theaftercare program and beyond.
Myth 2: Relapse is inevitable after abstinence because the triggers are everywhere
More than four-in-ten recovering alcoholics avoid relapse after leaving treatment, and it is this group that has the greatest chance of remaining sober for life.
To stay on the path to permanent sobriety, one must alter their attitudes and beliefs, learn new coping mechanisms, identify and disengage from self-sabotaging behavioral responses, work on methods for handling stress, and overcome negative thoughts that may have held the recovering addict back in the past. Relapse triggers are an obstacle on the road to recovery, but they are obstacles one can avoid once they know what to look for.
Myth 3: It takes only a moment of weakness to relapse
This is one of the most damaging myths about relapse because it causes people to let their guard down once they resist the initial temptation to drink during a particularly vulnerable moment.
The existence of those vulnerable moments is not a test of courage or strength, but a warning sign, one cannot afford to overlook. If one is continuously thinking about drinking, it means they’re responding to a trigger, and when that happens, one should consult with the addiction therapist about it before it becomes a trend.
Relapse is more of a slippery slope than an impulse, and the fact that one has such notions in the first place is what can set up for trouble.
Myth 4: Relapse is a sign of the weak will
On the contrary, relapse is an indicator of how chronic alcohol abuse alters mental and neurological functioning in ways that require time and enormous, sustained effort to overcome.
The brain’s reward circuitry can be re-trained to resist the pull of alcohol, and unhealthy and unproductive beliefs, attitudes, and behavioral responses can be unlearned. But one cannot expect the brain to return to normal simply because they’ve been clean and sober for a few weeks, and if the worse happens and users do relapse it is essential to get back on the wagon as quickly as one can—and if that proves too tricky, it could be a sign that one needs more time in rehab.
Myth 5: The recovering addict is alone in this journey
The path to sobriety should never be traveled alone. To avoid relapse, one needs the emotional and logistical support of family and friends. They should be the champions and the cheerleaders, helping to keep the spirit up when life’s stresses are putting addict’s recovery at risk.
They should also be careful not to expose a loved one to triggers by drinking in their presence, taking them to bars, clubs, or social events where alcohol is prominent, or adding to their stress and anxiety by creating conflicts. Their companionship can make a vital impact as they move forward in the recovery process.
Relapse Prevention Starts with A Willing
According to scientists and doctors, alcoholism is a chronic relapsing disorder. Many recovering addicts relapse, but they also bounce back stronger with the knowledge that they can fight the urges the next time.
Believing that triggers can be overcome is the key to preventing alcohol relapse. Know the enemies. Stick to the relapse prevention plan. But most importantly, seek help from trained counselors and peers who understand the disease and can help to understand it better.
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