HOLIDAY STRESS CAN LEAD TO RELAPSE

But Recovering Addicts Delay Seeking Help, Therapists Say

Winter typically connotes a season of merriment and joy, but for
those with a history of drug and alcohol use, it can cause an
avalanche of setbacks.

Empirical evidence is not available to confirm their observations,
but counselors at area treatment centers believe that drug and
alcohol relapses are more likely to occur during the winter months,
particularly because of holiday stress.

Yet between Thanksgiving and New Year's, they also notice a decline
in the number of people seeking addiction treatment. The number soars
again in January.

This trend concerns therapists who are seeing fewer people during the
time of greatest need and adds to the importance of pre-empting
relapse, said Susan Lee, program director of Quiet Care outpatient
program at Madison Center.

"We were discussing this in treatment that some of the people
attribute holidays to very high-stress times," Lee said.

"After New Year's, the requests (for treatment) skyrocket. I always
think that people do have a rough time over the holidays and have to
reach out after."

Stress caused by financial anxieties can lead to drug and alcohol relapse.

Holiday parties where alcohol is served can also be a temptation,
especially for those early in recovery.

Lee also sees symptoms of a "holiday letdown," disappointment when
expectations of feeling happy are not met.

"We have had people state in treatment that they're not feeling
motivated, that they don't have any energy," Lee said.

"And drinking or using drugs can relieve that. It's probably a
multicause problem."

Clinical depression may also be a factor. Depression can worsen
during winter for some people, making it more difficult to maintain sobriety.

Although only a small percentage of those depressed suffer from
seasonal affective disorder, its symptoms usually surface during the winter.

Relapses Common

Counselors at the St. Joseph County YWCA chemical dependency program
attest to similar treatment trends and also attribute the December
decline/post-New Year's spike to holidays.

"It can be a hectic time for people, a lonely time," said program
director Gary Robinson. "It reminds some people of what they don't
have ... Plus some people may have time off, and in that unstructured
time, they can begin to use again."

Other local institutions detect these seasonal patterns. The Alcohol
and Addiction Resource Center, a nontreatment referral center,
receives more calls after New Year's, said executive director Sharon Burden.

A spokesman for Alcoholics Anonymous said they do not see an influx
of new alcoholics over the holidays, in part because it becomes more
acceptable to drink.

The St. Joseph Regional Medical Center emergency room treats more
alcohol-related injuries in the winter and particularly on holidays,
said Dr. Michael Born.

But homeless shelters report a different experience. At the Center
for the Homeless, the number of people seeking treatment usually
remains steady year-round.

Yet Hope Rescue Mission sees a decline in drug and alcohol abuse
during winter when people come to the shelter to escape the cold,
said substance abuse administrator Pat Miller.

More relapses occur during the spring and summer months, she said,
because people return to the streets, where temptation and
opportunity is much greater.

Other therapists join Miller in cautioning against the assumption
that winter is the only high-risk time for relapse.

"Almost every time of year has some risk element involved," Robinson
said. "In winter, because of weather and holidays, it's a unique set
of circumstances.

"Holidays are highest-risk times, but I don't want people to think
the rest of the year is smooth sailing."

A Personal Battle

One Niles resident knows that well. He asked that his name not be
used because of his affiliation with Alcoholics Anonymous, where
anonymity is a fundamental tenet of the program.

Ever since his dad left his family when he was 12 and later died from
alcoholism, he had made it his life's goal not to be an alcoholic.

But a compulsion was there. He would have only a drink or two, but it
never occurred to him to choose a Pepsi over a beer.

He would not frequent bars but kept his garage stocked with beer in
case there was a blizzard. He could give up drinking for Lent, but it
was considered a test or a sacrifice.

"Finally, I just said, 'I don't know if I'm an alcoholic or not but
I'm going to give this thing a try,'" he said. "I laid down on the
floor and cried like a baby."

His life was turned around, aided by a stay in a 30-day treatment
center, weekly AA meetings and a constant resolve. Now at age 64, he
has been sober for 26 years.

But the disease remains a big part of his life. Every week, he meets
with other alcoholics, upholding a personal vow never to let anything
get in the way of helping others in the struggle.

He tells them that during the early years of sobriety it is
especially important to keep on a program during the winter. During
his first few years after quitting drinking, every holiday revolved
around AA-sponsored parties, dances and meetings.

Programs like AA alone cannot keep a person sober, he stressed, only
the committed person with the desire not to drink. But what they can
do is help provide alternatives.

"In recovery, particularly in the early years, people have been used
to going different places and expecting the same results: This is
what I do at Christmas, this is what I do at New Year's, this is what
I do at weddings," he said.

"Recovery is a program of substitution. If what you did in your
normal life was drink all day, you've got to do something so that
you're not drinking," he said.

Make A Plan

Therapists agree. People with a history of drugs or alcohol abuse
should approach the winter months with a plan.

"We always talk about the holidays before they happen," Lee said. "We
go over planning with each person, what are they going to do that
day, whether their plan is safe.

"If they go to Uncle Roy's and there's a lot of drinking and carrying
on, that's probably not where they want to be."

Because family support is crucial to sustained success, especially
during a season of heightened family togetherness, Quiet Care and
other treatment places involve relatives through family sessions.

Also, Alcoholics Anonymous and Narcotics Anonymous provide special
events on holidays. AA holds an all-day, drop-in meeting called an
"Alcothon," and their dances and parties are outlets for those who
desire substance-free fun.

Counselors stress that with foresight and support, hard-won sobriety
does not have to be derailed during the holiday season, nor need it
be considered a burden.

"It's really amazing how we alcoholics and addicts ... think
everyone's going to be drinking, and it's amazing how many people
don't, and certainly there's an awful lot of people who can drink and
can drink sanely," the Niles resident said.

"So you come to find out in time that weddings, Christmas, New Year's
can really be an awful lot of fun, and you can enjoy and know
everything's going on in a sane and sober way."