The holidays are stressful. Judging from the number of survival guides out there, it seems pretty clear that many of us are exhausted by the ostentatious cultural charade we call the holidays. Amidst this season of consumerist escapism, please try to remember that while holiday stress may lead some folks to a little victimless overindulgence, it can tempt others to break sobriety and wash oxys down with eggnog (true story). It's dark, but it's real. People who struggle with addiction are at significantly higher risk for relapse during the holidays.
However, while everyone in the recovery community knows that the holidays are prime time for relapse, there are few stats and resources for support. Why? Stigma.
“Data is difficult to come by because of laws protecting privacy and people's feelings of shame,” says Tim Powell, a New Orleans-based therapist and addiction specialist. “Anecdotally, in treatment, we see an increase in admissions after New Years’. Self-reporting from clients also seems to indicate the holidays are a time of high relapse.”
Holiday relapse is real but no one talks about it enough. Keeping secrets is a classic component of addictive behavior. Ironically, but unsurprisingly, the only way to overcome the stigma that individuals managing addiction face is by having compassionate and frank conversations. I joined forces with an addiction specialist to offer some anti-relapse strategies that might help you (or someone you love) avoid relapse or overdose.
Identify the issues and make a plan
During the holidays, a lot of people travel, or they have more time off and don’t keep their regular schedules. For those of us struggling with addiction, these stints of mandatory fun come with a lot of landmines.
I, for example, am spending the holidays a thousand miles from home. There are no ACA (Adult Children of Alcoholics) meetings near my family’s home, I don’t have any friends there, and my family’s actions and words — which often drip with condescension and ignorance — are triggering. But like any other battle, ours can be won with the right strategizing. Make your war plan.
Know your triggers
Sometimes we are taken off guard by the things that trigger us, but some of them are pretty predictable. “I recommend developing a trigger list to help avoid or prepare to cope with triggers,” says Powell.
What do you do with that list? Pair it with coping mechanisms to manage the urges brought on by the triggers, he says.
Take a sheet of paper and fold it in half. On one side of the page, record things that you know might happen to trigger you. On my list for example, I will put, “someone asks me when I am going to get a real job.” On the other side of the paper, write down a list of things that you can do when and if one of those triggers arise.
Think of it as an “if...then” list. What goes on the coping skills side of the list? Distractions, talking to someone supportive, challenging irrational beliefs about the triggers or urges ("I can't stand this" or "I have to use/drink’), and staying busy with positive activities and friends, says Powell.
Establish a support network before the holidays start
Whether we are traveling or other people are visiting us, it often means a temporary loss of access to our usual support networks. Before I travel, I reach out to people who are close to me, explain to them that I may need extra support during the holidays, and ask them if it’s okay to call on them and how I should contact them if I need to.
If I feel comfortable enough with someone, I ask them to check on me. I write these people’s names and contact information down on an actual piece of paper with an actual pen so that I have something to keep in my pocket. By the end of every holiday, this piece of paper is generally tearstained and worn to pieces but it's become something of an amulet that protects me when I am feeling weak.
If you usually go to meetings as part of your recovery and you can't during the holidays, there are a ton of online recovery resources. Powell recommends SMART Recovery’s daily online meeting. Recovery Dharma is my personal favorite addiction recovery group because their program is one of the few recovery support groups that is not God-based, but is still spiritual. Recovery Dharma has several online meetings a day. In The Rooms is a one-stop shop for 12-step online meetings. Seriously, whatever you’re addicted to, they’ve got your back, and they have everything from text meetings to video chats.
Plan your time wisely
“The most important thing is to avoid boredom, isolation, and becoming overwhelmed,” says Powell. Boredom is of the major problems with time off, right? What do you do with it? Getting loaded alone in your room may seem like more fun than trying to have QT with your Republican uncle, but the risk of fatality is a lot lower with the latter.
Personally, I make a schedule for myself and I set expectations with family members in advance. Knowing what’s going to happen next makes me feel safe. I’m not the only one. Therapists theorize that structure is a trusted antidote to anxiety.
What might you put on your holiday schedule? “Meditation, exercise, yoga, mindfulness, and spiritual or religious activities are helpful,” says Powell. If you run, plan out your running schedule. If you knit, bring a project with you. Sign up for an online yoga series. This Christmas, I’ll be taking an online class about rope bondage.
If you don’t have any hobbies that are easily transportable, read or listen to podcasts that remind you that you aren’t alone. My favorite books on recovery are by Russell Brand and Jack Grisham, and Mary Karr’s Lit will poignantly remind you why you got sober. If planning out every minute of your day feels uncomfortable or unnatural to you, just have a list of things to do that aren’t dangerous.
What if you relapse anyway?
For a lot of us, relapse is part of recovery, but it can be the most dangerous part. When folks go back to using after they’ve been clean, they are at a higher risk of overdose. Even after preparing, if you still feel shaky, call the SAMHSA (Substance Abuse and Mental Health Alliance) hotline at 1-800-662-HELP. There’s someone there 24/7/365.
If you have an overdose, call 911. You can get Narcan (a.k.a. Naloxone, a pharmaceutical treatment for opioid overdose) free at many drugstores and libraries. If all of this seems overkill to you, you’ve probably never lost anyone you loved to addiction. I hope you never do.