Saturday, November 23, 2013

SATURDAY REWIND: Understand relapse, because it's not at all uncommon

A man I've come to admire in recovery, Bill, relapsed four times in 22 months. It's part of having a chronic disease as this article from the alcohol research news archive points out.  However, so is bouncing back from relapse part of having a chronic disease.  Bill relapsed four times, but gave sobriety a fifth try.  His name: Bill Wilson, one of the founders of the 12-step group Alcoholics Anonymous. Whether or not you subscribe to AA's methods, here is some of the science behind relapse.

Ozzy Osbourne recently suffered a relapse and has admitted to drinking alcohol and taking drugs in the last 18 months. The solo artist and Black Sabbath frontman confessed on his Facebook page April 15 that he was “in a very dark place” and has apologized to his family for his “insane behavior.” He reports he has now been sober 44 days since ending his relapse.

Relapse – a return to a pattern of drinking – is very common among those with the disease of alcoholism. Relapse is considered by most counselors to be part of the recovery process, yet some cynically state that relapse isn’t part of recovery it’s part of drinking.

Terence Gorski, author of Staying Sober, notes “you cannot experience recovery without experiencing a tendency toward relapse.” Louise Bailey Burgess, author of Alcohol and Your Health adds, “Unfortunately, despite desperate determination, the depressing fact remains that not more than 50 percent of those who decide to quit, manage to attain sobriety for the rest of their lives.”

Neuroscientist George Koob of the Scripps Research Institute, in the public TV special "Close to Home: Moyers on Addiction," puts the number at 80 percent of those who have detoxed relapsing within the first year. Yet another expert, Michael Dennis of Chestnut Health Systems says in HBO's, "Addiction: Why Can’t They Just Quit?" “Seventy percent of patients relapse after the first time getting help. It’s not like fixing a broken bone.”

The 2013 book Every Silver Lining Has a Cloud puts the number at nine of 10 sober alcoholics returning to alcohol at least once, noting relapse isn’t even unique to alcoholics. "People with chronic depression have a relapse rate also at 50-80 percent. High blood pressure patients only have to keep taking their meds—a really simple task compared to staying clear of alcohol—and their rate of non-compliance is as high. Patients with seizure disorders: Same thing. Diabetics? Ditto . . . high rate of relapse/non-compliance. Asthmatics are even worse. Relapse is a part of having a chronic disease."
-- from (see full article)

Studies completed in 2012 and reported in my book point to an elevated level of the stress hormone cortisol in practicing and recovering alcoholics are a key part in relapse.  Too much cortisol creates an exaggerated startle response, confusion and mood changes like irritability. These non-physiological reactions to cortisol have a direct connection to lapse/relapse and are to what I’m referring when I use the term Symptoms of Sobriety.

Ironically, research from the University of Chicago showed conclusively what does block cortisol. Alcohol. “Alcohol can decrease the cortisol the body releases to respond to stress,” says Emma Childs, a research associate at the university quoted in Alcoholism: Clinical and Experimental Research, October 2011. That’s one of the many paradoxes of alcohol and the Alcoholic: The quick, easy solution to cortisol giving you the Symptoms is to drink. After all, relieving stress is the number one or two reason most people, including non-Alcoholics, drink. Lapse or relapse is, obviously, a ridiculous alternative that only makes the stress—and the cortisol—worse in the long term. In the hand of an Alcoholic alcohol is no answer, it is a question: “What do you feel like losing today?”

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.