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Addiction Recovery Process and Steps

Woman talks to group of people about the addiction recovery processRecovery is a process that often takes years. Many people not only have to learn how to stop using drugs but also repair relationships, deal with financial or legal issues, manage health problems, and get their career or education back on track. The process may differ from person to person.

One of the more popular explanations of the recovery process is the transtheoretical or stages of change model pioneered by Dr. James Prochaska and Dr. Carlo DiClemente. This model identifies 6 stages or steps individuals cycle in and out of as they recover.2

The model is covered in detail below, along with some tips on how to get started on your recovery from alcohol or drug addiction.

What Is the Recovery Process?

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery as:

…a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.4

SAMHSA has listed 4 dimensions that support a life in recovery:4

  1. Health. Overcoming or managing one’s condition while making choices that enhance physical and emotional well-being.
  2. Home. Living in a stable and safe place.
  3. Purpose. Engaging in meaningful activities such as a job, school, and hobbies, as well as having the independence, income, and resources to participate in society.
  4. Community. Having support and positive relationships that contribute to love, friendship, and hope.

The recovery process is supported by social networks and relationships and may include family and friends who become advocates for their loved one’s recovery.4 Many rehab centers offer family/friends support groups for this purpose. With this support network in place, individuals in recovery know who they can turn to for help when intense cravings or relapse occurs.

Stages of Addiction Recovery

Sad woman sitting on couchDr. James Prochaska and Dr. Carlo DiClemente’s stages of change model breaks down addiction recovery into specific steps. It is one of the most common models used to describe the recovery process.

The model is based on the assumption that people change when they are ready, and change is a gradual process.7

The stages of the model are:2

  • Precontemplation. The person does not intend to change their behavior or is not aware of the problem.
  • Contemplation. The person is aware of the problem and seriously contemplating change, but there is no commitment to take action.
  • Preparation/Determination. The person intends to change and makes small behavioral changes (ex., researches different types of treatment options).
  • Action. The person decides to take decisive action to change (ex., enrolls in an inpatient rehab program).
  • Maintenance. The person works to prevent relapse and continues to take action (ex., goes to 12-step meetings or sees a therapist).
  • Relapse. The person reverts to unhealthy behavior.

Not all individuals move through the stages linearly. People may recycle through the steps or regress to an earlier stage.

According to DiClemente, motivation to change is seen as a series of tasks. The transtheoretical model attempts to set up these tasks, namely: “concern, decision-making, preparation, planning, commitment, taking effective action, revising plans, and integrating behavioral change into your lifestyle.”2

Not all individuals move through the stages linearly. Some take a few steps forward and then a few steps back. People may recycle through the steps or regress to an earlier stage. The model was set up to allow for this type of ebb and flow.

Working With a Professional

Practitioners gauge what stage of addiction recovery the person is in to get a sense of their readiness to change. Motivational interviewing, a counseling approach designed to encourage behavior change, instigates the person’s own motivation to make changes that promote their well-being.3 The practitioner helps motivate the recovering user to take action, and he or she may use different interventions at each stage to move the person to the next stage.7

The model also incorporates an environmental dimension. For example, to help someone stop smoking, clinicians seek to understand lifestyle, diet, exercise habits, and other aspects of a person’s life that may impede optimal health. Such information is useful in motivating change.

Beginning Your Journey

Woman in group therapy smilingAccording to the National Institute of Drug Abuse (NIDA), addiction can affect many aspects of a person’s life, so the best rehabilitation programs incorporate a variety of services.1 Because the recovery process occurs in different ways for different people, treatment may include:

  • Inpatient or outpatient rehab.
  • 12-step groups.
  • Faith-based programs.
  • Medication-assisted treatment (MAT).
  • Job skills training.
  • Family therapy.

When researching treatment options, look for programs that address your specific needs. Consider the rehabilitation facility itself, the individual practitioners, the demographics of the clients in the program, and the treatment program method. Research each program and speak with the admissions department to get a clear sense of each facility. Treatment is an investment in your future, so choose wisely.

If you or a loved one is ready to get help, you can start by asking a few questions, such as:

  • How long have you or your loved one been addicted?
  • Do you have medical or mental health concerns?
  • Does your insurance cover addiction treatment?
  • Do you need detox?
  • Are you interested in a program that serves a specific population (teens, elderly, faith-based, LGBT)?
  • Do you have other needs in treatment, such as job-skills training, family or couples therapy, or the ability to complete schoolwork in treatment?
  • Do you want to stay close to home for treatment, or would you rather put some distance between your treatment and your current environment?

Dealing With Relapse

Using a strong support system…and asking for help during stressful times can reduce the risk of relapse.

Quitting drugs is just one part of the recovery process. People also need to reprogram deeply entrenched thought patterns and form new behaviors.

The nature of addiction assumes that relapsing at some point is not only possible but likely. According to NIDA, relapse rates for people with substance use disorders are similar to those for chronic medical diseases such as diabetes, hypertension, and asthma.1

Studies have shown that stress, people, places, things, moods, and exposure to drugs are the most common triggers for relapse.1 Using a strong support system, following an aftercare plan, living in an environment conducive to recovery, and asking for help during stressful times can all reduce the risk of relapse.

Aftercare can include:

  • Sober living.
  • Check-ups or “booster sessions” at a treatment center.
  • 12-step meetings.
  • Regular individual or group counseling sessions.

Sources

  1. National Institute on Drug Abuse (2014). Drugs, Brains, and Behavior: The Science of Addiction.
  2. Werch, C., Ames, S., Moore, M., Thombs, D., and Hart, A. (2009). Health Behavior Insights: The Transtheoretical/Stages of Change Model. Health Promotion Practice 10(1):41.
  3. Center for Substance Abuse Treatment. (1999). Enhancing Motivation for Change in Substance Abuse Treatment.
  4. Substance Abuse and Mental Health Administration. (2015). Recovery and Recovery Support.
  5. Kauer, J., & Malenka, R. (2007). Synaptic Plasticity and Addiction. Nature Reviews, 8, 844­–858.
  6. Boshears, P., Boeri, M., & Harbry, L. (2011). Addiction and Sociality: Perspectives from Methamphetamine Users in Suburban USA. Addiction Research & Theory, 19 (4), 289301.
  7. Boston University School of Public Health. (2016). The Transtheoretical Model (Stages of Change).

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