Relapse Warning Signs

[Jen]

I found myself needing to review these today and thought others might find them useful, too:

Relapse Signs and Symptoms

Experiencing Post Acute Withdrawal: I start having problems with one or more of the following; thinking difficulties, emotional overreaction problems, sleep disturbances, memory difficulties, becoming accident prone, and/or starting to experience a serious sensitivity to stress.

Return To Denial: I stop telling others what I’m thinking/feeling and start trying to convince myself or others that everything is all right, when in fact it is not.

Avoidance And Defensive Behavior: I start avoiding people who will give me honest feedback and/or I start becoming irritable and angry with them.

Starting To Crisis Build: I start to notice that ordinary everyday problems become overwhelming and no matter how hard I try, I can’t solve my problems.

Feeling Immobilized (Stuck): I start believing that there is nowhere to turn and no way to solve my problems. I feel trapped and start to use magical thinking.

Becoming Depressed: I start feeling down-in-the dumps and have very low energy. I may even become so depressed that I start thinking of suicide.

Compulsive And/Or Impulsive Behaviors (Loss Of Control): I start using one or more of the following- food, sex, caffeine, nicotine, work, gambling, etc. often in an out of control fashion. And/or I may react without thinking of the consequences of my behavior on myself and others.

Urges And Cravings (Thinking About Drinking/Using): I begin to think that alcohol/drug use is the only way to feel better. I start thinking about justifications to drink/use and convince myself that using is the logical thing to do.

Chemical Loss Of Control (Drinking/Using): I find myself drinking/using again to solve my problems. I start to believe that “it’s all over ‘till I hit bottom, so I may as well enjoy this relapse while it’s good.” My problems continue to get worse.

Adapted from Terence T. Gorski's Warning Sign Identification Process
THE TEN MOST COMMON RELAPSE DANGERS

1. Being in the presence of drugs or alcohol, drug or alcohol users, or places where you used or bought chemicals.

2. Feelings we perceive as negative, particularly anger; also sadness, loneliness, guilt, fear, and anxiety.

3. Positive feelings that make you want to celebrate.

4. Boredom.

5. Getting high on any drug.

6. Physical pain.

7. Listening to war stories and just dwelling on getting high.

8. Suddenly having a lot of cash.

9. Using prescription drugs that can get you high even if you use them properly.

10. Believing that you no longer have to worry (complacent). That is, that you are no longer stimulated to crave drugs/alcohol by any of the above situations, or by anything else – and therefore maybe it’s safe for you to use occasionally.


RELAPSE ATTITUDES


SOBRIETY IS BORING
I’LL NEVER DRINK/USE AGAIN
I CAN DO IT MYSELF
I’M NOT AS BAD AS …..
I OWE THIS ONE TO ME
MY PROBLEMS CAN’T BE SOLVED
I WISH I WAS HAPPY
I DON’T CARE
IF NOBODY ELSE CARES, WHY SHOULD I?
THINGS HAVE CHANGED
I CAN SUBSTITUTE
THEY DON’T KNOW WHAT THEY ARE TALKING ABOUT
THERE’S GOT TO BE A BETTER WAY
I CAN’T CHANGE THE WAY I THINK
IF I MOVE, EVERYTHING WILL CHANGE
I LIKE MY OLD FRIENDS
I CAN DO THINGS DIFFERENTLY
NOBODY NEEDS TO KNOW HOW I FEEL
I’M DEPRESSED
I SEE THINGS MY WAY ONLY
I FEEL HOPELESS
I CAN HANDLE IT
IF I HIDE BEHIND EVERYONE ELSE’S PROBLEMS, I WON’T
HAVE TO FACE MY OWN
I CAN’T DO IT
WHY TRY

THE EVENT: A RETURN TO THE USE OF ALCOHOL AND/OR DRUGS.

[agd263]

Thanks for posting this VERY helpful. Things have been going so good for me..sometimes it feels like...okay its beautiful now..when does the tsunami hit? But really as many of the things indicate there - its a slow, drift into old thinking and habits - that's why daily review is so important for at least 90 days, i think.

[Indiglow]

Jen, this has "sticky" written all over it. Printed it out to keep. Thanks.

[Jigsy]

Thank you, thank you, thank you.

[Hopey]

These are great and very helpful.

One thing I saw that shocked me was seeing that relapse thinking is the "I will never drink again." thought.

That really surprised me. I have that in my signature. I don't know what to make of that.

[RedheadGI]

Thanks, Jen! EXTREMELY helpful for me right now, and I'm sure for many others.

[Jadebird]

Great post about relapse dangers.

What do you do in a situation though where you are told to take a prescription drug that might lead to a relapse. For example, I had my wisdom teeth pulled a year ago and they put me on this stuff that made me really loopy before going in, and then vicodin after the incident. Another time was I had to have a female procedure done (I won't get specific) and the doc wanted me to take valium prior to the procedure so I would be relaxed, and it did help. Should we always refuse all chemical assistance in situations where it would otherwise help if we weren't addicts? Because I was still drinking, neither one of those examples led to a relapse because I was still lapsing.

[agd263]

.... and the doc wanted me to take valium prior to the procedure so I would be relaxed, and it did help..

I am still flabbergasted that doctors do this . I was ANGRY when my grandmother died and the doctor 'perscribed' something to 'make her feel better' (which she was still taking four years later) would any doctor think of saying -well your mom died - drink whiskey it will help...
True some sedatives can help temporarily -but the same benefits can be had with guided relaxation and breathing....sorry to rant ....my answer would be - ask the doctor if there are non drug alternatives.

[Happy]

Things have been going so good for me..sometimes it feels like...okay its beautiful now..when does the tsunami hit? But really as many of the things indicate there - its a slow, drift into old thinking and habits - that's why daily review is so important for at least 90 days, i think.

A couple of years ago, a member who was very strong in her quit, had a very bad crash at about 5-6 months....she said that she saw the tsunami coming, and all she could do was stare at it until it hit....I think that reinforces the point that continually reviewing those points often and acting pre-emptively is important because In all likelihood, when you see tha tsunami, just as in real life, its too late.....thanks for posting Jen!

[sweet]

Great list Jen - a lot to think about there.

[sharksandwich]

I've read this thing several times.

Now I think I'll just print it off.

Great post.

[Hopey]

i think i'm gonna change my signature

that really makes me think

and really it all comes down to today right ?

one day at a time ?

[agd263]

i think i'm gonna change my signature

that really makes me think

and really it all comes down to today right ?

one day at a time ?

I don't know...first thing they are only warning signs..secondly they don't apply to everyone at all times - I would more look for a 'cluster' of symptoms/signs rather than think 'oh i am in a celebratory mood...better worry about taking a drink' - because in a mild way most everything on the list is always happening....

Don't get me wrong - the list is very very very useful...but if something's working for you like that you like - like your signature, I would keep it.

[Hopey]

*grins* Hey agd. Thanks.

I changed it from "I won't drink EVER again!" to "I won't drink today."

I don't know why but for some reason I think I like the latter better.

Because really all we can control is today.

I see you all over the place agd and I'm glad to finally "chat" with you. I need to visit your journal.

[Jen]

I'm no expert, just passing the list on, but I interpreted the "I'll never drink again" to be more like "I'm completely past this addiction now." Like... complacency.

[Hopey]

I'm no expert, just passing the list on, but I interpreted the "I'll never drink again" to be more like "I'm completely past this addiction now." Like... complacency.

Hrrmm .. good thought Jen. And great great list!!! Thanks again.

I hope you're having a good day hun.

[Charlie]

Great post. Thanks Jen.

[Happy]

I changed it from "I won't drink EVER again!" to "I won't drink today."

I don't know why but for some reason I think I like the latter better.

Because really all we can control is today.



I will never drink again, one day at a time...:D The first is a goal and the second is how I will accomplish that goal....Most things in life are easier to handle in small chunks Hopey....today is a manageable chunk that I can handle....I like your new sig line!:D

[PBgirl]

Thanks for posting this, Jen.

[Freya]

I shook hands with Gorski!! :) I was at a lecture he gave here last winter, he's a really great guy. American. He's written a ton of books on addiction and we use his techniques in the relapse prevention group I'm apprenticing in on Thursday nights.

Regarding pre, during, and post-operative drugs, etc....inform your doctor that you're an alcoholic and he'll prescribe something that doesn't set off your addiction. It's very common, and it's certainly better to swallow your pride than suddenly (potentially) having a monster on your hands again.

[Doodlebug!]

Great post, Jen

At 1 month, I'm probably still floating on my pink cloud, but then, who knows when it'll evaporate? It's good to have something that I can refer to when that happens!

[miffy]

Very informative and eye opening. Thanks, Jen!

[Maximus]

Good post, i will definetly keep these things in mind!

[John]

Bumping this excellent thread back up for two reasons. First, it may be of interest to some people. Second (selfish part) is a request for additional thoughts.

I am getting close to the point of my longest quit (just over 4 months) which was last year. That time, I didn't really relapse exactly since it was planned once things were "re-calibrated".:o This time I want to be on the lookout and admittedly have had a few thoughts of "a drink would relieve stress" (urges/cravings). It isn't serious yet but has alarmed me given the timing.

The signs below are great but maybe a bit vague. Are there more resources that might provide examples of how these might look in real life?? Thanks if anyone has thoughts.

I found myself needing to review these today and thought others might find them useful, too:

Relapse Signs and Symptoms

Experiencing Post Acute Withdrawal: I start having problems with one or more of the following; thinking difficulties, emotional overreaction problems, sleep disturbances, memory difficulties, becoming accident prone, and/or starting to experience a serious sensitivity to stress.

Return To Denial: I stop telling others what I’m thinking/feeling and start trying to convince myself or others that everything is all right, when in fact it is not.

Avoidance And Defensive Behavior: I start avoiding people who will give me honest feedback and/or I start becoming irritable and angry with them.

Starting To Crisis Build: I start to notice that ordinary everyday problems become overwhelming and no matter how hard I try, I can’t solve my problems.

Feeling Immobilized (Stuck): I start believing that there is nowhere to turn and no way to solve my problems. I feel trapped and start to use magical thinking.

Becoming Depressed: I start feeling down-in-the dumps and have very low energy. I may even become so depressed that I start thinking of suicide.

Compulsive And/Or Impulsive Behaviors (Loss Of Control): I start using one or more of the following- food, sex, caffeine, nicotine, work, gambling, etc. often in an out of control fashion. And/or I may react without thinking of the consequences of my behavior on myself and others.

Urges And Cravings (Thinking About Drinking/Using): I begin to think that alcohol/drug use is the only way to feel better. I start thinking about justifications to drink/use and convince myself that using is the logical thing to do.

Chemical Loss Of Control (Drinking/Using): I find myself drinking/using again to solve my problems. I start to believe that “it’s all over ‘till I hit bottom, so I may as well enjoy this relapse while it’s good.” My problems continue to get worse.

Adapted from Terence T. Gorski's Warning Sign Identification Process
THE TEN MOST COMMON RELAPSE DANGERS

1. Being in the presence of drugs or alcohol, drug or alcohol users, or places where you used or bought chemicals.

2. Feelings we perceive as negative, particularly anger; also sadness, loneliness, guilt, fear, and anxiety.

3. Positive feelings that make you want to celebrate.

4. Boredom.

5. Getting high on any drug.

6. Physical pain.

7. Listening to war stories and just dwelling on getting high.

8. Suddenly having a lot of cash.

9. Using prescription drugs that can get you high even if you use them properly.

10. Believing that you no longer have to worry (complacent). That is, that you are no longer stimulated to crave drugs/alcohol by any of the above situations, or by anything else – and therefore maybe it’s safe for you to use occasionally.


RELAPSE ATTITUDES


SOBRIETY IS BORING
I’LL NEVER DRINK/USE AGAIN
I CAN DO IT MYSELF
I’M NOT AS BAD AS …..
I OWE THIS ONE TO ME
MY PROBLEMS CAN’T BE SOLVED
I WISH I WAS HAPPY
I DON’T CARE
IF NOBODY ELSE CARES, WHY SHOULD I?
THINGS HAVE CHANGED
I CAN SUBSTITUTE
THEY DON’T KNOW WHAT THEY ARE TALKING ABOUT
THERE’S GOT TO BE A BETTER WAY
I CAN’T CHANGE THE WAY I THINK
IF I MOVE, EVERYTHING WILL CHANGE
I LIKE MY OLD FRIENDS
I CAN DO THINGS DIFFERENTLY
NOBODY NEEDS TO KNOW HOW I FEEL
I’M DEPRESSED
I SEE THINGS MY WAY ONLY
I FEEL HOPELESS
I CAN HANDLE IT
IF I HIDE BEHIND EVERYONE ELSE’S PROBLEMS, I WON’T
HAVE TO FACE MY OWN
I CAN’T DO IT
WHY TRY

THE EVENT: A RETURN TO THE USE OF ALCOHOL AND/OR DRUGS.

[Reachup]

John - thank you so much for bumping this. It was something I needed to read as I think I have been a little pink cloudy with my brand new 3 week old quit, but also have been experiencing some drinking thoughts and some super emotionalism.

In my heart, I really do not want to drink again. I really want to be free. This post helped me.

To the extent it is kind of vague - well, I think that's because what might provoke a relapse is highly individual and I don't think any of these factors guarantee a relapse (no more than the absence of them guarantees permanent sobriety).

I see this list as more of a touchstone by which you can examine your own thought patterns in a different way. Like I read it just now and looked again at my tearfulness today and the fact that a pretty routine and minor confrontation made me really upset.

That doesn't mean I will drink, but I maybe should be on the lookout for an impulse to drink so that I am ready to practice non-attachment when the impulse comes.

[TwinCity]

mental preparation is the key. have to be prepared for anything life throws at you, that you will drink no matter what. I can honestly say I wouldn't drink for a million dollars; I wouldn't sell my soul to the devil, even though he still tries to tempt me every so often.

[Reasontoquit]

GREAT POST!!!

I added it to my subscription list so I can come back and read it when I need too! This is going to be a huge help to me in the months to come.
Thank you for posting it.

[T-Bone]

I liked this article (link below). I am not familiar with the person or organization, but I liked the content of the article. Check it out.

This is a great thread, thanks for bumping it up.

http://www.tgorski.com/gorski_articles/levels_of_rws%20010506.htm

[Hopey]

http://wqd.netwarriors.org/showthread.php?t=5775

I want to bump up this old thread because it has a lot of awesome information.

[twcz71]

I just wnated to say thanks for bumping this

[cashew]

Yes - thanks Hopey! I've been here for months and never stumbled across that thread.

Thanks!

[Hoots]

Thanks Hopey, I flagged most of the items on the list....eeekkk!

[typhoon111]

lots of those things in the list i have done although i am now realising that you really don't have to drink to have fun - its just a false fun anyway what's so good about being pissed for days then the vomiting shakes and hangovers

ty

[gee]

bugger........ so that helps explain the last month :(

thank you for this - will print out keep for reading in tough times

thanks again

[bigsister987]

Hopey that is one of the best posts I have seen on here.

[Shift]

This is wonderful, thank you for sharing this again. This is extremely important to remember as I continue on this journey. Now that I have one month, I need to stay alert!

[Steve]

I agree and think that all of us should print that out and put it in our wallets or purses. The relapse is a set up.

[cashew]

*bump*

Such a good thread...want to keep it near the top for newbies...

[Gardengirl]

Lately I've felt a lot of those. I'm trying to "ride out the feelings." It actually works, you CAN feel better later after the bad spell passes.

[bree]

i am currently experiencing those feelings too. its disturbing me, actually.

[Jay]

at the end of 2.5 years i had gotten bored of talking about drinking and not drinking, and was more focused on other things. I stopped coming to this site altogether for months. I'm sure if the relapse signs were in my eyeline before i did slip then, i probably would have been more aware of what was happening.

There are so many symptoms on the list i am surprised that breathing and eating isn't on there LOL!

Still, the list is worthy of a sticky.

[Twiggy]

I found myself needing to review these today and thought others might find them useful, too:

Relapse Signs and Symptoms

Experiencing Post Acute Withdrawal: I start having problems with one or more of the following; thinking difficulties, emotional overreaction problems, sleep disturbances, memory difficulties, becoming accident prone, and/or starting to experience a serious sensitivity to stress.

Return To Denial: I stop telling others what I’m thinking/feeling and start trying to convince myself or others that everything is all right, when in fact it is not.

Avoidance And Defensive Behavior: I start avoiding people who will give me honest feedback and/or I start becoming irritable and angry with them.

Starting To Crisis Build: I start to notice that ordinary everyday problems become overwhelming and no matter how hard I try, I can’t solve my problems.

Feeling Immobilized (Stuck): I start believing that there is nowhere to turn and no way to solve my problems. I feel trapped and start to use magical thinking.

Becoming Depressed: I start feeling down-in-the dumps and have very low energy. I may even become so depressed that I start thinking of suicide.

Compulsive And/Or Impulsive Behaviors (Loss Of Control): I start using one or more of the following- food, sex, caffeine, nicotine, work, gambling, etc. often in an out of control fashion. And/or I may react without thinking of the consequences of my behavior on myself and others.

Urges And Cravings (Thinking About Drinking/Using): I begin to think that alcohol/drug use is the only way to feel better. I start thinking about justifications to drink/use and convince myself that using is the logical thing to do.

Chemical Loss Of Control (Drinking/Using): I find myself drinking/using again to solve my problems. I start to believe that “it’s all over ‘till I hit bottom, so I may as well enjoy this relapse while it’s good.” My problems continue to get worse.

Adapted from Terence T. Gorski's Warning Sign Identification Process
THE TEN MOST COMMON RELAPSE DANGERS

1. Being in the presence of drugs or alcohol, drug or alcohol users, or places where you used or bought chemicals.

2. Feelings we perceive as negative, particularly anger; also sadness, loneliness, guilt, fear, and anxiety.

3. Positive feelings that make you want to celebrate.

4. Boredom.

5. Getting high on any drug.

6. Physical pain.

7. Listening to war stories and just dwelling on getting high.

8. Suddenly having a lot of cash.

9. Using prescription drugs that can get you high even if you use them properly.

10. Believing that you no longer have to worry (complacent). That is, that you are no longer stimulated to crave drugs/alcohol by any of the above situations, or by anything else – and therefore maybe it’s safe for you to use occasionally.


RELAPSE ATTITUDES


SOBRIETY IS BORING
I’LL NEVER DRINK/USE AGAIN
I CAN DO IT MYSELF
I’M NOT AS BAD AS …..
I OWE THIS ONE TO ME
MY PROBLEMS CAN’T BE SOLVED
I WISH I WAS HAPPY
I DON’T CARE
IF NOBODY ELSE CARES, WHY SHOULD I?
THINGS HAVE CHANGED
I CAN SUBSTITUTE
THEY DON’T KNOW WHAT THEY ARE TALKING ABOUT
THERE’S GOT TO BE A BETTER WAY
I CAN’T CHANGE THE WAY I THINK
IF I MOVE, EVERYTHING WILL CHANGE
I LIKE MY OLD FRIENDS
I CAN DO THINGS DIFFERENTLY
NOBODY NEEDS TO KNOW HOW I FEEL
I’M DEPRESSED
I SEE THINGS MY WAY ONLY
I FEEL HOPELESS
I CAN HANDLE IT
IF I HIDE BEHIND EVERYONE ELSE’S PROBLEMS, I WON’T
HAVE TO FACE MY OWN
I CAN’T DO IT
WHY TRY

THE EVENT: A RETURN TO THE USE OF ALCOHOL AND/OR DRUGS.

Fantastic post!

[greengirl32]

For me, I can't spend too much time thinking about not drinking or I'll go crazy and drink :) But I do prepare myself when I notice I'm getting irritable or an "f-it" mood. It helps to keep these in the back of your mind.

[4abetterlife]

In my view, it is fine to spend a moment each morning to recommit to sobriety and another moment each evening appreciating that day's sobriety. That doesn't show weakness, it shows strength. Start strong, end strong, live strong.

I love that Ronnie!

[HollyJM]

Here's a list of signs that's pretty much bang-on to how I felt when I crashed, and it's the list I reviewed when looking back over what happened. This is pretty much the order in which it happened, (I might have skipped one or 2 in there), in fairly rapid succession..like a few weeks.

http://alcoholism.about.com/od/relapse/a/relapse_signs.htm

[Gardengirl]

Holly,
I read that list very carefully. I can feel when these start happening to me. Usually, its in response to job stress.

I know I'm having a good week this week because I'm off work and relaxing.

I wish there was something specific I could pinpoint in that list, and turn it around before I shut off all my common sense and buy alcohol.

I wonder if not wanting to come here is one of the signs?

I know I start to feel a bit like, "nothing I do matters." As if life is stressful whether I drink or don't drink, and things never really change, so I might as well drink.

That one is huge, but its also a lie, because we all KNOW how much worse things get when we drink, its just so easy to forget, shut off the brain, drink.

I'm posting a lot here because sometimes I actually feel like I'm standing on the precipice, and I could easily fall off the edge and drink, and that frightens me.

Thanks for posting this information, I will return here frequently to remind myself.