When Does Recovery Stop? 4 Arguments for a Strong Aftercare Program

The brain is hardwired to seek pleasure and avoid pain.

It doesn’t matter whether the addiction started as a few innocent drinks to calm unsteady nerves after a tragic event, or if the first experience with cocaine was driven by curiosity. The chemical-dependent body reacts the same. It screams for relief until the urgency is satisfied.

Recovering from drug addiction is a life-long journey that never ends. There are many types of rehabilitation programs that can help an addict transition to recovery, but the most successful ones all have one thing in common – a carefully planned aftercare program designed for maintaining sobriety.

Reasons a Strong Aftercare Drug Treatment Plan Is Critical to Success

What does an intentionally designed aftercare drug treatment plan look like, and why is it so important? This article will explore four reasons that everyone entering an inpatient rehabilitation center deserves exceptional, ongoing support.

Number One: Relapse Rates Increase Shortly After Release From an Inpatient Facility

Relapse is so common after inpatient treatment that most rehabilitation providers consider them a normal part of recovery. Even though many factors have been identified as predictive indicators, science has not yet found a way to tap into that knowledge to prevent relapse effectively. Studies show that only 15 percent of substance abusers who receive inpatient care will reach their one-year sobriety anniversary before returning to their pre-treatment lifestyle.

There is some good news for addiction sufferers. Advanced medical imaging technology and improved testing methods allow researchers to identify significant predictors of addiction relapse, which may one day lead to new treatment planning guidelines that reduce relapse rates.

Until then, the aftercare program provides a lifeline during the first few weeks and months after release, when physical and psychological stress is often at its highest for the recovering addict.

Number Two: Stigma in the Community Often Derails Sobriety Efforts

Sobriety Efforts

Stigma and discrimination in the community often shape the way recovering drug users see themselves. The chronic stress of trying to convince people they have changed, or are doing everything they can to stay sober, takes its toll. Perceived stigma may mean that the joy of achieving sobriety is quickly replaced with feelings of profound isolation.

When people feel unworthy or devalued, they may suffer mentally and socially. Depression symptoms may worsen, and resolve weakens as they further cut themselves off from friends and family.

People who feel stigmatized tend to have smaller support networks and are less likely to seek help from medical professionals when cravings and other withdrawal symptoms emerge, making them even more vulnerable to relapse.

A strong, post-inpatient aftercare program offers individuals a safety net against both real and perceived stigma. The ideal program includes:

  • Developing a clear, actionable post-treatment plan that includes daily, weekly and monthly goals, and tips for navigating a sober life beyond the treatment facility.
  • Regular contact by phone, web-chat, telemedicine technology, or in-person meetings to discuss victories and challenges.
  • Personal development opportunities.
  • Support group referrals – and introductions whenever possible. Support groups include both meetings in a professional setting, as well as referrals to safe social groups for recovering addicts.
  • Ongoing counseling, including dual diagnosis support when applicable, or a referral to a local psychiatrist or psychologist after discharge.
  • A path to return to inpatient treatment if appropriate for further in-depth treatment to prevent relapse.

Number Three: Ongoing Counseling Is Necessary to Maintain a Healthy, Drug-Free Lifestyle

Drug-Free Lifestyle

Follow-up programs, often referred to as “alumni programs,” provide an avenue for graduates to stay connected during the life-long recovery journey. This connectedness is in and of itself a form of therapy, especially during the early months of sobriety.

Because a good rehabilitation program helps individuals develop relationships built on trust and support during inpatient treatment, participants may feel abandoned by their community when they are abruptly separated from counselors they have grown attached to over a three-month, or longer stay.

Powerful psychological and social factors influence drug abuse relapse risks. Follow-up care, including ongoing counseling, gives clients an opportunity to explore ways to cope with these stimuli. Therapists may leverage counseling session time to discuss lessons learned during the rehab stay.

Some common stressors for the newly sober individual include:

  • Physical and emotional stress, especially unexpected stress that arises as part of daily life
  • Making contact with friends or family members who still use illicit drugs or misuse prescriptions
  • Environmental triggers, like experiencing the sights, smells and sounds when revisiting an old neighborhood

Each individual may benefit from continuing unique counseling and therapy protocol established during an inpatient drug rehabilitation stay, as well as adding new therapies when appropriate.

For example, behavior-modification therapy includes both positive and negative reinforcement strategies, where the recovering addict receives praise for exhibiting desirable behavior and loses something for inappropriate behaviors. The negative sanction could be something as simple as temporarily losing privileges or serving a few hours in a community service project – which could yield positive results in the long-term.

Both inpatient and outpatient rehabilitation treatment plans may incorporate more than one type of behavior therapy delivery. Below are two examples.

Cognitive Behavior Therapy focuses on learning to identify risky behavior and applying self-control to avoid giving in to urges and cravings.

Dialectical Behavior Therapy is beneficial for recovering addicts struggling to maintain emotional control. These patients may have recurring thoughts of suicide or issues with self-mutilation. This counseling approach empowers people to accept difficult thoughts and develop response patterns that eliminate self-destructive behaviors.

Aftercare drug treatment counseling sessions may address substance abuse, and other challenges not related specifically to recovery. For example, as many as 20 percent of drug addicts may also struggle with an addiction to gambling.

Research confirms gambling and drug abuse both trigger the same reward center responses in the brain. Dr. Flora Matheson, a research scientist affiliated with St. Michael’s Hospital, says substitution is a known pattern in the field of addiction. She suggests, “In the absence of illegal drug purchasing, and the many behaviors that go with it, gambling can provide an alternative form of excitement.” Addressing other addictive habits is necessary to maintain a healthy lifestyle beyond the inpatient stage of recovery.

Promoting abstinence of all drugs is a key element of addiction recovery, and this can include providing smoking cessation support. The CDC recently recommended integrating tobacco cessation interventions in substance abuse programs. In their report, the agency quoted published research that suggests these interventions have the potential to reduce tobacco-related deaths and improve outcomes for substance abuse disorders.

The CDC further reported that less than half (35 percent ) of substance abuse treatment facilities in the United States surveyed have a smoke-free campus.

Aftercare drug treatment programs play a significant role in helping program graduates adjust to sobriety when they return to their communities and resume daily activities with a renewed strength and spirit.

Number Four: Accountability Partners Boost Self Confidence & Motivate Positive Behaviors

Continuing care benefits the recovering addict by deploying accountability partners and encouraging positive behavior. As mentioned earlier, behavior-modification therapy helps patients develop positive responses to emotionally charged environmental factors that may have originally contributed to drug abuse.

An ideal aftercare plan encourages sober graduates to leave unhealthy relationships behind and replace them with life-affirming accountability partners who will help them focus on achieving life-changing goals.

Every goal achieved boosts confidence and motivates a person recovering from drug abuse to keep pursuing a life of freedom. Aftercare may incorporate recreation therapy elements that promote physical exercise and facilitate goal setting and achievement milestones.

Conditioning therapy started during inpatient treatment may continue with aftercare. Linking a mental image with negative behavior is a good motivation to work toward exhibiting positive behaviors that build a healthy self-image and reduce relapse potential.

One of the more important aspects of successfully moving from a controlled environment back into the public domain is being connected to a thriving support system.

Goal setting and a well-rounded support system work together in harmony to create an environment that empowers personal growth and development. A post-treatment outline for incorporating a mix of goal setting and relationship building may look something like the example below.

  1. Maintain or improve physical health. Take medication as directed. Get plenty of rest. Follow the prescribed diet and exercise recommendation. Arrive on time for every scheduled doctor’s appointment.
  2. Avoid addictive substances and activities to maintain sobriety.
  3. Make mental health a priority. Call post-treatment counselors just to touch base, or as part of the written aftercare plan.
  4. Connect with spirituality partners who share a common faith or belief system.
  5. Explore self-improvement opportunities. Read books, join support groups, search online for information about past hobbies abandoned when addiction claimed available free time and money.
  6. Implement lifestyle choices that support fitness and wellbeing.
  7. Rebuild relationships and create new ones.
  8. Meet all basic daily needs. Find suitable housing. Secure reliable transportation. Apply for financial assistance, if necessary. Locate a nearby farmers market or grocery that offers a wide selection of affordable fresh fruits and vegetables.
  9. Re-examine employment goals. This may be the perfect time to change occupations or get additional training as preparation for a new career path.
  10. Develop a realistic budget that includes paying off old bills and saving for emergencies.
  11. Resolve any lingering legal issues.
  12. Give back to the community. Volunteer, raise money for a worthy cause or become an advocate for others struggling to find their own freedom from addiction.

All of the goals listed above are achievable when paired with reasonable expectations and clearly defined expiration dates. Some goals have a short completion date. Others may renew or be extended for longer periods. Number 2 may be a daily goal that never finds its way off the list. However, meeting daily needs, like finding reliable transportation is something that should be done within a short time after leaving the inpatient facility.

The Case for Implementing a Strong Aftercare Plan Continues to Expand

As emerging medical technology provides more insight into the natural brain responses to certain drugs and other external stimuli, research will most likely shape future substance abuse treatment protocol and aftercare design. Today, innovative alternatives to traditional treatment models recognize the importance of viewing a drug addict as a whole person. Someone with a complex set of emotional, mental, spiritual and physical needs. Modern treatment plans often incorporate complementary therapies, alternative diet plans and integrated dual-diagnosis protocol that addresses mental disorders not directly related to substance abuse. Treatment facility administrators are also bolding stepping away from the historically narrow approach that fails to recognize drug and alcohol as a chronic illness that demands ongoing treatment, much like hypertension or diabetes.

Relapse is prevalent, but not entirely unavoidable. Recovery never stops. That does not mean people cannot achieve a healthy, happy life. Everything is possible with the right attitude and the right support team. The mental health community has made great strides in educating the public about ways they can reduce real and perceived stigma for people who have achieved sobriety but will remain in recovery mode for the remainder of their lives. More can be done. Perhaps the first step is helping treatment graduates gain a healthy image of themselves by promoting esteem-building exercises and encouraging personal accountability with a strong, intentionally designed aftercare plan that focuses on a hopeful future, without discounting the experiences of a painful past.

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