One is too many, a thousand not enough: Does a slip or relapse mean the end?

  • Breaking news: When alcoholics who have gone through treatment have a drink after a certain length of sobriety, most don't go off the deep end.

    Just the thought of a relapse can bring about anxiety and stress for many struggling with drug abuse and addiction.

    Slip scares and abstinence

    The old AA adage: "One drink is too many, and a thousand not enough," refers to the fact that alcoholics who are sober are assumed to return to their evil ways after even a small slip. This notion is meant to warn AA members to resist temptation lest they find themselves right back where they started. Or worse.

    Most research into sobriety considers a person a success only if they remain sober throughout the study period. The followup periods last anywhere between 6 months to a year (or sometimes more). Have a drink, and you've lost. Game over. No one's ever really looked at what people who have relapsed actually do after the relapse.

    Recent relapse findings

    This is why the recent findings reported in the journal Psychology of Addictive Behaviors are so intriguing:

    When looking at the behavior of 563 participants, the researchers found that 30% stayed sober for the entire 12 month follow-up period. This leaves a whopping 70% who had at least a drink in the year following treatment. However, the vast majority of those who drank in the first year after treatment (82%) developed moderate, infrequent, drinking habits. In fact, only about 6% started drinking heavily and frequently after their relapse. Even of those who drank, as many as 25% were completely dry for at least an entire month after their relapse.

    The bottom line on relapse

    These findings suggest that at least for a year after becoming sober, a relapse is not necessarily the detrimental, destructive, event it has always been feared to be. It is surely possible that these drinking habits change, but according to these findings, if drinking frequency goes anywhere after the initial relapse, it's down, not up.

    I'm not trying to make light of relapse here, and I'm certainly not saying that relapsing is a positive thing. Nevertheless, given the fact that relapse is almost always a part of the recovery process, I'm suggesting that having a relapse shouldn't scare everyone involved. It doesn't seem to in any way suggest a necessary demise.

    Citation:

    Witkiewitz, K. & Masyn, K. E. (2008). Drinking trajectories following an initial lapse. Psychology of Addictive Behaviors, 22, 157-167.

    November 22, 2009 @ 10:05 PM

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  • Oh and another note- the main reason I chose abstinence as my path of choice is that it was my aftercare recommendation upon leaving treatment. If we're looking at addiction on the disease model, then one can only assume some will follow recommendation, and some won't, with varying results. It's the same way as treating diabetes. An individual can go a holistic, non-medical route, and still have their diabetes under control. They can also follow the insulin path. Or other options that I probably don't know about- but what I do know, is if they do nothing, they will experience consequences. Same with addiction.

    December 14, 2009 @ 11:08 PM

  • Having read a lot of what this author has written, I see both sides of the issue. Obviously, being a member of a 12-step program can benefit most people who struggle with chemical dependency. For others, it may be outside issues which create a need for medication- sometimes illicit medication. As a member of the 12-step community, I myself have chosen the path of abstinence. However, that's not the end-all be-all. Relapse does happen- and sometimes the consequences are immediate, and sometimes they aren't. That's the deal. NO ONE here has any reason to judge either party- the author was reporting on research. This isn't "dangerous information," it's simply information. Take it or leave it.

    December 14, 2009 @ 11:04 PM

  • You know, on second thought. I'm done with you. I'm reading your posts and it is obvious you have no interest in the truth. The only thing you are interested in is protecting your pathetic little ego and your reputation. Whatever that is. You ARE a dangerous man, and I will do my best to keep anyone I know who is in recovery or thinking about recovery away from you.

    You are no more a scientist than I'm the man in the moon. I can only hope that you don't cause some poor soul to use or drink to the point that they injure themselves, someone else, or worse.

    December 14, 2009 @ 10:51 PM

  • That would be a typing error. Using "basis" instead of "bases" and "you're" instead of "your" would be errors indicating improper use of English.

    You indicated that my being an addict or not would affect my ability to conduct research or have any knowledge of addiction. I would call that your precious ad hominem argument. Do you ask your doctor if he's ever had the flu or cancer before you go in for treatment?

    Aside from my own addiction, my knowledge about addiction comes from research. Deal with it.

    December 14, 2009 @ 10:48 PM

  • "I welcome any discussion of the researcch itself and I'm not the one who introduced personal issues into the debate (you're the one who called me an "unwise" "youngester" who "shouldn't be allowed" to report such things)."

    And you called my intelligence into question because of spelling. Really. ;)

    It's obvious you do not know what an ad hominem attack is. And I notice how you keep doing the "you did it first" thing. You just continue to affirm your immaturity.

    "I personally think it's dangerous for people to stop searching for answers because they think they have it all figured out.

    I couldn't agree more. In fact, through my searching over the past 40 years or so, I have found that surveys give the results the designers wish to find. And many people who want to see the truth as they want it, interpret findings in that light. That may or may not be the case here. As I said earlier, I'll look it over and get back to you. In my opinion. You do not know the alcoholic behavior as well as you think you do.

    December 14, 2009 @ 10:42 PM

  • And thanks for your support Melinda! I Hope you'll keep reading at www.allaboutaddiction.com

    We report on things that go along with and against popular thinking about addiction. I do my best to stick to the science but do include stories andd some opinion pieces (they're under... yes, the opinions category).

    Best

    Adi

    December 14, 2009 @ 10:32 PM

  • For the last month or so, it has been just you and I on this discussion. I've been disagreeing with you and have pretty well put doubt in your claims and then all sudden someone posts an amazing compliment about your brilliance. How convenient. Next thing you know, the moderator will step in and give his two cents as to why I need to lay off.

    If you cannot deal with truth, or if you are afraid to be wrong, then why be in research at all? Or are you in it for another reason?

    December 14, 2009 @ 10:31 PM

  • I have no problem with doubt, but I question your calling me a dangerous man for reporting a scientific finding (which is what I was doing).
    My agenda is to report science and educate, yours is to prove that AA is the way to go for addiction treatment. I think that's pretty clear.
    I welcome any discussion of the researcch itself and I'm not the one who introduced personal issues into the debate (you're the one who called me an "unwise" "youngester" who "shouldn't be allowed" to report such things).
    I personally think it's dangerous for people to stop searching for answers because they think they have it all figured out. But that's just me. Let's keep the rest of this discussion focused on facts regarding this study, shall we?

    December 14, 2009 @ 10:31 PM

  • Thanks for the amazing article! I'm a new reader (thanks to @duncaninla) and really appreciate your insight and ability to share views that aren't always "popular". Thank you, Melinda @MeNolt

    December 14, 2009 @ 10:23 PM

  • I do doubt the researchers and I doubt your interpretation of the results. I think you are a dangerous man to those who may be alcoholic and/or drug addicts.

    With very little effort I found a link to the report. There are quite a few references to this report.

    www.statmodel.com/download/WitkiewitzMasyn.pdf

    After a brief scan I found the criteria for the drinking behavior.

    I'll look it over more carefully when I get a chance and get back to you with more comments.

    FYI...I googled the title. It's funny that you weren't aware that this article was available on the web. I really doubt your sincerity on the issue.

    December 14, 2009 @ 10:17 PM
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