Anyone who has ever gone through recovery knows that coming back from the depths of a substance abuse problem is a long process. HBO’s Addiction Project estimates that recovery can only be considered fully successful after four or five years of support.
More often than not, it can be very frustrating and arduous, especially when it seems like life is not completely better from day one of sobriety. Some people get stuck in this limbo for so long that it becomes a problem in itself, and friends and family members might know all too well about the particular niche of the recovery process known as “dry drunk syndrome.”
What Does ‘Dry Drunk Syndrome’ Mean?
“Dry drunk syndrome” is the term given to the conditions that afflict patients who have successfully endured alcohol withdrawal to the point where they no longer have a physical craving for alcohol, but still have unresolved psychological and behavioral issues that stem from their addiction.
This is usually because they have not received any kind of counseling or therapy following their detoxification, perhaps because they believed they did not need such help, or they felt they could not afford that segment of their treatment.
Whatever their reasons, they are making a grave mistake. The National Institute on Drug Abuse makes it quite clear that detoxification alone, with no follow-up, is not a complete form of treatment. It merely solves part of the problem, leaving all the mental and emotional issues unresolved, putting the patient at risk for relapse, and subjecting their friends and family to behavior that should have been resolved in the therapy stage.
Causes and Signs of Dry Drunk Syndrome
Part of the reason for this is because detoxification is a very difficult, and potentially dangerous process. The Fix explains that as the patient goes through the various withdrawal symptoms of physically disengaging from their drug of choice, their moods, thoughts, and behaviors are scrambled by numerous body and brain systems painfully repairing themselves. Even people who are trying to help and support the patient can be on the receiving end of verbal abuse. If this is left unresolved, even as the patient successfully weathers the withdrawal storm, he or she is greatly at in danger of developing dry drunk syndrome.
A blog on Psychology Today identifies six signs of patients with dry drunk syndrome:
- They are resentful of the person who has been the most instrumental in getting them to stop drinking.
- They are frustrated by the fact that they cannot drink ever again for fear of triggering a relapse.
- They become disconsolate at the realization that their drinking has robbed them of their potential.
- They are fearful of failure, knowing that they can never fall back on alcohol to nurse their wounds or boost their confidence.
- They become jealous of how other people can deal with issues without alcohol, or how others can enjoy alcohol without fear of being addicted.
- They feel burdened by having to take responsibility for the damage caused by their drinking.
Scratching the Itch
Dry drunk syndrome forces the patient to focus on the negative side of recovery and the short-term losses. Without therapy, they do not have the perspective to see the positives of recovery, or what they gain in the long-term.
This, in turn, makes life difficult for the friends and family members of the patient. They have to constantly be fearful of mood changes, emotional overreactions, hurtful statements, and antisocial behavior because their loved one never learned the tools and skills that a course of therapy would include.
To alleviate the irritability and frustration of dry drunk syndrome, some patients may embark on risky, compulsive behavior. They may do this out of boredom, because life doesn’t have the same color to it since they stopped drinking (and without therapy, they don’t know how to find new activities and hobbies).
They may do it to lash out at the world and the people around them, out of bitterness and fear that, despite quitting the drink, things haven’t improved enough. Some patients might take up equally dangerous behaviors, like gambling, because they still have an itch that they haven’t learned how to scratch.
Dry Drunk Syndrome and Home Detox
Dry drunk syndrome is a good example why detoxing at home, or even alone, is a bad idea. Kicking an alcohol habit is a complicated medical process that resonates far beyond getting over the compulsion to drink, and it should not be attempted without medical oversight.
This is due to a number of reasons:
- Alcohol withdrawal can be fatal (uncommon, says Live Science, but possible).
- The possibility of abandoning detoxification and taking alcohol to alleviate the withdrawal symptoms is prohibitively high.
- The patient is at risk for falling back into old and destructive habits.
Falling off the Wagon
Dry drunk syndrome can also be a sign that someone is in the process of falling off the wagon. Imagine a patient who has done all the right things with his recovery: he has completed his psychotherapy treatment, he is part of 12-Step programs and other aftercare support groups, he has made a number of positive and healthy changes to his life, and it seems like the dark days of his substance abuse problem are really behind them.
But the frustrations of life never really go away. There are always bills to pay, there are still bad days at work, and there’s still the occasional fight with the spouse. Gradually, 12-Step meetings are missed, the bad days at work become more frequent and pronounced, and the relationship with the spouse seems to have taken a downward turn.
Belief in the power of sobriety and abstinence is questioned. Slowly, insidiously, it seems like all the triggers that once might have been a good reason to pick up a bottle are still there. As a result of all these pressures, the patient may fall back into the same kind of negative thinking patterns that preceded his drinking problem.
This stage can also be part of the dry drunk syndrome: the patient is “dry,” in that he has not relapsed and is not abusing alcohol; but he is “drunk” in the sense of still being in the same headspace as he was when he drank. But he has the added frustration of not being able to drink to alleviate his perceived obstacles and problems, and takes it out on himself (with self-pity and self-blame) and the people around him.
Working the Program
Dry drunk syndrome can be a very insidious element of recovery, because lots of people may not even know that it exists. So much media attention is given to the more dramatic and shocking withdrawal and detox stages that the importance of psychotherapy gets glossed over, because there is so much misconception and skepticism about psychology.
But the truth is that psychology is a fundamental component of treating an alcohol or a drug problem, and it can make the difference between a successful recovery and one where the patient is stuck in the purgatory of dry drunk syndrome. Seeing a rehabilitation program through to the very end will be instrumental in teaching a patient how she can regulate her emotions, control her behavior, and deal with the problems that arise when newly in sobriety.
Staying in touch with support groups and aftercare programs will help the patient make it through the bad weeks and the fights with the spouse, constantly reminding him or her that returning to drinking is not an option worth considering. In the parlance of Alcoholics Anonymous, this is known as “working the program.”
Getting Help for Dry Drunk Syndrome
Frustration in recovery is a very natural part of the process, and it may be better to accept and confront that reality instead of trying to set unrealistic goals to try and evade it. Having strategies to cope with dry drunk syndrome can be as simple as having a support sponsor’s phone number, or having an accountability partner to make sure you are always connected with the 12-Step program of your choice.
We know that recovery from a drug or alcohol problem can be much more difficult than it appears to be. That’s why we have trained admissions coordinators who are ready to take your call, answer your questions, and tell you what you need to know about withdrawal, therapy, dry drunk syndrome and long-term treatment options. We can’t promise that your recovery will be easy, but we can promise to be there with you through every setback and step forward. Please call us today at 844-768-1248 with your questions; we are here to help.
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton