Guilt Spiral: Why Harm Reduction is Dangerous

Harm Reduction Ensures Relapse

Relapse. It’s such a dirty word to us alcoholics. When we first dip our toes into the frigid waters of sobriety, avoiding relapse is, quite necessarily, our singular focus. But it happens, and when it does, our failure can be brought on in a variety of ways. Sometimes it happens in an instant – a solitary trigger overwhelms us, and we are drinking before we can rationally process the situation.


But often, relapse doesn’t work like that. It isn’t instantaneous and unpredictable. Often, relapse is the last step in a series of events. It is a downward spiral spread out over some period of time. We try to fight it, but resistance seems futile. It is as if the universe or the devil is working against us in a diabolical plot to keep us mired in alcoholism.


But what if I told you we are our own worst enemies – that we are the reason relapse is sometimes unavoidable? That by the choices we make, and our own faulty strategy to beat alcoholism, we give the demon strength and renew our vow of loyalty to our addiction. When we ignore science and do recovery the traditional way, we are to blame for our own relapses.




My very last relapse occurred about three months after my second-to-last drinking session. The relapse didn’t start with a drink, it started spiraling down about 22 hours prior to consuming alcohol. It started with an argument with my wife. I’m not going to share the details of the argument here, and not because I’ve suddenly developed a sense of modesty, but because the topic of our disagreement is both insignificant and irrelevant. It was like most spats in an alcoholic marriage. The actual substance of the dispute was so trivial that within minutes of the start of the discussion, we both knew it wasn’t what we were shouting about. We were arguing about resentments of our alcoholic past with an unwarranted ferocity and conviction. We were both wrong and both right, and neither of us could claim the moral high ground as we tore each other apart as we had done on so many of my drunken nights.


So that was step number one: an irrational disagreement. Well, at least I didn’t drink, goes the conventional wisdom. So what if we had ignored the wall of resentment between us for three months just begging for an incident like this. Unresolved trauma is a trigger, and I stared it down without reaching for the bottle. Victory, right?


We stayed up all night, emotionally and mentally tearing each other apart. I didn’t drink, but the ragged little shred of trust that existed between us took another huge hit. With less than an hour of sleep, I got out of bed and took a shower to start another miserable day.


I ate a scone for breakfast, and potato chips for lunch. I knew better. I had not yet learned about the regenerative power of clean animal fats and proteins to produce much needed neurotransmitters, but I was pretty sure eating sugar and processed pseudo-food wasn’t a good decision. Back in my drinking days, I had soothed the pain of a sleepless night with vodka in the morning. This morning, I did not drink. I beat the temptation and beat back the trigger. Victory, right?


I worked a long, 14 hour day. I never stopped to rest despite my sleep deprivation. I drank sugary sodas full of caffeine all day, something I never do. For dinner, I again reached for comfort without concern for nutrition. I was exhausted, angry, ashamed, hopeless and in excruciating pain. When the day was done, when I’d made all the bad, reflexive decisions I could fit into a 24 hour period, I didn’t have any strength left to resist my destiny. I reached for the bottle of vodka, and I drank until I passed out.


My final relapse wasn’t about a lack of willpower. It was about the fallacy of harm reduction. It was about abusing my own standards and an accumulation of guilt. I didn’t drink that night because of my addiction. I drank that night because there was so much wrong with my recovery.


When I stayed up all night fighting with my wife, I was ashamed of my behavior and hurt by hers. When I disregarded everything I knew about nutrition, and ate sugar and carbs all day, I piled on more shame and guilt. When I drank sodas for the sugar and caffeine, and didn’t drink an ounce of water all day, I felt even worse about myself. I didn’t relapse when I drank alcohol in the evening. I relapsed when I ate potato chips for lunch.That’s when the pile of shame and guilt reached an insurmountable height. The drinking actually brought the pain of the relapse to an end.


Alcoholism isn’t the “thing” from which we suffer. It’s just the manifestation with the most collateral damage, so it gets all of the attention. Every alcoholic I’ve ever met suffers from some sort of insecurity. It can be low self-esteem, a traumatic experience, financial uncertainty or detached relationships. We feel bad. Then, we feel guilty about feeling bad. When we engage in behaviors that are less harmful than drinking alcohol, we have traditionally viewed that as victory over our addiction.


But harm reduction most certainly is not winning. It is just another form of losing, and it leads to the kind of thirst from guilt and shame that only booze can quench.


I know the story of a heroin overdose that didn’t really have anything to do with heroin. It was all about chocolate cake. After months of in-patient, then out-patient recovery, a woman was slated to start a new job and make serious progress toward getting back on her feet. She was so nervous about her first day of work, that she ate an entire chocolate cake the preceding afternoon. She felt weak and guilty about the cake – a depth of shame she hadn’t experienced in months. As her insecurity rose, the lessons of recovery were drowned-out by the screaming echoes of her own worthlessness. She found her dealer who found her body to be his preferred form of currency, and she let him have sex with her in exchange for heroin. She felt so despicable – so disgraced and guilty, that she injected far more heroin than her body could process. She didn’t show up for her triumphant first day of work because she was dead. She was dead, because she stress-ate a chocolate cake, and the resulting shame spiral killed her.


This is a dramatic explanation of how addiction works. The alcoholism isn’t the problem, although it creates all the chaos. The problem is internal, and we can’t solve those with external inputs of any kind. Our external attempts to medicate only take the insecurity, and cover it with heaps and gobs of guilt and shame. The guilt can only lead to one, inevitable, insidious place.


Harm reduction leads to disaster. Chocolate cake and potato chips won’t solve our problems. Neither will sex, porn, shopping or binge watching TV. If you have a spot of skin cancer, you can’t cover it with a bandaid and hope it goes away. You’ve got to have it surgically removed, just like we have to dig out the source of our insecurity that’s leading to our alcoholic tendencies.


Harm reduction means covering pain with chocolate cake. How does that make any sense?


If we want to avoid relapse, we’ve got to find the root cause of our problems, roll up our sleeves and dig in. Finding something to make it feel better will only make us feel worse. The spiral won’t end until we’ve self-destructed, temporarily or permanently. There is work required. It’s the kind of introspection and honesty that makes us feel weak and vulnerable. It’s the only way out.


If you are ready to roll up your sleeves and do the work of recovery, we want to help you make healing a reality. If you drink to cover up your pain, please check out our SHOUT Sobriety program to help people navigate early sobriety. If you love an alcoholic (sober or actively drinking), we want to help you recover, too. Please read more about our Echoes of Recovery program for the loved ones of alcoholics. Sobriety doesn’t fix anything. Neither do chocolate cake or potato chips. If you want to connect with others and evolve into your recovery, we want to help you make it happen.

SHOUT Sobriety

Echoes of Recovery

The Second Time I Quit Drinking Alcohol
December 11, 2017
Sheri’s Story, Part 2: Recovering Our Marriage
July 10, 2019
Our House of Scars
June 2, 2021
  • Reply
    Christie Hardwick
    May 1, 2020 at 7:37 am

    Powerful sharing. Thank you.

    • Reply
      Matt Salis
      May 1, 2020 at 8:30 am

      Thanks for reading, Christie!

  • Reply
    May 2, 2020 at 6:09 am

    I’m not familiar with all of the technical terms and concepts related to addiction. I know it’s an actual “thing”, but could you provide a brief explanation of what “harm reduction “ actually is?

    • Reply
      Matt Salis
      May 2, 2020 at 8:14 am

      Harm reduction is just transferring your addiction to one that is considered less harmful. Many alcoholics gorge on sugar in an attempt to stop drinking. That has been traditionally viewed as a good change. We are learning now that sugar flows on the same neuro-pathways as alcohol, so by eating sweets, alcoholics are feeding their cravings for alcohol. Harm reduction keeps the addiction alive. Thanks for reading, B!

Leave a Reply

Your email address will not be published. Required fields are marked *