The first year of sobriety is awful, no doubt. You are anxious.
You are restless. You are flat-out pissed. Within a matter of weeks, the worst of the withdrawal is gone, but the subtle symptoms linger on and on, and their persistence itself becomes a continual cause for rage.
Experts in addiction management point out that although most of us think of fidgeting, seizures, and other physical symptoms when we hear the term alcohol withdrawal, those elements only make up the first couple weeks of any substance detox. After that, and for years to come, the pain goes from being primarily physical to mostly emotional.
It's called Protracted Alcohol Withdrawal Syndrome (PAWS), and it isn't any easier to manage than the first stage of detox—especially with abstinence in mind. Beyond physically tolerating withdrawal symptoms, a key factor in successful long-term sobriety is motivation: Patients need to be optimistic if they want any hope of withstanding their cravings (again, these continue for a long, long time). The jarring reality that the battle did not end with detox is enough for many addicts to abandon ship: they cannot possibly make it through this for months and years to come, so why not roll their dice with the booze and, worst-case-scenario, at least die comfortably?
Fortunately, PAWS can be managed, though it requires a lot of effort, cooperation, and patience from addicts and, ideally, their friends and loved ones. With the use of extended out-patient treatment programs, community support groups, and a supportive network of peers, relapse can be avoided for life. Addicts who feel they are on the verge of relapse despite having just recently completed inpatient rehab should not be ashamed to go back or move on to an out-patient program (the latter of which should be done either way, actually).
Recovering addicts who feel confident, without withdrawal symptoms, should keep their guard up and continue to attend their program of treatment regardless. Addiction is sneaky, and so is life. Stress can happen unexpectedly, and it is always best to keep a little angel on one shoulder to hush the little devil on the other.
And if you do relapse—don't panic. Meet with your doctor, be honest about your situation, and figure out what the next step should be for your addiction recovery.