The First Slip, or the First Sip?
So you’re home from rehab, doing what you think you’re supposed to do, staying off whatever landed you in rehab, all the while juggling family, friends, work, school, kids, parents, pets, plants… it can get overwhelming. It is overwhelming! Is it any surprise that most people have a slip in their abstinence at some point after rehab? (For the sake of this column, we will assume that abstinence is the goal, though other goals are possible.)
How can a family and a person who has been to treatment work together to keep a slip from becoming a full blown relapse? How can they keep a slip from driving a family apart, and a person in crisis further down the hole of hopelessness? Can we use a slip as a family learning opportunity, rather than a time to heap on shame and punishment, or resentment and rebellion?
Here are some tips for families.
1: Create an atmosphere of honesty.
A slip is more dangerous if it’s kept secret. Unfortunately, most people are too afraid to tell their families if they’ve had a slip. If they fear that yelling, further limitations on their freedom (such as grounding or taking away the car keys), or just being left out of family activities will be the consequence of telling, they won’t tell.
Have an open discussion after rehab about slips. Say you’d rather be told than find out, and that there will be no negative consequences if the person slips, as long as they are honest.
2: Don’t take it personally.
A slip isn’t an attempt to “act out” or get back at you. It is a natural reaction to living life without the one coping mechanism that many addicted people have. Your loved one isn’t drinking or using again to hurt you – they’re drinking or using again because they hurt.
3: A slip is a cry for help.
Much of the time, a slip is a person’s way of telling you that they need help. Remember that for a long time alcohol and drugs were their main way of coping. When life’s stresses hit, everyone needs a little more support, but this is even more true of people in early recovery. Sometimes a slip is a cry for help that a person is afraid to say in words. Offer help and support, not punishment.
4: Don’t ask for payback.
It’s natural for family members who have shouldered the burden of taking care of an addicted person while taking care of all the business of life – from supporting a family to caring for multiple children – to want some kind of payback from the addicted person once they get out of treatment. Unfortunately, this kind of thinking can drive a recovering person into exhaustion as they try to do all the dishes, make more money by working an extra job, and otherwise do more to make up for lost time.
Exhaustion is a major cause of a slip. Feeling pressure to do everything and more in order to “pay off” their past can push a person past the breaking point, and into a full blown relapse.
5: Focus on health, not blame.
When a slip leads to serious health danger, like a near overdose or a severe alcohol binge that could cause detox seizures, focus on the person’s health, not on their character. A favorite saying of harm reduction – those of us who believe that health and safety of all, even those who use drugs, is more important than “sobriety” is “You can’t get better if you’re dead.
An addicted person knows that taking another drink or shooting up contaminated heroin is dangerous. They do not need to be reminded. What they probably do need is a doctor.
6: Don’t expect rehab to “fix” a person.
Popular press and television shows portray rehab as a cure all. You pack your loved one off to rehab, they come back “fixed.” You’ll have everything you loved about that person back, and none of the things you didn’t love.
It doesn’t work that way. Rehab may be a start, but it’s a start down a long road that takes many years. The pressure to act like everything is perfect after rehab only pushes a person to take that first sip again.
Rehab may help a person quit alcohol or other drugs, but rehabs rarely address any of the underlying issues that drove a person to use substances in the first place. Anxiety, depression, post-traumatic stress disorder: they will all still be there, even after you take away the drink or the drug. Life may be harder for the person who has been to treatment once they are abstinent: finally they are feeling the feelings that the drug covered up. They will be experiencing a lot of emotions, and family members and other loved ones will too.
Expecting your loved one to be perfect, or “fixed,” when they come home from rehab is a guarantee of a slip sooner or later. Families need to take it easy on their loved one, and take it easy on themselves. That means that instead of monitoring their loved one’s meeting attendance, whereabouts or general mood, get back to focusing on yourself. Go back to the gym. Do what you like to do – your life shouldn’t revolve around your loved one’s “sobriety.” Give them a chance to manage their own lives, and give yourself a chance to get back yours.
Recovering After a Slip
A slip doesn’t have to mean a relapse, and it doesn’t have to tear a family apart. Everyone is disappointed, everyone is scared. But that is the nature of recovery, indeed, of being human. Focus on how everyone in the family is really feeling, instead of who drank what when.
Recovery isn’t about putting down the drink or drug. That certainly helps, and ceasing problematic substance use can be a necessary condition for growing behind the pain that drives it. But one slip doesn’t mean an end to recovery or starting over.