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Staying sober: Six tips to avoid living in fear of relapse

staying sober

Everyone who spends some time in a drug and alcohol treatment center faces a moment of truth after leaving: Will I be able to stay sober?

The short answer is a simple one: Yes, if you want to stay sober. While relapse is certainly a concern — “there is evidence that approximately 90 percent of alcoholics are likely to experience at least one relapse over the 4-year period following treatment,” according to a 1989 article published by the National Institute on Alcohol Abuse and Alcoholism [1] — it’s critical for newly minted treatment center graduates to remember that relapse is always a choice.

Bottles of liquor don’t mysteriously appear in the passenger seats of our cars. Bartenders aren’t hiding in the bushes, ready to leap out at us with a funnel and a bottle screaming, “Surprise!” The taps in our homes don’t magically begin dispensing beer.

A relapse begins with choices that we make, and rarely do those choices start out with a drive to the bar or liquor store. A reputable treatment center has purged our body of alcohol through a Medical Detox regimen, and various residential treatment programs give us the tools we need to stay sober. We just have to use them on the outside, where they become indispensable weapons against a return to the abyss of our disease.

So if we know we can stay sober, how do we do it? Here are some suggestions that can help.

Staying Sober Through the PAWS

staying soberIf treatment was the cure-all for alcoholism, everyone who came out of the other side would be golden. Unfortunately, it’s not. Medical Detox treats acute withdrawal symptoms, but as Dr. James C. Garbutt, a professor of psychiatry and an addiction specialist at the University of North Carolina, points out in an article for The Fix [2], “But then there’s this phenomenon that can persist after acute withdrawal, which is called PAWS, Protracted Alcohol Withdrawal Syndrome. You’re still having withdrawal symptoms but they’re not as acute — you may not be feeling well, but even more than that, the feelings can contribute to relapse risk.”

In other words, there could very well be some lingering physical symptoms associated with recovering from alcoholism. You didn’t become one overnight, and you won’t get better overnight, either, and it’s imperative to understand that PAWS can be a factor in the initial phase of your post-rehab journey. Your brain has undergone some serious physiological changes during your alcoholism, according to the Semel Institute for Neuroscience and Human Behavior at the University of California Los Angeles [3]: “The brain makes adaptations to accommodate for the changes in available neurotransmitters, and these changes can result in excitability when levels of these neurotransmitters change during abstinence. Scientists hypothesize that that the brain’s capacity to deal with stress is reduced with prolonged substance abuse and the related withdrawal experiences.”

So how do you treat PAWS? The University of Wisconsin Madison’s School of Medicine and Public Health has some excellent guidelines [4]:

  • Identify your support system. It can be family, friends, counselors, health care providers, spiritual or religious group. Anyone that supports your desire to stay clean and sober.
  • Stay in touch with your support system.
  • Identify emotional states that trigger your desire to use: anger, boredom, sadness, loneliness. Get more support when they arise.
  • Make a daily routine that allows time to rest and relax.
  • Try to have a routine sleep pattern.
  • Eat throughout the day. Reduced junk or processed foods and eat more healthy foods, such as fruit, vegetables, and whole unprocessed foods.
  • Exercise can help reduce stress and increase your energy.
  • Treat yourself with patience and understanding

Staying Sober, With Some Assistance

Any reputable rehab facility has introduced recovering alcoholics to the 12 Step programs that are the foundation of traditional sobriety. We’re talking about Alcoholics Anonymous, of course, but there are other programs out there that are equally beneficial, from Narcotics Anonymous to Celebrate Recovery to Refuge Recovery. What matters most is that you find your tribe — individuals who share a similar trajectory through addiction and alcoholism, to whom you can be accountable and hold to similar accountability.

Recovery predecessors like to say, “get in the middle of the boat,” which means that addicts and alcoholics should get involved in meetings as a way to continue to stay sober. The first step, obviously, is finding the right meeting, Sometimes if you’ve grown used to a regular routine of meetings that you attended while in treatment, finding your place in a new group can be difficult. But look at it this way: Pick several, and go one time. No one is going to chain you to the radiator and force you to sign a membership pledge. Sit for an hour. If you can’t stand it, you never have to go back … but if you hear just one thing that makes you feel a little bit better by the time the meeting ends, why not go back?

Eventually, you may find a new group of individuals around whom you build a social network, and you’ll find ways to get out of your own head and be of service to others. And it will help you stay sober: According to an April 2019 article published by Harvard Medical School [5], “Of people who attend AA, 44 percent of those who remain free of alcohol for 1 year probably will remain abstinent for another year. This figure increases to 91% for those who have remained abstinent and have attended AA for 5 years or more.”

Stay Away From the First One

staying soberThere’s a particular colloquialism in Alcoholics Anonymous, one of a number of 12 Step programs that provide support for recovering addicts and alcoholics, that says, “If you don’t take that first drink, you can’t get drunk.”

If we take an honest look at our alcohol use, we can see that for many of us, we always thought we could control how much we drank. Eventually, it became a labyrinthine ritual of lying to others and to ourselves about how bad our problem was. We were careful never to let on to others the extent of our drinking, and on the few occasions it frightened us, we may have even quit cold turkey for a short time. Sooner or later, however — once the consequences disappeared and the danger signs seemed to have passed — that old way of thinking reasserted itself: “I can have just one.”

And because “just one” never amounted to any problems or did any serious damage, we thought, “Maybe I don’t have a problem after all.” And so all of the boundaries we set for ourselves were immediately disassembled, and within a short time, we found ourselves back in the same predicament. Time after time, we find ourselves on the edge of complete and total collapse in all areas of our lives, holding our heads in our hands and wondering, “How did I get here again?”

That’s an easy answer: We took the first drink. If we don’t do that, then we don’t start that vicious cycle all over again. And really, on the surface, that’s the simplest solution, because instead of focusing on how many drinks we should limit ourselves to, we only have to concentrate on avoiding one drink: the first one. Instead of counting how many drinks we might have on a bender, we only have to concern ourselves with not taking the first one.

Play the Tape

can drug and alcohol use in college lead to addiction?Our disease is a cunning, baffling thing, because it tries to convince us that we don't have a disease. And one way they do so is through what's known as euphoric recall.

Euphoric recall is when a recovering alcoholic gets lost in the fond remembrance of drinking, recalling that behavior as ecstatic rather than insane. In euphoric recall, we fail to remember the massively negative consequences that brought us to sobriety. In some ways, that’s the brain’s way of protecting itself; we’re hard-wired to forget the pain that’s associated with traumatic experiences. Pleasurable memories and emotions are easier to recall — the first car we owned, the first kiss we ever had, the first time we fell in love. We remember the event hand-in-hand with the emotion … but the more traumatic things that happen to us, unless we suffer from Post Traumatic Stress Disorder, are only remembered as events. The first time we lost a loved one … the first time we were in the hospital … we remember those things happening to us, but it’s difficult to summon the fear, the grief, the sadness that accompanied them.

The further we removed we become from the last time we drank, the harder it is to recall the negative emotions associated with those times. As a result, when a holiday or celebratory event comes around that we always celebrated with drunken revelry, we can feel a little melancholy, like we’re missing out on some fun we used to have. We remember the good times — the weekends at the lake, drinking beer and grilling out and laughing with friends. What we conveniently forget is that because we're alcoholics, we're remembering those times through a misleading filter. We conveniently forget about getting so drunk that we knocked over the grill, ruined everyone's dinner, puked on our feet and fell into the lake. We forget how security had to escort us out of that concert, kicking and screaming, or how we blacked out halfway through the show and can't remember a single song that was performed.

That’s why recovery teaches us to “play the tape all the way through” — in other words, don't just focus on the good times; carry that memory through to the end, to the point where we usually ended up broke, desperate, miserable and wanting to die. For most of us, the “good times” associated with alcohol are gone. We can never do one of anything, so if we’re tempted to have a beer over the course of a holiday weekend or any other, all we have to do is remember how out of control our lives get after we pick up the first one.

Remembering the last time we drank is a vital tool in the recovery process, because our disease wants us to forget. It wants us to romanticize our alcoholism, but when we “play the tape all the way through,” we see that such a romanticization is a lie.

Pick Up the Phone

staying soberEver had a crazy thought pop into your head? Sure. We all have, which is why it shouldn’t be a surprise when a drinking thought shows up. Remember: It’s not a reason to panic if we find ourselves thinking about drinking. After all, it occupied our every waking thought for weeks, months and years, and they’re not going to go away overnight. That doesn’t mean it’s a passing thought; sometimes, they can turn into a full-blown craving that has a physiological response as well: We start to shake, perhaps our mouths start to water, we feel as if we’re about to explode if we don’t give in. The longer we stay sober, the more those obsessions are lifted, especially since we now have tools to lessen their influence over us.

One of those tools is our willingness to pick up the phone and call someone. Whether it’s reaching back out to Cornerstone and one of the Recovery Coaches in the Continuous Care program or one of our peers in whatever fellowship we attend, we don’t have to go through those cravings alone. In fact, most of us are given a list of phone numbers at the first AA or NA meetings we attend; if they’re not voluntarily given to us, all we have to do is ask for a list, and we’re of course encouraged to keep adding to it by getting the numbers of those we meet and talk to in the rooms.

That list, however, is useless unless we avail ourselves of it. We’ve heard our predecessors talk about remembering when “the phone weighed 1,000 pounds,” and we know exactly what they mean: The idea of calling someone we don’t know makes us extremely uncomfortable. After all, we can’t put a face with many of those names, and the ones we do remember, we’ve barely talked to at a meeting. The idea of calling them when we’re feeling out of sorts or vulnerable is, in a sense, terrifying … but our predecessors suggest it for good reason: It works.

Consider this: When you were drinking, how many times did you strike up a conversation with random strangers in a bar and, as the drinks continued to flow, think of them as a new best friend? If we never hesitated to call or open ourselves up to those who helped us on our downward spiral, why in the world would we hesitate to reach out to someone who might lift us up and offer us as little bit of hope?

Be Aware of Your Surroundings

There will be occasions where we find ourselves around alcohol; after all, we can’t reasonably avoid gas stations or grocery stores just because there are coolers full of beer in those places, can we? It’s not a reasonable expectation, but more importantly, we shouldn’t live our lives in fear of situations and individuals where alcohol might be present.

Do you enjoy going to see and hear live music? If so, it’s difficult to do so if you’re stridently attempting to avoid places that serve alcohol. And in early sobriety, that’s probably not a bad idea. We sometimes feel the need to “test” ourselves, but what’s the point in that? Why would we put our sobriety in jeopardy by attending an event where we know temptation could be lurking? A general rule of thumb in early sobriety is that if attendance at such an activity makes you nervous, don’t go. It’s not worth the stress beforehand or the pressure you may feel in the moment to do something that will endanger your sobriety.

By the same token, the goal of sobriety isn’t to don the robes or habits of a religious order and live under measures of austerity that deny us pleasure. If the goal of the program is to teach us a new way to live, we can certainly apply those principles to do the things that bring us joy, and to do them without feeling as if our sobriety is in jeopardy every time we do so. As time goes by, we begin to understand that not drinking is the only decision we need to make to live happy, productive lives.

We find ourselves able to be in the company of those who order a beer or a glass of wine without staring at it in envy; we find we can stand in a crowd of fellow rock ‘n’ rollers and scream for the band’s latest hit without having to have a drink in each hand. We realize that we don’t want to withdraw from the rest of the world because so many people in it are able to drink and use casually, and why should we? After all, there are others who are allergic to gluten or shellfish or strawberries, and they don’t deny themselves the simple pleasure of a meal at a restaurant; they simply take the precautions needed to safeguard their own health, just as we do when we venture out among “normal” people.

When we choose to do so, we first and foremost check our motives. By the same token, we should expect no special treatment in order to safeguard our own recovery — after all, we can’t ask the management at a restaurant to lock up the liquor. Most importantly, we should always remember that if we feel backed into a corner, through peer pressure or just a general sense of unease that arises once we arrive in these situations, that we have the power to walk away whenever we want.

Eventually, the longer we stay clean and sober and the more involved we are in a program, the more we find that the company we keep consists mostly of our fellow addicts and alcoholics. In fact, when we attend a concert or an event where alcohol (and perhaps drugs) will be consumed, we often do so in the company of our friends in recovery. There is, after all, strength in numbers, and having a wingman or woman by our side often provides us with a sense of comfort.

Either way, life in recovery, we discover, can be adventurous, fulfilling and fun — without the need to drink or use. As long as our motives are in check, we can participate in these things that bring us joy without fear of relapse. Relapse, after all, is not a monster waiting in the shadows to shove a bottle between our lips or a pill down our throats; it’s a conscious decision we make, and if our recovery is strong, we can move freely in the world of “normal” people, even those who imbibe, without the constant specter of our old way of life reasserting itself.

We can stand on our own two feet, decline anything put in front of us and instead focus on the reason we attend these events in the first place — to live life instead of hiding away out of fear that our disease will leap from the bushes and overpower us.

SOURCES

[1]: https://pubs.niaaa.nih.gov/publications/aa06.htm

[2]: https://www.thefix.com/content/making-it-through-first-year

[3]: https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS

[4]: https://www.uwhealth.org/healthfacts/psychiatry/7228.pdf

[5]: https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z