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Dry Drunk Syndrome

Dry drunk syndrome refers to an ongoing manifestation of addictive behaviors and thought patterns after quitting substance use, often stemming from unresolved emotional issues, inadequate coping skills, or mental health challenges. While the person may not be actively drinking, they have not fully healed the behaviors that triggered their alcohol use and abuse, putting them at risk of relapse.

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If someone you love is experiencing dry drunk syndrome, offer support and encourage them to seek professional assistance, such as working with an addiction treatment specialist or a therapist who specializes in recovery.

What Is Dry Drunk Syndrome?

A dry drunk is a term that refers to someone who has stopped drinking but continues to display behaviors and traits associated with heavy alcohol consumption. It often describes the emotional and psychological consequences associated with post-acute withdrawal syndrome (PAWS).[1]

How Did the Term ‘Dry Drunk’ Get Started? 

Initially coined by the creators of Alcoholics Anonymous (AA), dry drunk was defined by R.J. Solberg in his 1970 book The Dry Drunk Syndrome. He described actions and attitudes that marked an alcoholic before recovery that remain even when the person is no longer actively drinking alcohol.[2]

What Are the Causes?

Dry drunk syndrome’s origins remain uncertain. However, it may be linked to trauma, untreated emotional struggles like anxiety or depression, and environmental factors.[2] 

It may also be part of the process of relapse in recovery and not necessarily a standalone issue. Sobriety is a long and ongoing journey, but with help and treatment, it can become easier. Some people may have dry drunk syndrome early in their recovery, but they learn to manage it with effective treatment.

Signs & Symptoms of Dry Drunk Syndrome

Here are some common signs and symptoms of dry drunk syndrome:[2]

  • Anger, irritability, or frustration
  • Low mood or energy
  • Impatience, restlessness, or difficulty focusing
  • Anxiety or worry about your ability to maintain sobriety
  • Resentment directed toward yourself, people who can still drink, or people who want you to quit drinking
  • Negative or hopeless feelings about your ability to stop drinking
  • Distraction or boredom

In addition to these mood symptoms, specific behaviors and experiences often linked to this syndrome can include the following:[2]

  • Aggressive or impulsive behavior
  • Trouble sleeping
  • A tendency to judge, blame, or criticize yourself harshly
  • Frustration with treatment, which may lead you to skip meetings or therapy sessions, or give up on them entirely
  • Frequent daydreaming or fantasizing, often about alcohol use
  • Dishonesty
  • Using other behaviors, like shopping or gambling, to cope with life while abstinent from alcohol

Why Does Dry Drunk Syndrome Develop?

People engage in alcohol consumption for various reasons, with motivations often depending on who they are and when they tend to drink the most. Below are some common reasons behind heavy drinking:[3]

  • To relax or socialize
  • To celebrate or commemorate special occasions
  • To deal with boredom
  • To cope with stress or difficult emotions
  • To boost confidence or self-esteem
  • To escape from reality or problems in life

In some cases, people may start drinking to cope with serious issues, such as mental health symptoms, severe trauma, or difficult life circumstances. While alcohol may provide a temporary escape from the discomfort, it doesn’t solve the problem, leaving the person to keep drinking to keep symptoms at bay. 

Over time, the negative effects begin to pile up, including physical health issues, difficulties at work, problems with one’s partner or other family members, and worsening mental health symptoms. When the individual stops drinking, they may begin to free themselves from those problems but haven’t yet dealt with the issues that drove them to seek solace in alcohol use in the first place. In these situations, dry drunk syndrome can develop.

The Connection Between Dry Drunk Syndrome & Co-Occurring Disorders

Dry drunk syndrome is a unique mental health issue on its own that generally exists alongside separate co-occurring disorders that generally include a specific mental health disorder and alcohol use disorder (AUD).[4,5] 

The term co-occurring disorders refers to mental health conditions that coexist alongside substance use disorders, making dry drunk syndrome a third condition since it relates to both diagnoses.

There is a strong connection between dry drunk syndrome and co-occurring disorders. People with co-occurring disorders are more likely to experience dry drunk syndrome, and people with dry drunk syndrome almost always have co-occurring disorders.

Both dry drunk syndrome and co-occurring disorders frequently stem from issues like trauma, low self-esteem, and poor emotional coping skills. People with dry drunk syndrome may also struggle with unhealthy coping methods, like perfectionism and control, which can worsen co-occurring disorders.

The condition is more likely to appear during the first year of sobriety, which is often one of the most vulnerable times in recovery.[6]

How to Help Your Loved One With Dry Drunk Syndrome

If individuals in recovery are supported, they are less likely to experience dry drunk syndrome.

The best approach to overall well-being in recovery and a lower risk of relapse is ongoing addiction treatment that includes therapy. Encourage your loved one to continue with their treatment and aftercare plan, including attending therapy sessions, support group meetings, and follow-up medical appointments. Offer to drive them to therapy sessions or attend an open support group meeting with them. 

Make it known that you are available to talk when they are feeling down or when they have the urge to relapse. If they have someone to turn to, they will be better able to process feelings and address underlying issues and habits related to their AUD.

Treatment for Dry Drunk Syndrome

With dry drunk syndrome, many root issues related to alcohol abuse have not been effectively addressed. In order to effectively treat the condition, these problems need to be identified and treated. 

This can often happen as part of a comprehensive treatment program for AUD. Most people with dry drunk syndrome have not been through a complete alcohol rehab program.

Here’s what to expect:[1,5-8]

Individualized Therapy

Dry drunk syndrome is closely associated with feelings of defensiveness and overwhelm when it comes to alcohol abuse and ongoing recovery. In personalized therapy sessions, you’ll begin to unravel the contributing factors to these feelings. Once you get to the root causes, you can begin to develop better coping skills.

Medication-Assisted Treatment

AUD sometimes requires medications to effectively manage the condition. If your AUD symptoms are under control via medication-assisted treatment, you’ll be better able to progress in therapy.

Support Group Meetings

Dry drunk syndrome involves feelings of hopelessness, as the person may view their recovery efforts as a failure since they don’t feel better. In peer support meetings, you can see that you aren’t alone, and you can learn from the journeys of others in recovery. These stories can often serve as inspiration, lifting your perception of recovery and your efforts.

Diagnosis & Management of Co-Occurring Disorders

Since dry drunk syndrome is so closely linked to other mental health disorders, it’s imperative to get any co-occurring disorders diagnosed and treated. Without management of other issues, it’s unlikely that dry drunk syndrome will improve.

Lifestyle Changes

It’s important to find purpose in recovery, and this can mean taking up new hobbies or returning to old activities you enjoyed before drinking. Exercise regularly or learn a new skill. Get involved in local social groups, like a book or hiking club. While it might not happen immediately, you’ll eventually gain a sense of fulfillment from activities that don’t involve alcohol, and this can boost overall well-being.

Updated November 6, 2023
Resources
  1. Post-acute withdrawal syndrome Semel Institute for Neuroscience & Human Behavior. Accessed October 17, 2023.
  2. The dry drunk syndrome. Hazelden Publishing. Published 1983. Accessed October 17, 2023.
  3. The relationship between reasons for drinking alcohol and alcohol consumption: An interactional approach. Abbey A, Smith MJ, Scott RO. Addictive Behaviors. 1993;18(6):659-670.
  4. Co-occurring disorders and other health conditions. Substance Abuse and Mental Health Services Administration. Published July 2023. Accessed October 17, 2023.
  5. Dry drunk syndrome in alcoholics. Ranganatha SC. Indian Journal of Psychological Medicine. 1985;8(1):26-28.
  6. The Psychodynamics of the “dry drunk.” American Journal of Psychiatry. Flaherty JA, McGuire H, Gatski RL. 1955;112(6):460-464.
  7. Information about medication-assisted treatment (MAT). U.S. Food & Drug Authority. Published May 2023. Accessed October 17, 2023.
  8. Diagnosis and pharmacotherapy of alcohol use disorder. Kranzler HR, Soyka M. JAMA. 2018;320(8):815-824.
  9. Advances in the science and treatment of alcohol use disorder. Witkiewitz K, Litten RZ, Leggio L. Science Advances. 2019;5(9):eaax4043.
  10. The case for screening and treatment of co-occurring disorders. Substance Abuse and Mental Health Services Administration. Published September 27, 2022. Accessed October 14, 2023.
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