December 2017

Triggers and Relapse

By Scott Swanezy, LCSW


Staying sober requires more than an absence of substance use.  It requires constant vigilance and awareness of everything in our life which can trigger a relapse.  We know the obvious triggers, going to a bar or keeping our dealer's phone number.  Other triggers include hanging around with friends or acquaintances who use alcohol or drugs can be dangerous and inviting trouble.  You are leaving yourself vulnerable if you are not surrounding yourself with support from sober people.


We know that many innocent things trigger cravings that are not obvious as going to a bar or keeping a drug dealer's phone number:


Over the counter medications: Medications sold over the counter sometimes contain chemicals that can be abused or used addictively. NyQuil is a good example.  NyQuil relieves the symptoms of a cold or flu.  An addict may find that NyQuil or similar medication gives them a warm fuzzy, groggy feeling that is soothing.  NyQuil contains 10% alcohol (although you can also buy a non-alcohol version).  Reading the directions will advise you to use no more than three or four doses a day.  A substance abuser may drink the whole bottle without worrying about it because NyQuil is an over the counter substance.  Abusing NyQuil or other over the counter substances that contain alcohol or mind-altering chemicals can be physically dangerous, and can easily trigger relapse.


Medical problems and prescription medications used to treat them:  Recovering alcoholics or addicts who struggle with medical problems or physical pain may be given prescription medications under a doctor's supervision.  When these medications are doubled up or not used as prescribed, relapse has begun.  Doctors are not always well trained in relapse prevention. And prescription opioids are now the leading contributor to the heroin epidemic as a result of heroin being the less expensive opioid.  If you have medical problems that require opioid treatment, discuss the treatment and medication regimen with your physician.


Depression: Undiagnosed or untreated depression can cause an addict to seek out chemicals for relief from feelings of sadness or despair.  Addiction is often triggered by trying to self-medicate when you have mental health issues that are not being treated.  If an addict's efforts to relieve depression are not working (this does not include using substances), see a doctor.


Extreme happiness:  Extremes of any kind can be threats to sobriety, and that includes happiness, excitement and other good feelings.  Recovering addicts may be surprised to find that if they go through a period of extremely good feelings, they may have the urge to pick up substances to prolong or intensify extreme feelings of happiness.


Relationships in early sobriety:  Addicts have a tendency to use all things including people addictively. It is not unusual for a relationship early in sobriety to trigger a relapse.  This could be triggered by stress within the relationship, up to an including breakup.  Avoid rushing into relationships when you first get sober.  In early sobriety, we are looking for relief from our struggle, to be distracted.  Romantic relationships fill the void.  Take the time to get to know yourself when you are not under the influence of any chemicals, so that ultimately you can have a healthy relationship.


Trying to get other people sober:  If your own sobriety is not built on a solid foundation, you may find that trying to help someone else get sober can backfire on you.  They may cause you to want to pick up a drink or drug.  Addiction is a dangerous and insidious disease.  If you are suggesting recovery to another addict, bring someone else in recovery with you to a meeting.


Isolation: If you find yourself keeping to yourself and avoiding others, you may be inviting a relapse.  Twelve step programs are a "we" vs. "me" program.  "Ain't no me in we."


Scott Swanezy LCSW is an addiction and substance abuse counselor in Westchester County. He can be reached at 914-434-9945 and visit for more information.




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