The 5 Stages of Addiction Recovery
Addiction and recovery are two things that are unique to every individual. No two addictions are exactly the same and therefore no two recoveries will be either. There are simply too many influential variables that it is impossible to accurately predict how an individual will respond to abstinence or treatment. There are however certain stages that every person must go through when getting clean and sober, as well as some fairly predictable needs that must be met in order to maintain motivation and secure long term abstinence.
The five stages of recovery are identified as follows;
1. Recovery Contemplation (pre-abstinence)
2. Detox and Early Abstinence (0 – 3 months)
3. Treatment and Early Recovery (3 month to 1 year)
4. Active Recovery and Maintenance (1 – 5 years)
5. Advanced Recovery (5 years and beyond)
For an individual struggling with addiction to heal, they must take the time to follow through the stages. Rushing the process will yield inadequate results and increase the potential for relapse. Of primary concern is entering into a residential treatment program too soon after becoming abstinent. The body and mind has not yet had time to heal and as such, the individual will receive limited benefit from such treatment. Residential treatment digs deep into an individual’s mind to uncover the root causes of addiction. If an individual does not yet have the mental or emotional capacity to handle this information, they are likely to push back or suppress the information even further. The result can be devastating, as digging up old wounds without an actual resolution, can quickly manifest into more destructive behaviors. It is so important to the overall success of treatment that the individual is healthy enough, both physically and mentally, to take on the challenge of their darkest demons.
Recovery Contemplation (Pre-Abstinence)
Recovery Contemplation is the first stage of the recovery process. The individual begins to experience negative consequences from their addictive behavior. In an effort to minimize these consequences, the individual tries to regain control by reducing use or changing their behavior. Perhaps they will try to regulate times of use and perhaps even try to shut it down at a specific time. Some people may even go so far as to have their DOC or alcohol present in their home, or tempt themselves with their behavior, in order to prove to themselves that they can control it. Eventually they are forced to acknowledge that there is a problem and they begin to consider reaching out for help. This stage of the recovery process can go on for some time with the individual wavering between the pre-contemplation, contemplation and preparation stages of change. True recovery does not in fact take place until the individual makes a commitment to change and acknowledges that they cannot do it on their own. Whether or not there is a significant motivating factor directing this change of mindset, when an individual is at the point of acceptance of the problem, immediate access to support is necessary, as this window of opportunity can sometimes close very quick. It is imperative that people are afforded every opportunity to get clean and sober when they are ready as there may not be another chance. Drugs and alcohol kill people every day and one can quickly lose all hope by not having this support available when they are ready for help.
Detox and Early Abstinence (0 to 3 months)
The second stage in the recovery process is the detox and early abstinence stage. It is at this point that the individual has decided to get clean and sober and stops using their drug of choice. This stage can be excruciating for some people and may require medical supervision for the first week to ten days. During this stage, in particular the first month, individuals will go through some significant physical, mental and emotional changes. For some, it may have been years since they did not have any drugs or alcohol in their system. This will be a new and frustrating experience and requires a lot of support and attention. Mental processes may be foggy and learning anything other than basic self-analysis will likely prove to be rather ineffective and perhaps even counter-productive. It is not until the treatment stage that the clients will be required to look deep within themselves to the source of their addiction. The primary goal during this stage is to maintain support for abstinence while the body heals. Physical nourishment along with cognitive awareness are the two main focuses. With a healthy body and mind, the treatment stage will be that much more effective and not sidetracked with withdrawal symptoms and cognitive distractions. Given the state of treatment in Canada right now, immediate acceptance into a residential treatment program is not likely anyways and as such, programs like the Residents in Recovery program supports the individual until a bed becomes available. The preferred length of time for this stage would be two to three months.
Treatment and Early Recovery (3 months to 1 year)
This is the meat and potatoes of any recovery program. Residential Treatment, group therapy, one-on-one counseling, therapies (ie. EMDR, REBT, CBT) and 12-step or other related meetings are the key features of this stage. This stage typically starts with residential treatment. Intensive self-examination combined with 24 hour supervision and support helps the individual identify and expose the underlying issues that manifested into their addiction. A detailed preliminary evaluation in the previous stage will help determine the appropriate and most effective residential treatment program. It is fairly typical for an individual to simply be placed in the closest treatment program or one associated with the detox facility. There is very little thought put into the appropriate or most effective program for the individual. As every person is unique, certain programs would be much more effective for certain people and placements should be determined based on the individual's temperament, history, addiction as well as their mental and emotional state. Getting the person into the most appropriate residential treatment program will greatly increase the effectiveness of the program. A proper fit of program and client will support the exposure of issues and facilitate the dealing with such issues. The residential treatment program is used to identify, expose and develop a recovery plan with the underlying issues in mind. Treatment of the underlying issues will typically require extensive therapy beyond the residential treatment program. Returning to a program such as the Residents in Recovery program after treatment, will ensure that these issues are actually addressed in an effective way and they are resolved so that they no longer pose a threat to the abstinence of the client. Regardless of therapy, the individual must get themselves into a healthy environment to ensure that they receive the treatment or therapy that they require. This stage will typically last anywhere from 6 months to a year but could last up to 18 months in certain circumstances.
Active Recovery and Maintenance (1 to 5 years)
The active recovery and maintenance stage begins once the individual has come to terms with their issues and has accepted that the work and awareness will continue throughout the remainder of their lives. The individual will have completed extensive work on themselves and begun a complete transformation of their lives (mind, body and spirit). People at this stage of their recovery have learnt new tools to cope and the guard against relapse. Individuals reaching this stage of recovery are also aware of the importance of managing their thoughts, emotions and behaviors and know the connection between each of them. They are also keenly aware of how their old beliefs and thoughts can creep back into their lives, and without being kept in check, will ultimately lead to a lapse or relapse. They continue with counseling when necessary and seek support through self-help groups or meetings. Careful attention is paid to maintaining a balanced lifestyle with healthy and stable relationships. This stage lasts approximately five years and is still to be considered to be early recovery in a number of programs.
Advanced Recovery (5 years and beyond)
Advanced recovery is depicted by at least 5 years of clean time. At this stage of recovery their program has evolved into a living and almost subconscious program. The tools that the individual has learnt become second nature and get used every day without even realizing it. Typically by this stage of recovery, the recovered individual has become a positive and productive member of society. Life free of their drug of choice or alcohol is second nature at this point and urges or cravings are few and far between. The person is able to quickly identify when there is a problem with their program, as old habits creep into their lives or they start having frequent urges again. By this point they are very comfortable in their new identity and purposefully live a wholehearted and authentic life. Many people will continue with their support programs such as 12 step groups and tend to be active in service. Giving back and volunteering to help others is a good indicator of an effective and active advanced recovery program. This stage continues until death and provides the recovering individual the opportunity to pass on knowing they lived their life to their full potential and just as it was meant to be.
