Before we discuss what to say to someone who has relapsed, let us define a relapse. The Merriam-Webster dictionary defines relapse as:
- The act or an instance of backsliding, worsening, or subsiding
- A recurrence of symptoms of a disease after a period of improvement
- To Slip or fall back into a former worse state
When we hear about a relapse, the first thought is the person started using alcohol or drugs again. That is how people define a relapse in recovery. Alcoholics and Narcotics Anonymous members celebrate their sobriety year after year by accepting a chip. Is this the best way to define sobriety, and is it telling the whole story? How do 12-step programs for process addictions such as sex, love, or eating disorders define a relapse? After all, people are still romantic, and they still eat, so why isn’t engaging in sex or eating a meal a relapse? In these programs, they define relapse by behavior and intent. If addicts and alcoholics did the same thing, their chips would likely not pile up.
Relapse on alcohol or drugs happens long before the time the person uses substances. When behaviors, thoughts, and habits slowly revert over some time, it makes the addict or alcoholic highly susceptible to relapse. Nobody wakes up while in recovery and says today is a good day to drink or use drugs unless their behaviors have relapsed long before this thought.
We define relapse in addiction recovery this way:
“Relapse occurs when a person’s old behaviors and thinking have returned to their original state before treatment and go unaddressed over time. When these behaviors worsen over time, and the person starts to justify their actions and thoughts, sooner or later, the alcoholic or drug addict will lose the power of choice and consume substances. Addicts and alcoholics who never improve their condition and address their behaviors and thoughts who do not use drugs or alcohol during this period of abstinence do not relapse; they resume. Looking at the definition above, you will realize that their behavior did not return to a previous state, backslide, or worsen; it never changed”.
What Causes Someone to Relapse into Drugs or Alcohol?
What recovery from alcohol and drug addiction means is recovering from a thinking problem. It means changing one’s perspective and addressing the underlying thoughts, feelings, emotions, traumas, and negative experiences. The book of Alcoholics Anonymous says that resentments are the alcoholic’s number one offender.
Resentment means to re-feel and hold hatred towards those you feel have wronged you. A big part of a recovery program is learning not to be a victim and stop blaming everyone or everything else for your problems. It is about ownership, accountability, and looking at what you did to put yourself in a position to be hurt by another person. Walking through life, a victim resentful at the world can hardly help anyone recover. When there is a shift back to these old thoughts, behaviors, and patterns, a relapse into alcohol and other drugs happens.
Nobody can say with absolute certainty what causes addiction. Scientists are still trying to find that gene to solidify their beliefs about the disease model. We are not here to debate where it started or whether or not addiction is a disease. We only hear to discuss evidence-based treatment that works. The number one evidence-based treatment that works is 12-step facilitation.
12-step facilitation encourages a change in perception and ownership of one’s problem. The other top evidence-based treatment is Cognitive Behavioral Therapy (CBT). CBT, to put it simply, helps you address unrealistic and unhelpful thoughts. We’re not saying 12-step facilitation and CBT are the same; we’re just saying these are the top two evidenced-based treatments for alcohol and drug addiction recovery. When these two treatments stop, relapse is often around the corner.
What to Say to Someone That Has Relapsed on Alcohol or Drugs
Families often ask what to say to help an addict or an alcoholic quit or what to say to them after a relapse. What you say is essential, and what you do is more important. Families who are engaged in their recovery program through our S.A.F.E. Family Recovery coaching program after the intervention will have seen the behavioral warning signs long before the relapse on alcohol or drugs.
Family members in recovery involving Al-Anon, Families Anonymous, Codependents Anonymous, and Adult Children of Alcoholics and Dysfunctional Family meetings would know what to do and say should a relapse occur. The point is, whether the alcoholic or drug addict is sober, has relapsed, resumed, or has been using for a long time, families need a recovery program for themselves to see the warning signs before their loved one turns to alcohol or drugs.
Families in recovery will know what to do and have the support of a sponsor and other members of their groups to understand what to say. You cannot say much more than encouraging them to return to treatment or their recovery program. The reason we say this is because the relapse happened long ago. The behaviors that led to the deterioration have been brewing for months and sometimes years. The behaviors when someone resumes never go away. It is not that simple for someone to stop after a relapse. If the addict or alcoholic could snap out of the relapse with what you say, you most likely would not have gone through what you did before they sought help.
“It is much easier to prevent relapse on alcohol or drugs when you catch the behavioral warning signs. Once the addict or alcoholic uses a substance, the destruction may run its course before they realize the need to return to treatment or their recovery program that they stopped being part of.”
Many interventionists like to think what they say to your loved one is what convinces them to accept help, and this could be true for a small window in time during an intervention. The interventionist may connect with them and help them surrender at that moment. What brings the addict or alcoholic to accept help at that moment is the love of the family and the intervention letters that the family wrote and read to their loved one with mediation services of the interventionist being present. Behind the scenes and after the intervention, what brings your loved one to treatment and keeps them in treatment are the same principles if they relapse.
Family Recovery, Boundaries, Accountability, Love, and Affirmation will always win over enabling, codependency, feeling sorry for them, believing they are victims, and buying their manipulations and broken promises. What you say to someone can be as simple as providing resources and telling them to call their sponsor or return to their previous treatment program.
You cannot bail them out of the relapse as you bailed them out of the addiction before seeking help. The same principles apply. We are not trying to be harsh; if you help them the wrong way, you will get sucked right back into where you started.
How to Help Someone Who Has Recently Relapsed and Reverted to Substance Use
The more you learn about behaviors that drive addiction, the more you will understand why addicts and alcoholics do not seek help or relapse after they do. How you help someone who has recently relapsed is the same way you help someone who has never stopped. Detaching from an addict or alcoholic is one of the healthiest things you can do for yourself and your loved one. When you detach yourself from the addiction and the behaviors, you allow yourself freedom. Detachment does not punish or shame your loved one; it sends a message that you will not allow their behaviors and destruction in your life. If a loved one relapses or chooses not to seek help in the first place, the last thing you want to do is enable them.
Enabling encourages bad behavior and can send the message that the relapse was ok. Some professionals encourage you to be by their side immediately after a relapse, and it is an opinion they are entitled to and an action you are free to attempt. In our experience, a relapse brews long before active substance use. If you choose to be by their side after a relapse, you are encouraging the relapse on substances and validating the behaviors that led up to it.
Families can relapse on codependency and enabling just as much as a substance user can relapse on substances. When a family relapses and reverts to old behaviors that encourage substance use, it allows the addict or alcoholic a more accessible path back to addiction and a more challenging path back to addiction recovery. The CRAFT Model of addiction recovery is based on the theory of operant conditioning. If family members and friends encourage bad behavior, then the addict or alcoholic is more likely to continue bad behavior. If the family discourages negative behavior, the addict or alcoholic is more likely to see the consequences of their actions and move closer to addressing the problem.
How to Support Someone in Addiction Recovery
The best thing a family can do to support their loved one in addiction recovery is to start with family recovery. Families often struggle after an intervention when their loved one goes to treatment. Up until the intervention, many families had a false sense of control. Many believed they managed or controlled their loved one’s drug addiction or alcoholism. After the intervention, changing the focus from your loved one to yourself is difficult. Families often struggle, and their fear turns to anger towards other family members, the intervention team, your loved ones’ treatment team, and their loved one in treatment.
The most effective way to support your loved one in addiction recovery is to address your emotions and struggles with the change that has occurred with your loved one entering treatment. For those whose loved ones have not accepted treatment or have relapsed, the same anger and fear will emerge. The healthier a family becomes, the better the chance their loved one can achieve a successful addiction recovery outcome. The family will benefit from not being involved in their loved ones’ active addiction, recovery, or relapse unless under the supervision of an interventionist, clinician, or you or your loved ones’ treatment team.
To learn more about how to help your loved one accept help or how to come back after a relapse, please call us. Change is possible, and we can help.
