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.

Slip scares and abstinence relapse

RelapsingThe 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 (known as a relapse). 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. Which is why the recent findings reported in the journal Psychology of Addictive Behaviors are so intriguing.

Recent relapse research findings

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.

4 Replies to “One is too many, a thousand not enough: Does a slip or relapse mean the end?”

  1. Though I believe it is wonderful to highlight the fact that many with alcoholism who go through a recovery program are able to at some point find moderation in their drinking habits, please do remember the six percent of recovered alcoholics who are unable to do so. Perhaps they should not forgo the success of treatment and positive changes in their lives for a chance to pick up a glass of whatever it is they’re craving.

  2. Thanks Starshine,
    There’s no doubt that a significant portion of alcoholics can never return to consume any alcohol. Nevertheless, I think it’s important to stress that even if they can’t, there’s little reason to think that a slip is a sure ticket to hell. This research seems to suggest that most slips don’t lead down a fast track back to problems use.

    I think both angles need to be covered.
    .-= Adi Jaffe´s last blog ..Drug use isn’t the problem – Addiction and the question of legalization or decriminalization =-.

  3. as a recovering alcoholic, this is one of the most dangerous articles I’ve ever read. someone that is struggling can definitely misconstrue what you’ve written. Taking one drink for a recovering alcoholic/drug addict can have devastating effects.

    1. Isn’t that true no matter what anyone writes? That is could be misconstrued? I am reporting on research findings AND my own experience… What would you have us do instead, simply ignore knowledge and just move forward in whatever way we see fit because it supports our own built-in notions?

      I would argue that such an approach is far more dangerous.

      In case it wasn’t said clearly enough in this article and hundreds of others I’ve written – tens of thousands of people are currently dying every year from addiction. I would suggest that our current system is failing them and I, for one, am not going to sit by and take the safe “just say no” bullshit road…

      Feel free to do as you will.

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