I have a loved one who is an alcoholic and stayed sober for about 5 years. He recently started drinking again. I have heard that the disease continues to progress while someone is sober, and because of that he will have a rapid increase in his drinking and a decline in mental and physical health. Is this a myth, or is there truth here? If true, how does the disease progress while someone stays sober?
Janice Dorn: Thank you for reaching out for answers. It has to be disappointing for you, him and your family that he started drinking again after fix years of abstinence. We know that relapse is part of the process of recovery, so the hope is that he can get back into recovery and stay away from alcohol.
This is a really great question because it speaks to one of the oft-repeated sayings that you hear in 12-Step Groups. For purposes of our being on the same page, I will also refer to alcoholism as a disease since that is the way it is stated in your question.
The saying goes something like this:
“While you are resting on your laurels, your disease is out on the front lawn doing push-ups.”
This is often interpreted to mean that, if a person stops drinking and then starts again, he will be right back at the place he was when he stopped drinking.
No two brains or bodies react or respond the same to alcohol abuse. They also do not recover and heal in the same manner when the drinking stops.
We know that damage to the brain induced by alcohol can begin to heal as early as two weeks after a person stops drinking. Of course, this is going to depend on a lot of different things: the extent of the brain damage, quantity of alcohol that the person drank before stopping, the amount of time that the person has been abstinent, age, diet and lifestyle. So, in answer to your question, the damage to body and brain does not usually progress. It either stays dormant or begins to heal.
It makes sense that, the longer the abstinence, the more healing will occur. If he had been abstinent for five years and did not have serious brain damage, it is possible that he could have a large amount of brain and body repair. It makes sense from a physiological point of view that, depending on the initial amount of pathology to brain and body, longer abstinence means more healing.
In the case of relapse after five years, it is possible that a lot of the mental and physical damage has been repaired. If this is the case, I would not expect him to immediately be right back where he was when he stopped drinking. However, if he continues to drink, it will not take long for all the pathology to return. Because of the real possibility that there was damage to brain and body before the drinking stopped, those areas are weakened and would be more susceptible to further damage once the drinking begins again.
I wish you and your loved one much success in getting through this relapse and into a solid recovery.
Janice Dorn, MD, PhD, specializes in psychiatry, addiction psychiatry and addiction medicine. She is certified by the American Board of Psychiatry and Neurology (General Psychiatry), the American Society of Addiction Medicine and the American Board of Addiction Medicine. Full Bio.