Recovery from substance use and addiction is not a straight line.
The journey simply isn’t the same for everyone, and if you or your loved ones expect that it is, then you set yourself up for stress and disappointment. [updated March 2023]
To navigate the windy road from denial and acceptance to addiction treatment and eventually, long-term maintenance, flexibility will serve you well. There will be big wins as you see the hard work start to pay off. But there also may be setbacks.
Substance use disorder is a chronic condition for many that may lead to chronic relapse. Not everyone experiences these slips, but for those who do — it’s just part of the process.
The ups and downs of recovery bring with them valuable lessons and opportunities to grow stronger, more resilient, and increasingly aligned with who you truly want to be.
Residential Addiction Treatment Is a Great Start But It’s Only the Beginning
Habit change is difficult — plain and simple.
Some behavioural changes are straight forward, like going for a 20-minute walk every morning to improve cardiovascular health. Others, like quitting problematic drinking or drug use, are far more complex. Either way, when you make any meaningful change in your life there’s a process.
The transtheoretical model in health psychology breaks this process down into 5 Stages of Change. While these stages aren’t a hard and fast rule, they illustrate the potential phases that you or your loved one may have to navigate on the road to recovery.
It’s important to notice that it’s not until the 4th stage that concrete action is taken. When it comes to substance use disorders (SUD) that means that it may take a while for someone struggling with substance misuse to be willing to take the first big step in recovery — which when dealing with acute dependency — is often residential addiction treatment.
Denial is a prominent characteristic of substance use disorder. In the Pre-Contemplation stage (the first of the five), there is no acknowledgement that there’s any issue at all and therefore no perceived need to even consider treatment. Eventually, consequences related to drinking or drug use lead to the Contemplation stage when there’s recognition of an issue but not necessarily one to take action against — yet.
In the third stage, which is Preparation, you or your loved one admits there is a problem and plans to get help sometime in the near future. This is a painful place to be for both the person suffering from SUD and those who love them. But as consequences and suffering increase, so might the willingness to go to treatment.
The fourth phase, is when action is taken toward making a necessary change. This is the true beginning of the recovery journey. It’s important to manage the expectations of what this monumental step means.
While yes, it’s certainly worth celebrating, it doesn’t mean that recovery is in the bag. In truth, recovery is rarely linear. It ebbs and flows depending on the person, their history and degree of substance use, and the help they’re accessing.
Treatment is not a “cure”. It’s an opportunity for you or your loved one to be removed from familiar environments where easy access to alcohol or drugs makes temptations nearly impossible to ignore. For those who need medical assistance through the detox process, it’s critical to be in a facility that can meet these needs.
In addiction treatment or rehab, you begin the process of learning new coping skills, managing your cravings, and asking for help when you need it. These are a few of the many skills that set the foundation for learning an entirely new way of living. And it simply doesn’t stop there.
The fifth and final stage is Maintenance and it is arguably the hardest part of the recovery process.
Maintaining Recovery From Addiction and Substance Use
Completing in-patient treatment is huge. It generally puts 30-90 days between you and the last time you drank or used drugs.
This glimpse into what it feels like to live drug and alcohol-free can give some people the aha moments they need to dive head first into continued recovery, while others still experience a lot of uncertainty and discomfort.
Early abstinence is the period after leaving treatment. Stepping back into your old life without falling into old habits and patterns is challenging for many. This is a critical time to get support from healthy loved ones, support programs, or one on one recovery coaching.
Immediately after completing treatment, some people experience ongoing withdrawal symptoms and cravings. Returning to your home, job, and relationships will likely present triggers that can compromise your recovery. Preparing ahead of time for how you’ll handle these difficult times and building a support system around you is powerful relapse prevention.
People who haven’t struggled with drugs or alcohol have a hard time understanding the challenges of recovery. Those who suffer from SUD have likely spent years, if not decades, relying on substances to manage difficult emotions. Feelings of sadness, frustration, disappointment, anxiety, and even boredom, can be overwhelming to sit with and process.
Maintaining your recovery requires learning how to manage your internal state and cope with the external world. If you’re the loved one of someone undergoing this process, the more grace you can offer them as they learn entirely new ways of living, the better you will be positioned to support them in meaningful ways.
Throughout the course of recovery, your needs for guidance and support will continue to evolve. What once felt impossible will become second nature and then a new challenge will present itself that requires you to learn more about yourself and who you want to be in the world.
Is Chronic Relapse in Recovery a Failure?
Experiencing a relapse after achieving a period of sobriety can be devastating for someone in recovery and their loved ones.
However, the risk of reoccurrence is simply part of the recovery process and should not be viewed as a failure.
Similar to chronic illnesses like Asthma or Chron’s Disease, substance use disorders are subject to a recurrence of symptoms after a period of abstinence or remission. One U.S. study showed relapse rates for substance use disorders were 40-60% — comparable to the 50-70% relapse rates of Asthma sufferers.
An article published in The Canadian Journal of Addiction reported similar findings. Among the 855 study participants examined, 48.8% experienced one or more relapses after beginning the recovery journey. Nearly 30% of those respondents experienced six or more instances of relapse.
In other words, laps and relapses in recovery are neither unique nor an indicator of treatment failure. It’s a normal, albeit difficult, component of this chronic condition. When asked to identify what barriers to maintaining their recovery lead to their relapse, the above participants listed several contributing factors, including:
- Difficulties securing or maintaining employment and/or stable housing
- Lack of access to programs that supported maintaining their recovery
- Insufficient professional help with emotional issues
- Lack of healthy and supportive social networks
If you or your loved one experiences a relapse, the story you tell yourself about what that means will make all the difference. If you decide to view it as a failure, it opens the door to feelings of shame, guilt, resentment, and hopelessness. This will only make it harder to get back on track.
Instead, try looking at it as a time to reevaluate what was missing from your treatment plan. Sometimes when people start feeling stable in recovery, it’s easy to get too relaxed about your commitment to doing the things that helped you get sober in the first place. A relapse can be a signal that it’s time to double down on those efforts.
The bottom line is — the recovery journey isn’t a singular thing to accomplish. It’s not a finish line you cross and suddenly no longer have to put in the work. It’s a lifelong endeavour. One that is constantly evolving, inviting you to step further into your highest self so that you can create a life that you love.