Why We All Need to HALT

April 15th, 2024

By P. Casey Arrillaga, LCSW, LCDC

In the room of recovery fellowships, there’s a common
acronym that gets passed on to people who are new to recovery: HALT. It is a
reminder to not let yourself get too Hungry, Angry, Lonely, or Tired, because
these factors will leave you more vulnerable to relapse. Like many things in
recovery fellowships, it seems to have been born of the hard experience of
people who were trying to turn their lives around from addiction and other
mental health issues. As this post will explain, this may have been discovered
by trial and error, but there is solid scientific evidence to support it.

What We Know So Far

People who are trying to recover from any serious mental
health disorder, including addiction, are facing an uphill battle.
Unfortunately, no matter how long recovery has been sustained, there is always
the risk of relapse. This means that anyone who is trying to recover needs any
advantage they can get and likewise needs to avoid any pitfall they can.

While much of this will be accomplished through working on
the person’s thinking, and in some cases their spirituality, there are some
factors that are more obviously neurological. Some of these are the types of
chemical imbalances that a prescriber needs to treat with medications, but
others are simple enough that anyone can tend to them by themselves.

Enter HALT. This simple acronym can help a recovering person
remember four simple but profoundly influential factors that can affect their
brain health, and thus their chances of sustaining recovery. They are also
things that are good for anyone to be aware of, whether they have a mental
health issue or not. That’s because the vulnerabilities associated with these
factors are not unique to people who are trying to recover. They apply to any
one of us.

Let’s look at each one in turn and see what research can
tell us about its effects and thus its importance for relapse prevention.

Hungry

When we let ourselves get too hungry, we may
be experiencing hypoglycemia, or low blood sugar. This has been shown to reduce
our ability to think clearly, and many people associate it with heightened
emotional responses, such as getting angry more easily. It can also reduce how
well we respond to stress. These things leave us more likely to make risky
choices, such as deciding to relapse or otherwise abandon healthy caution.

In a particularly
dangerous twist, some people who are trying to get sober from alcohol find that
they have trouble telling pre-meal hunger from alcohol craving. This may be a
fluke of genetics, but it has been shown to put such individuals at
significantly higher risk of relapse. It should be noted that even if the
person’s primary issue is not related to alcohol use, drinking alcohol can
still have a cascade of negative effects on mental health in general and lower
that person’s inhibitions around other self-destructive behavior. Thus, a
person whose hunger leads them to alcohol use is putting themselves in greater
danger of using other drugs, falling into a depressive episode, or even attempting
suicide while under the influence.

Angry

Anger is a natural emotion associated with
threat response. While it is a normal part of life, how we handle it can make a
big difference in our lives. Unfortunately, when we are trying to give up old
behaviors and engage in a recovery-oriented lifestyle, we often find that no
matter how positive the changes we are making, this process can feel
threatening all by itself. We may feel self-doubt and some level of uncertainty
about whether these changes are really the best thing for us. Can we be okay functioning
without our “old trusty friends” such as alcohol and other drug use, avoiding
people, or pretending to be okay when we are not? When we aren’t sure about
such things, anger can come up unexpectedly.

Anger changes our brain function, such that we do not reason
as well and thus may make worse decisions. Almost anyone can think of a time
when they said or did something in anger that they regretted, whether that
regret came right away or much later. Anger can lead to taking greater risks
and also increase self-justification. Unfortunately, this means that someone
trying to recover is at greater risk of doing something that undermines that
recovery when they are angry. Thus, even though anger is natural, “indulging”
in it is often not safe for someone in recovery.

Lonely

Humans are social creatures. Loneliness has
been shown to have terrible effects on mental and physical health, such as
increased depression and anxiety. In fact, loneliness does as much to shorten
lifespans as obesity or nicotine use. Loneliness makes us more vulnerable to
wanting to consume things as a way to make up for the emotional pain and
perceived threat of feeling alone. It can also make us more self-centered. In a
particularly dangerous spiral, greater loneliness can breed mistrust of others,
making future loneliness more likely. Loneliness can also contribute to
feelings of self-pity.

These thoughts and behaviors are bad for anyone, but they
are particularly dangerous for those trying to stay in recovery. The desire to
consume could easily translate into compulsive shopping, a return to alcohol or
other drug use, or spending and then regret, which can then further exacerbate
mental health issues. Self-centeredness and self-pity can lead to
self-justification for self-destructive behavior. Mistrust of others makes it
easier to push away the social supports that are so vital to people in recovery.
All of this makes relapse a much greater danger.

Tired

Fatigue is known to be a leading cause of
accidents and poor judgment, yet it often goes either unnoticed or unreported.
When we are fatigued, we are less likely to notice or react to danger, and we
can become a danger to ourselves and others. Research has found that working or
driving while tired is as dangerous as driving while drunk. In recent years,
work and driving accidents due to intoxication have been going down while
fatigue-related accidents have not. This is likely because most of us don’t
realize how much being tired impairs our judgment.

When it comes to relapse, the dangers of being too tired are
clear. Because fatigue leaves us more neurologically vulnerable due to reduced
judgment and more prone to irritability, anxiety, and self-pity, it becomes
easier to make a self-destructive decision that leads to relapse.

What Can Be Done?

While it’s not possible to always avoid getting hungry,
angry, lonely, or tired, there are things you can do to avoid these factors
turning into a relapse. First, be aware of how you are doing in each area.
Noticing when you are vulnerable can do a lot to help you avoid disaster. When
you see one of the factors becoming a problem, take care of it. Second, if
there is one you can’t do much about at the moment, such as having a tired day
because of insomnia the night before, take extra care with the others. Make
sure you are well fed, emotionally regulated, and in touch with supportive
people. By cultivating this awareness and using it to guide self-care, relapse
need not happen.

The Bottom Line

There is good scientific evidence to support the use of the
HALT acronym. Each factor is one that warrants attention by itself, and extra
effort should be put into making sure they don’t stack up. By being aware and
exercising self-care, nothing about HALT needs to lead to relapse.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.