Relapse in the treatment of alcoholism is common—but not inevitable—for several reasons, including post-acute withdrawal symptoms, stress, and the fact that recovery programs are voluntary, and most importantly, because it is easy to forget that addiction is a fatal disease.

Post-Acute Withdrawal

When we stop using drugs or alcohol, we enter an acute withdrawal phase of withdrawal, the first stage, if the quantity and frequency of use was sufficient enough to produce symptoms. Acute withdrawal symptoms, which often can last 7 to 10 days, usually not longer than a few weeks, are mostly physical and vary depending on the person and the drug. But acute withdrawal symptoms that last for months after we stop using our drug of choice are a condition known as post-acute withdrawal syndrome (PAWS), the second stage of withdrawal, that affects us emotionally and mentally and can last for up to 2 years.

Some of the common PAWS symptoms are:

• An inability to think clearly
• Emotional overreacting (during good times or bad times)
• Memory impairment
• Problems sleeping
• Problems with physical coordination
• Stress sensitivity

After a head injury that results in a concussion, a person can experience post-concussion syndrome weeks to months later with exactly the same symptoms we see in post-acute withdrawal. Like a blow to the head, addiction damages its target, the brain. Experiencing post-acute withdrawal symptoms can contribute to a relapse in the treatment of alcoholism.

Strategies to deal with PAWS symptoms include:

• Self care, including a balanced diet and exercise
• Patience with yourself and others
• Developing skills such as meditation to cope with stress and other triggers