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

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 (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.