If you have a loved one going through the addiction recovery process, it can be tempting to get frustrated. Why can't they just stop drinking (or smoking, or taking pills)? Why does the process seem so hard?
For non-addicts, it can be difficult to conceptualize the hold that an addiction has over the addict.
Recovery is a process, and there are stages of addiction recovery that every addicted individual has to go through in their own way in order to come out successful and sober.
To really get an in-depth understanding of the recovery process, you have to understand a few things.
First, we're going to take a look at addiction itself and what it does to the body. Understanding the physical and mental hold that addiction can have can help develop the empathy necessary to properly support and assist and recovering addict.
A supportive network close to the individual may not make recovery easier, per se, but it makes recovery more likely to be successful.
Let's take a look at the stages of addiction.
When we talk about addiction, the way we frame the problem is vital.
Too often, addiction is seen as a personal failing. In reality, addiction is a disease. There are many factors involved, some circumstantial, some genetic, but the truth of the matter is that addiction is something over which the individual has little control.
Addiction literally changes the functioning of the brain and body.
The human body craves homeostasis and balance. Addiction is a malfunction by which the body begins to recognize the impaired state (drunk, high, etc) as the new "normal" and so begins to crave it in an effort to maintain that homeostasis.
More and more of the substance is needed to maintain the balance over time, making the addiction more and more dangerous and increasing the hold it has over the addict.
Think of it this way.
Two people may make the decision to have a beer after work.
Person A has their beer, enjoys the light buzz, and moves on. They may even enjoy the beer every night. But if they have to skip it for whatever reason, or if their favorite bar closed down, or if they just decide to stop drinking for whatever reason, it's not an issue.
This person can stop drinking with no consequences, and never has the urge to start again.
Person B has their beer, and their body and psyche begin to recognize the light buzz as the new norm. So now, to get buzzed, it takes two beers instead of one. And it becomes three beers, then four. Before Person B realizes what has happened, they have stumbled into alcoholism.
And even while they are drunk to the point of non-functioning, their body is telling them that this is the norm. This is balance.
This didn't happen because Person B has a weak will. It just means that other factors have predisposed them to abuse what, for others, might be a harmless diversion.
A lot can factor into this disposition. Depression, anxiety, family history of addiction, and certain executive function disorders can all increase the risk for addiction.
Understanding the Stages Of Addiction Recovery
In 1983, researchers Carlo C. DiClemente and J. O. Prochaska released a study detailing the stages of addiction recovery. They called it the Transtheoretical Model of Change and included 6 Steps on the road to recovery.
This approach was considered revolutionary at the time and took into account addicts who were still so early in their recovery that recovery had not yet really begun.
Prochaska & DiClemente described the following six stages of recovery:
Let's take a look at what these terms mean. See if you can spot your loved one (or yourself) in the steps.
Some argue that pre-contemplation isn't a step in the recovery process at all. And to the untrained eye, it can look that way.
The Pre-contemplative individual does not see the problem with their addiction, and may even deny that they are addicted. This mechanism can take several forms.
Reluctant pre-contemplators do not fully see the impact their addiction is having. They may avoid conversations about their addiction and do not want to consider changing.
With rebellion, the individual may be fully cognizant of the fact that they are addicted or that their addiction is a problem, but may appear no to care. They do not want anyone to tell them what to do or to surrender their ability to make their own choices. Their addiction is a misguided expression of their desire to be in control of their decisions.
Like rebellion, those in the resignation category may recognize that they have a problem.
But to them, there is no way out, recovery won't work anyway, they are too far gone to try to save. They have resigned themselves to a life of addiction
Those in this category have often attempted recovery before.
Here, an individual rationalizes why their drinking (smoking, shooting up) is not a big deal. The problem is with others, or with the situation, or with society. They do not have a problem, others have a problem. They can stop anytime they want!
This is a stage that can cause much frustration for those close to the addict.
Here, a person may realize they have a problem. They may even admit to the problem.
But now a decision must be made as to whether or not to get help. After all, do they want to give up this thing that has been making life bearable? How will they function without it? Recovery means they may never drink again. Are they really ready for that commitment?
This stage can be best categorized as the "What if" Stage.
What if they fail?
What if life is worse without the drinking?
What if? What if? What if?
Addicts may spend a large amount of time here, maybe even oscillating between pre-contemplation and contemplation.
However, in this stage, they are often receptive to information, especially presented in a non-judgemental way. Seeing a therapist during this time can be immensely helpful, as a therapist can assist the individual in a risk-reward analysis to help them see the benefits of recovery.
Now we're getting somewhere!
Once they've reached the determination stage, the individual has made the conscious decision to stop drinking.
There may be doubt, or fear, or ambivalence, but those things are no longer the driving decision-making forces. Instead, the individual is ready to make a plan for recovery.
It is vital that once this step is reached, a professional is consulted. Too often, individuals reach this step, make a fragile attempt at a plan, and give up at the first set-back.
A professional addiction therapist can help with tools and strategies to avoid setbacks and help create a realistic plan toward recovery. Being realistic is so important in this step.
If an individual is committed to recovery but does not fully appreciate the difficulty of the road before them, they may not stick with a recovery attempt and may relapse back into old habits.
Recovery has truly begun now.
A plan has been made, hopefully with the help of a mental health professional, and treatment can now begin.
Depending on various factors, from home circumstances to finances, the method of recovery may differ. Some may choose a full inpatient recovery program, while others opt for an outpatient program.
Individuals in this stage should also be as public as they can about their decision. Encourage them to tell friends and family that they are in recovery. While they do not need to shout it from the rooftops, telling people creates a network to whom they are accountable, even informally.
The action stage should also be accompanied with meeting attendance. AA and NA can be a vital step in the process as they recover. Working side-by-side with other individuals struggling with the same things, and taking guidance from those further along in the journey, can be an invaluable tool for recovering addicts.
Now, this isn't technically a step in DiClemente and Prochaska's method, but we feel it's an important thing to be ready for.
Addiction recovery can be painful. Whether opioids, alcohol or even heavy cannabis use, the physical and mental effects of cessation can be grueling.
Withdrawal symptoms fall into two categories, mental and physical.
Mental Symptoms can include anxiety, depression, sleep issues and cognitive troubles.
Physical issues can affect the GI tract, muscles, head, skin, chest, or heart.
Those in recovery may have some of these or all of them. Symptoms may occur in isolation or in conjunction. They will fade with time, but the urge to use again will spike during this time if only to make the pain go away.
If the addiction is severe enough, some doctors may recommend a supervised detox. Addiction cessation can be life-threatening in rare cases, and having a doctor on hand in the event of worst-case scenarios may be a good idea in some cases.
After three to six months in the action stage, actively working through recovery, most addicts will enter the maintenance stage.
At this point, the desire to drink or use is decreasing daily, and it may no longer be necessary to be in active treatment.
However, even in this stage, relapse is a possibility. Individuals here should continue attending AA or NA meetings. Open communication should be maintained with their closet support network, and continued therapy sessions are a good idea.
Difficult circumstances may trigger a relapse, or the individual may feel that they are fine for "just one drink". A recovering addict may have the urge to "test" themselves. It's a sneaky way for the addiction to worm its way back into a life.
Most addicts will relapse at least once, but the chances go down the longer an individual remains sober.
If your loved one relapses, it can be frustrating. But there is good news here. Because they have recovered once, they have the tools to do so again. They may not need as much convincing to get help again, and they will learn from the experience.
This is the end goal of any addiction recovery program.
Once an addict has been sober for 12 to 18 months, they typically enter this final stage. Once in the termination stage, the urge to drink or use again goes down.
The addiction is no longer a constant struggle or a driving force in the individual's life. They can cope with daily stress without having the urge to dive back into addiction.
There is freedom at this end of the process, and a huge sense of accomplishment.
As always, recovering addicts should be mindful of things that trigger them to be tempted to drink again. They should continue to be realistic about their own self-control and abilities to withstand temptation.
The good news is that, as time goes on, the chance of relapse continues to drop, bottoming out at only 15% after five years of sobriety.
Many addicts say that you never stop recovering. Others will refer to themselves as recovered after two to five years of sobriety. How you label your journey is up to you.
The stages of addiction recovery are arduous. They are difficult and long and full of setbacks.
But life on the other side is worth it, for both the individual and those close by.
If you or a loved one is ready to start the journey toward recovery, contact us today. We have can help you find the recovery option that is right for you.