Dry Drunk Syndrome

Dry drunk syndrome is a term coined by Alcoholics Anonymous (AA) that describes characteristics of someone who is no longer consuming alcohol but is experiencing several behavioral and emotional symptoms of alcoholism, such as irresponsible behavior, impatience, impulsivity, "black and white" thinking, and a rigid, judgmental outlook. These individuals may portray an exaggerated sense of self-importance and grandiose behavior, such as seeking the center of attention for both positive and negative reasons. Additionally, characteristics such as dishonesty, inde-cisiveness, mood swings, and overreaction may be displayed. They may experience nostalgia or fantasize about drinking, and they may limit alcohol treatment attendance or drop out altogether. These features are seen as being more chronic in nature rather than temporary fluctuations in mood or behavior.

To understand the significance of the dry drunk syndrome, it is important to understand why this term was conceived by AA. An integral component of AA is to work through the Twelve Steps, principles for recovery that aim to guide individuals seeking sobriety to create a worthy life, not only through abstinence from alcohol but also by making a spiritual transformation. These steps include admitting powerlessness over alcohol and reliance on a Higher Power (defined by the individual) for removal of character defects, guidance, and spiritual care. By following the 12 guidelines set forth by AA, individuals can begin to make a spiritual change that inspires a life worth living. AA posits that individuals who abstain from alcohol without fully integrating the lessons taught in the Twelve Steps, will continue to experience spiritual, emotional, and relational difficulties brought about by using "alcoholic" strategies for managing their lives. While these individuals may be "dry," or abstinent from alcohol, they will remain symbolically "drunk," continuing to experience pathology caused by alcoholism and living an alcoholic life. According to AA, they cannot achieve true sobriety without acceptance and implementation of the 12 principles of A A, which leads to spiritual change. The slang term dry drunk is typically a derogatory way to refer to someone who is abstinent from alcohol without working the steps.

The symptoms related to the dry drunk syndrome have also been viewed as warning signs of relapse for alcohol use. Much research has been conducted on factors that predict relapse from alcohol or other substance use. Common high-risk situations that precede relapse that also define dry drunk syndrome include experiencing negative emotions such as frustration, anger, hostility, aggression, hopelessness, and loneliness; relationship concerns [Page 346]and interpersonal conflicts; and believing or wishing alcohol use would enhance positive emotional states such as pleasure, joy, and freedom. Combined, these symptoms leave individuals vulnerable for relapse, and AA would argue that without spiritual change, the risk for relapse and dry drunk syndrome will remain.

Additionally, persons with dry drunk syndrome may experience several signs related to depression, such as sadness, tiredness, agitation, poor concentration, hopelessness, and suicidal ideation. Research has also found alcohol relapse to be subsequent to signs of depression. It has been suggested that some individuals who are currently experiencing symptoms of depression but are also abstinent from alcohol may respond better to alcohol treatment (versus depression treatment) if the underlying cause of depression is related to dry drunk syndrome.

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