There are many reasons men who are struggling to remain sober from alcohol or drugs relapse. Taken in reverse order, the four most common reasons are:
- They refuse to give up the friends, connections, and world of their addiction. There is a saying in 12-step recovery: To achieve lasting sobriety, you only need to give up three parts of your past – people, places, and things. (In case you’re wondering, that’s pretty much everything.) Another 12-step saying is: If you hang out at the barber shop, eventually you’re going to get a haircut. Pithy maxims aside, the simple fact is men who get sober but still hang out with the same old drinking/using buddies in the same old haunts will inevitably relapse. The drugs and alcohol are right there, just like always, and so are the triggers to pick up. At best, the recovering man is forced to watch his old pals still drinking and using and will feel left out. Any of the sober man’s former pals who are true friends and actually care about his well-being will happily spend time with him elsewhere, and will refrain from drinking or using (and even from talking about it). Eventually many sober people are able to socialize with people who still drink or use, but attempting this in the first year or two of sobriety is unwise.
- They have an undiagnosed psychiatric disorder. More than half the people struggling with drug addiction suffer from a co-occurring mental health disorder such as depression, chronic anxiety, bipolar disorder, or another personality disorder. These issues oftentimes cause uncomfortable feelings in the addict, which he may decide to self-medicate the only way he knows how – by ingesting alcohol and drugs. Until the underlying, co-occurring disorder is properly diagnosed and treated, the potential for drug addiction relapse is high.
- They experience extreme stress, challenging events, or, conversely, great success without a proper support network. Sometimes men in recovery are susceptible to life-changing events. “Disasters” like getting fired from a job or getting divorced can cause tremendous stress, shame, and even depression, all of which can trigger a desire to pick up. Likewise, joyous events like getting promoted or getting married can create a strong desire to “celebrate.” A University of Pennsylvania study shows that men are actually much more likely than women to relapse because of these positive emotional states. Either way – depressing events or joyous events – the real relapse culprit is lack of a social support network. Men are often reticent about participation in group therapy and 12-step meetings, feeling a “masculine need” to do things on their own. Because of this, they may have nowhere to turn for comfort or advice when their emotional state is at one or the other extreme. In fact, multiple studies have found that women in recovery are less likely than men to relapse, in part because they are more likely to engage in group counseling and more likely to ask for help when challenged. It is vitally important for men in recovery to develop similar support networks – a therapist, a sponsor, and multiple friends in recovery with whom they feel comfortable discussing their lives.
- They get into a sexual or romantic relationship before they are prepared to handle that relationship (or its demise). Relationships in early recovery pose one of the most significant threats to ongoing sobriety. If the relationship goes awry, the loss can send recovering addicts into an emotional tailspin. Until the addict’s new coping mechanisms are in place and ingrained as stress responses, there is a danger for relapse every time a connection goes wrong. Even a minor relationship setback can send an addict reeling, as interpersonal conflicts trigger underlying issues with shame, guilt, anxiety, depression, low self-esteem, and more. Plus, in early recovery the addict’s thinking is clouded and his emotions are running amok he is no longer able to self-medicate with his substance of choice. This is not a great time to be picking a relationship partner; usually the other person turns out to be as emotionally unhealthy as the addict. There is also the risk that a relationship begun during this period will replace recovery as the addict’s primary focus, greatly increasing the addict’s propensity for relapse.
In some cases, being drawn to unhealthy sexual or romantic relationships in the early stages of recovery is part of a larger problem. The simple fact is both drugs and sex stimulate the same basic rewards circuitry in the brain. In fact, fMRI imaging of the brain on cocaine and the brain when sexually aroused are virtually indistinguishable. Thus, people struggling with drug addiction are also at risk for sex and love addiction. Men who stop using drugs or alcohol but have not yet addressed their underlying psychological issues and emotional challenges often transfer their chemical addiction into the sexual or romantic arena. Many such men search obsessively, usually online or using smartphone apps, for sexual partners, regardless of whether they are in an existing relationship. Other men pick up women at AA or NA meetings, masturbate compulsively, visit prostitutes and massage parlors, or spend multiple hours a day looking at online pornography. These addictive relationships are distracting and dysfunctional, and they greatly increase the risk for substance abuse relapse. Sometimes men relapse with drugs because they “need” the disinhibiting substance to reduce their sexual inhibitions. Other times they relapse because their new playmate is using. They may also pick up because they want to “heighten” the sexual experience.