Clinical studies suggest that 40% to 60% of recovering addicts relapse in the first year after rehab. The relapse rate epitomizes the challenges in the early stages of recovery, and loved ones may sometimes doubt that treatment really changed the person. In some cases, the recovering addicts may have the same questions themselves. The Journal of Substance Abuse Treatment in 2007 said recovery is a voluntary lifestyle focused on the maintenance of sobriety, personal health and positive citizenship. This description provides a guide for changes that should occur during recovery. Has the loved one remained sober? Is the person taking steps to improve his or her physical and mental health? Has the recovering addict built a social support network and become more concerned about the needs of others? Recovery is an ongoing process of change, and the steps may be shaky at times, but the important sign is that the person is taking the right steps in the right direction. When loved ones learn about these steps, they can better assist friends and family members in their recoveries.
Abstinence in Addiction Recovery
Total voluntary abstinence from alcohol and non-prescribed drug use is the prime behavioral goal of rehabilitation treatment. The aforementioned Journal of Substance Abuse Treatment classified three stages of sobriety: early (first year), sustained (years one to five), and stable (more than five years). While the first year or two are often more challenging, the National Institute on Drug Abuse (NIDA) in 2008 said the average relapse rate drops to 14% after two years of sustained sobriety. Still the same biological risk factors that contributed to the initial addiction remain, and recovering addicts in all stages need to safeguard their sobrieties.
For friends and loved ones, the big question is how to respond if a relapse does occur. Speaking with a treatment professional is an ideal place to start, but any potential response will likely involve certain considerations, including the following:
- Do not accept the argument that this was a one-time setback and no response is necessary.
- Address the relapse in specific ways without being judgmental, critical or condescending.
- Insist that the loved one discuss the relapse with his or her sponsor and support group.
- Find ways to provide ongoing support and accountability in the week after the relapse.
- Work with the loved one to identify what cues triggered the substance cravings.
- Create new strategies to avoid and cope with these cues if/when encountered again.
In the case of severe or extended relapse, additional treatment may be necessary. Though about half of recovering addicts relapse in their first year of sobriety, this does not mean that they abandon their recoveries. Many people learn from their mistakes, reengage treatment principles and get their recovery back on track.
Health Improvements after Rehab
Despite the importance of sobriety, recovery is a more comprehensive process that improves the quality of life on several levels. Critical cornerstones in this process include improvements in physical and mental health, and any steps taken in this direction are signs of positive change. Examples might include ongoing mental health care, holistic therapies for chronic pain, better eating habits, yoga, and changes in employment that reduce stress and conflict.
In addition to creating a better quality of life, health improvement can also promote healing in the brain reward system. For example, an opiate addiction (e.g., heroin, painkillers, opium) suppresses the body’s natural production of feel-good chemicals like endorphins, but aerobic exercise can help restore normal production levels. Likewise, the American Journal of Psychiatry in 2005 noted that addiction and mental health disorders share similar neurobiological issues, and mental health treatments often help improve regions of the brain that substance abuse harms as well. During the early stages of recovery, the person may experience some mood swings, but taking real steps to improve one’s health is a good sign of change.
Social Support and Citizenship in Recovery
Recovery involves a period of self-redefinition in which behavior, hobbies and social relationships undergo change. Steps taken to improve social health and support are additional positive signs, and they potentially include the following:
- Finding a stable recovery sponsor who can provide guidance
- Connecting with recovery partners who can provide mutual support
- Becoming active in a local recovery support group
- Pursuing a defined course of action such as a 12-step program
- Participating in sober social gatherings and functions
- Finding healthy new hobbies, interests, and activities
- Making efforts to repair strained relationships
- Taking actions to help others and make up for past wrongs
The Occupational Therapy International journal in 2008 noted how peer support reduces a person’s risk of relapse, and the Journal of Cognitive Psychotherapy in 2005 stressed the value of positive community support. Recovery sponsors and support groups play invaluable roles, but loved ones who are not in recovery can provide invaluable help. If the addiction strained these relationships or motivated enabling behaviors, friends and loved ones should consider counseling themselves to restore healthy interpersonal dynamics and treat any psychological wounds.
Addiction and Recovery Help
The National Council on Alcoholism and Drug Dependence website says there are many paths to recovery, but the lasting recoveries typically start in rehab treatment. Our admissions coordinators are available 24 hours a day to discuss signs of recovery or relapse and provide information on treatment services. We can even look up health insurance policies and explain their rehab benefits. If you or a loved one has substance abuse struggles, please call our toll-free helpline now.