The 4 Stages of Addiction Treatment: Steps to Recovery
Important InformationThis information is for educational purposes only. We never invite or suggest the use, production or purchase of any these substances. Addiction Resource and it’s employees, officers, managers, agents, authors, editors, producers, and contributors shall have no direct or indirect liability, obligation, or responsibility to any person or entity for any loss, damage, or adverse consequences alleged to have happened as a consequence of material on this website. See full text of disclaimer.
Anyone who has undertaken the journey to a sober, healthy life free from addiction knows that it is neither short nor easy. It’s also a highly personal journey, so the individual steps or stages of addiction recovery are difficult to define, even in general terms. The specific addiction recovery steps one goes through will vary according to the type of addiction, the substance(s) one is addicted to, the treatment or recovery plan being followed, and the individual seeking rehabilitation. Read about the stages that most people on a path to successful recovery from addiction follow.
These stages have been synthesized from some of the most important writing and research in the field of addiction treatment. Some of the experts in this field list 3 primary steps for recovery, others specify 5 or 6, stages and a few list 9 or more. Here are four main stages of recovery: the steps to overcoming addiction that indicates the path that most recovering addicts follow.
The stages of rehab also shouldn’t be confused with 12-step programs. As useful as these insights might be, and as valuable as they have been and continue to be to generations of people seeking recovery and a sober life, they’re not really “steps” or “stages” per se, in that they don’t reveal much about rehabilitation from addiction as a process. These four categories do a good job of describing the key elements of the journey to recovery as a process, one that is completed by making simple steps, one after another, until the goal of freedom from addiction has been reached.
What are the Stages of Recovery from Addiction?
- Early Awareness and Acknowledgement – admitting the problem
- Determination / Commitment – deciding on a course of action
- Rehabilitation – discovering new ways of living free of addiction
- Ongoing Recovery / Maintenance – living sober, and living well
Stage 1: Early Awareness and Acknowledgement
The journey to recovery and a life of sobriety begins long before most people realize that they’re on any kind of journey. So it is important to understand that there are stages of addiction treatment that occur long before a person actually checks in to a treatment program, stages that are essential to being able to take advantage of such treatment and achieve recovery.
The earliest phase of addiction recovery has been termed the pre-contemplation stage, because the journey to recovery often begins long before the addict even realizes that he or she is undertaking such a journey. Often, those who are in the pre-contemplation stage have yet to admit to themselves that they have a problem. They may be “going through the motions” of talking about addiction because they’ve been pressured by loved ones or their employer or the legal system, but deep inside they still believe that they can “handle it” and are not really addicts. Addicts in this stage often blame their addiction on outside factors such as a stressful job or home life, rather than a situation that they created themselves.
People in this stage may be aware that there are negative repercussions associated with their addiction, but they tend to justify their behavior because they see its benefits more clearly than they see its deficits. This stage is often looked back upon by recovered addicts as their “rock bottom,” the “low point” of their addiction. But it has an “upside” in that the feelings one experiences during this stage often lead to the next stage of recovery.
During this stage, the individual has realized that he or she is an addict, and accepted that they need to make changes. They have become aware of the impact their addictive behavior is having on their lives, but they are still uncertain whether it is worth the effort required to change. They are still struggling to understand the root causes of their addiction, and unsure as to how to change. They’re open to change, as long as it’s “someday,” not right now. It is common for addicts to remain in this stage for months or even years, as they begin to think about potential courses of action.
The end of the contemplation stage is often signaled by a growing sense of simultaneous anxiety and excitement, because the addict starts to make concrete plans for their recovery. At this stage people begin to see that they are responsible for their choices and have the ability to make plans that can affect their lives in many positive ways.
Early manifestations of such plans can involve gathering information about possible rehab options, making a pledge of abstinence (even if it fails), or attending outpatient counseling or rehab sessions. They have begun to prepare for the possibility of a life without drugs or alcohol, and are starting to make plans as to how to achieve it. This is a huge step, and formulating a timeline to start the recovery process helps them move on to the next step – taking action.
Stage 2: Determination / Commitment To Action
This phase of addiction recovery is the stage in which people take actual steps to change, and the physical process of recovery actually begins. It may consist of the person changing his or her surroundings or behavior, developing a fitness plan or diet, or checking in to an accredited rehabilitation program.
This stage is the foundation for long-term sobriety. Making these changes not only “starts the ball rolling” in terms of the steps to recovering from addiction, it also builds confidence and creates a feeling of self-confidence. It also requires the most effort, but in the long term that can create the most feelings of satisfaction, because one is finally “doing something.”
During these early stages the individual can feel a great deal of vulnerability, because for many people it’s the first time they’ve allowed outsiders to look at their lives honestly. Fortunately, the feelings of satisfaction associated with finally taking action towards recovery often prove that their efforts and their feelings of vulnerability are more than worthwhile.
Among the steps to overcome addiction, this is extremely important, because one gets to meet with the rehab center, and determine whether it’s a good fit for the needs.
The rehab center will certainly have some questions for one as well, and may ask one to undergo diagnostic tests or screenings to determine how the program can best tailor its treatment plans to the particular recovery needs. The addiction treatment program staff will be interested in determining where in the preparatory stages one is, the severity of the addiction, personal history with substance abuse, financial situation and ability to pay for the treatment, either via insurance or personal funds.
Detox and Withdrawal
Most alcohol or drug treatment recovery programs – whether they are offered on an inpatient or outpatient basis – require a stage of detoxification at the beginning of the rehab process. This step of addiction recovery is to rid the body of all traces of the drugs or alcohol. Detox can be a challenging period and can cause a number of unpleasant symptoms.
During the initial period of detox, and even afterward in many cases, individuals may begin to experience withdrawal symptoms. These occur because the body has become accustomed to having high levels of the substance in its bloodstream. Depending on the addiction, withdrawal can start to appear within a few hours of the last use, and may include symptoms such as:
- Extreme depression
- Inability to concentrate
- Decreased appetite
- Severe fatigue
- Runny nose
- Sleep problems
- Extreme sweating
- Nausea, cramping or diarrhea
- Trembling or shaking
- Rapid heart rate
- Troubled breathing
- Muscle tension and pain
- Heart attack
This step of rehab is usually safe when undergone in a supervised medical setting. But because the symptoms of sudden withdrawal can be unpleasant and in some cases dangerous, medications may be used to ease them. The severity of detox symptoms varies widely, based on the type of addiction or volume of alcohol used, how long they were used, the individual’s body type and metabolism, and whether there are other addictions or mental health issues involved.
Even after the initial stages of withdrawal have passed, some people may experience a rehabilitation step that some have labeled Post-Acute Withdrawal Syndrome or PAWS. This, if it occurs, can last for months, and is characterized by irritation, panic, anxiety, trouble sleeping, poor concentration, and depression. Even if one doesn’t experience PAWS, it’s important to realize that one is not likely to transition into feeling great, so one will probably need to lean on the rehab community for support.
Stage 3: Rehabilitation / Finding A New Way Of Living
Once the individual has gone through the period of detox and physical withdrawal, now the real work of rehabilitation begins. This is the stage of the recovery process in which individuals delve into the core reasons for their addictions and then confront and address those issues so they can move on with their lives without relapsing back into addiction. There are a number of common therapies used in treatment programs to facilitate this stage.
Individual Behavioral Therapy
In individual, one-on-one therapy, people in rehab work with experienced therapists to identify when they first began to abuse substances and why they abused them. In these sessions, the therapists present strategies for how recovering addicts can re-direct their time to focus on new interests, and avoid falling back into destructive patterns. Individuals learn time-management skills so that they have less “downtime” to become boring and be tempted to relapse into addiction. They also learn how to identify addiction “triggers” and how to deal with triggering situations when they arise.
Most rehab programs supplement individual therapy with group therapy as well. These sessions allow people recovering from addiction to interact with others who are in the same situation. This often helps by reinforcing that they are not alone in their struggles.
Because the addict’s behavior cannot help but affect the people in his or her life, many rehab programs offer family therapy as one of their steps to rehab. In these sessions, people who have often been the most affected by their loved ones’ addiction get to participate in the recovery process. Family therapy can help tremendously to resolve past issues and create a present environment that serves as a pillar of support for the recovering addict. Thus it can be one of the most important of addiction recovery stages.
Stage 4: Ongoing Recovery / Maintenance
Even after individuals have completed their rehabilitation program, they are not finished with recovery. In fact, for many people the real work is just beginning, because recovery is a lifelong process, one that requires ongoing work and attention. It’s an ongoing journey, and will continue to have ups and downs that will tempt former addicts to relapse, so ongoing support is important. To provide this support, most programs will meet with each participant to prepare them for life “back in the world,” and to develop a plan for aftercare.
Most treatment programs provide followup programs to assist patients as they return to normal life. These programs may involve ongoing counseling sessions, either on an one-to-one or group basis. They may also involve weekend stays if the individual feels the need for a “refresher course.”
These ongoing programs are often not required, but they are highly recommended. Even after a person leaves the formal treatment program, it takes time to uncover and deal with the many feelings and issues that lead to addiction.
Once one has settled back into the normal life, it is unfortunately quite easy to grow complacent. The disease of addiction requires constant vigilance to overcome, and one of the best ways to avoid relapse is to work with follow-up counselors to recognize “prelapse,” the situations that – for one – have always been a temptation and made one feel the inability to cope without a drink or a hit of preferred drug.
Learning anti-relapse strategies can help to detect prelapse early, and realize that the temptation to stop the exercise program or skip follow-up counseling sessions may be a precursor to falling off the wagon.
In addition to follow-up programs run and supervised by primary rehab center, in every community there are numerous independent support groups for recovering addicts, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Many recovering addicts have found these groups to be tremendously helpful with their ongoing recovery.
- The Transtheoretical Model (Stages of Change), http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html#headingtaglink_1
- Moullec G, Ninot G, Varray A, Desplan J, Hayot M, Prefaut C., An innovative maintenance follow-up program after a first inpatient pulmonary rehabilitation, https://www.ncbi.nlm.nih.gov/pubmed/18164191
Where do calls go
Calls to our general hotline may be answered by Niznik Behavioral Health or other private treatment providers.