After Rehab Advice To Prevent Relapse, Reservation to Recovery

From Reservation to Recovery.

According to recent data, over the past year, we’ve lost an average of 300,000 people in the U.S. to drug overdose and alcoholism combined. Despite these numbers, only 10% of people diagnosed with substance or alcohol use disorder (SUD/AUD) receive treatment. This means millions of people in need of treatment are not receiving it every single year.

The Reservations About Treatment Centers

In working on both the admissions and rehabilitation counseling sides of SUD/AUD treatment centers, I’ve addressed the slew of reservations people have against entering into care. These reservations come from both potential patients and loved ones, commonly surrounding concerns regarding detox, absence from work, childcare, and anonymity due to a fear of peer judgment. However, above all else comes the skepticism towards the effectiveness of rehabilitation.

These concerns are not baseless either, as 40–60% of people who enter into a SUD/AUD rehabilitation program relapse within the first year. Unfortunately, forming opinions on the success of addiction treatment based solely on that statistic is flawed, but not uncommon.

SUD and AUD are chronic diseases that should be treated as such. This means sobriety and successful recovery are not just dependent on the treatment experience, but also how the addiction education and recovery skills acquired are maintained afterward.

Considerations regarding how often patients discharge from rehab against medical advice (AMA) and prematurely discontinue supportive transitional care should not be ignored when determining the general success of drug rehabilitation treatment centers. Chronic disease care has always needed to extend far beyond the provider’s doors.

Life After Successful Treatment

Inpatient residential treatment centers introduce a mass amount of necessary addiction education, coping, and recovery skills to residents for at least a month. Typically, discharging patients also have an aftercare plan developed by their in-house care team to provide some direction upon discharge. This begs the question…

“What will life look like now?”

The Value of Transitional Care

In theory, after treatment, patients are well equipped to apply the gained recovery coping skills to their lives, but things can look different in real-world practice. Transitional care can be an important piece to maintaining sobriety long term. These forms of transitional care and support are most commonly arranged upon discharge from treatment:

Partial Hospitalization Program (PHP) — PHP is structured to allow patients more freedom as they continue receiving treatment at a lesser intensity than inpatient care. Features of these programs include case management, drug testing, medication management, individual and group therapy. Additional services vary depending upon the PHP program selected. Patients of these programs receive treatment during the day and return to housing associated with the facility at day’s end.
Intensive Outpatient Programs (IOP) — IOP is structured as a step-down from inpatient care or PHP as the treatment intensity lessens. Individuals attend these programs for an average of 10–20 hours a week, much like students would attend school a few hours a day. Patients find these programs offer the flexibility needed to avoid work and childcare conflicts, as there are in-person and remote options. Supports in this program setting can include individual and group therapy, but other services vary depending on the IOP program chosen.
Sober Living — An option for post-treatment residential housing that allows patients a sober environment to re-acclimate into a sober lifestyle. Residents of sober living homes are held accountable for preserving their sobriety, as they have the independence to maintain their lives and continue implementing their recovery skills. Drug testing and medication management are often features of these homes, as sobriety is required to continue residency. At the point of achieving sober living, patients have completed treatment and strictly receive outpatient care as part of their long-term recovery support.

Long-Term Recovery Support

Due to the chronic nature of SUD and AUD, a long-term recovery care support system is essential.

PCP / Medication Management — The involvement of a PCP in the support system of someone in recovery is vital to sustaining sobriety. Health and medication management can present unique concerns after treatment. Medications routinely utilized and prescribed by providers for various medical needs may be addictive. Medical providers can help to avoid, monitor, and/or manage their usage. Additionally, physicians are the best point of reference for medical treatments considerate of a sober lifestyle.
Psychiatrists — Medical doctors specialized in behavioral disorders; including substance and alcohol use disorders.
Psychologist — Doctoral level clinicians specialized in supporting those experiencing behavioral challenges, which includes addiction.
Licensed Professional Counselor (LPC) / Licensed Mental Health Counselors (LMHC) — Clinicians with these licenses are similar in that they’ve successfully completed a Master’s level educational program and extensive internship to equip them with the skills needed for behavioral health counseling. LPCs and LMHCs may also be specialized in SUD/AUD.
Licensed Clinical Social Worker (LCSW) — LCSWs are specialized Master’s level educated social workers, targeting mental health and SUD/AUD people.
Licensed Chemical Dependency Counselors (LCDC) & Licensed Addiction Counselors (LAC) — Clinicians with these credentials have completed undergraduate studies specifically in alcohol and substance abuse disorders. They typically work in treatment centers and are often available to see clients on an outpatient basis following successful inpatient treatment.

Recovery Care Team Reinforcements

The skills learned during rehabilitation treatment are often revisited and reinforced throughout recovery by the long-term care team.

Understanding Triggers — External triggers include people, places & things, while internal triggers include negative, positive, and neutral emotions.
Congruence & Communication — The ability to be honest with yourself and others about where you are mentally, physically, and emotionally is pivotal.
Mindfulness/Meditation — This cognitive skill allows an individual to be in a state of consciousness and awareness at specific moments.
Relaxation Techniques — Understanding healthy relaxation techniques can often be a new skill for someone just beginning their recovery journey.
Physical Health/Exercise — Medical providers work with other members of a care team to support patients’ physical health needs and provide recommendations that align with sobriety.
Healthy Leisure — Having enjoyable activities to engage in that do not jeopardize recovery is paramount to developing a sober lifestyle after treatment.
Recognizing Precursors to Cravings — Understanding the symptoms of precursors to cravings for substances and/or alcohol will improve the ability to be proactive.
Navigating Your Social Support System — Understanding, navigating, and turning to relationships and social supports when needed will be key to recovery.

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Types of Social Support

Taking advantage of and engaging with support groups after treatment can provide an effective outlet for normalizing the challenges and celebrating the milestones of recovery. Support group options include the following:

Recovery Support Groups — Peer-led groups (i.e. alcoholics anonymous (AA), narcotics anonymous (NA), National Alliance on Mental Illness (NAMI))
Support for Loved Ones & Families — Al-Anon (AUD specific), Nar-Anon (SUD specific), Alateen (Teen specific), NAMI Family Support Group.
Licensed Marriage and Family Therapy (LMFT) — LMFTs facilitate group therapy between families and those in recovery, along with working with families through challenges individually.

Tips For Socializing Sober

Navigating social life after treatment can feel intimidating, these tips can alleviate some of the stress:

Be honest with loved ones about what you can handle and/or why you may need to excuse yourself from some activities.
Prepare to be in a position of educating your friends when unintentional peer pressure happens. There’s nothing wrong with advocating for yourself.
Routines and the previously frequented haunts may need to change, and that is okay. Sometimes driving certain routes, certain crowds, areas, or environments can be triggering.

Everyone Will Need Grace To Acclimate

Lastly, remember that walking this new path, are you and your loved ones in support of your recovery. This means it will take time to acclimate to a new sense of self and lifestyle, and there will likely be some changes loved ones need to make as well. They often come in the form of communicating differently with one another and addressing previously formed perspectives of each other.