Red flags of relapse

Sarah, an alcoholic patient in recovery, comes in with her husband. A question comes up: how can they watch for signs that she is headed for relapse. Any warning flags?

Michael Weaver, MD recently wrote in the Carlat Report Addiction Treatment: these clues may say “someone has relapsed, or may be headed that way.” He described the signs in the context of treatment, but they also occur in interactions with family or friends.

• Reduced eye contact when talking

• More anxious demeanor than usual 

• Less engaged, or a sense of holding back

Worsening emotional distress, anxiety, or depression

Vague answers to questions

• Reduced attendance at 12-step programs like AA, or therapy groups

Missed visits with a psychiatrist or other caregiver 

Dr. Weaver notes that on their own, each red flag does not signal impending relapse. The pattern tells the story. He writes, “this is known as desire thinking, and in 12-step programs, it’s called “drinking thinking.”’

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