Which process helps recovering alcoholics through rehabilitation?

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Which process helps recovering alcoholics through rehabilitation? 

The process that helps alcoholics with rehabilitation the most are detox, therapy, and rehab. As addicted persons go through the rehab process, they experience four stages of recovery.


They include: 

  1. Treatment initiation
  2. Early abstinence
  3. Maintaining abstinence
  4. Advanced recovery

Recovery is a lifelong process. Whereas several studies show the success rates for different substance abuse treatment approaches, very little is known about the process of recovery [1].  

What's worse is that there are cases where treatment gains from addiction treatment are short-lived. Multiple addiction treatment may also fail in breaking the addiction cycle. 

What is understood is that long-term recovery takes time, requires effort, willpower, and support.  

When you go for a professional alcohol and drug treatment program, you will go through a series of recovery stages and treatment process. 

Understanding which process helps you in your journey towards alcohol recovery is vital. This awareness will help you develop patience and determination through the alcohol rehabilitation programme. 

What happens during alcohol rehab? 

During alcohol rehab, you will go through the following treatment process: 

Detox 

A drug or alcohol detox is mandatory when seeking abstinence from substance abuse.

Professional detoxification may involve using medications such as benzodiazepines and barbiturates to help manage the symptoms of alcohol withdrawal.

It is essential for people with chronic substance abuse to go for drug and/or alcohol detox at a hospital or an addiction treatment centre. 

Rehab 

Rehab follows after you complete detox. This stage entails attending various therapies and support group sessions to help you discover the underlying causes of substance abuse.

A rehabilitation program is essential in the recovery process as it gives the person time to work on the aspects of their lives that fuel the substance abuse. 

Rehab comes with various treatment options, mainly outpatient and inpatient treatment options.

Anyone who wants to achieve long-term recovery should seek professional medical advice to decide which treatment option is suitable for them. 

Therapy 

There are multiple therapies provided during substance abuse treatment. Evidence-based substance abuse treatment therapies include behavioural therapy, motivational interviewing, dialectical behavioural therapy, and many others. 

Entering rehab for drug or alcohol use disorders is vital for anyone interested in maintaining abstinence.

The individualized treatment plan administered by professional addiction experts increases your chances for success in the recovery process. 

The stages of recovery during drug or alcohol rehab 

A popular question is 'what are the stages of recovery?' According to the National Institute on Drug Abuse, addiction recovery has four stages [2].  

These stages are: 

Stage 1: Treatment initiation. 

Treatment initiation begins when you reach out to a treatment provider. Whether it was a voluntary decision to pursue treatment, or you were coerced, this stage begins when you enter a professional treatment program. 

Most people experience uncertainty during the early stages of subst-abuse-treat (substance abuse treatment). 

You may feel that your alcohol or drug addiction is not as severe as others. The feelings of denial or uncertainty are your enemies at this stage. 

During this stage, the substance abuse counsellor will help you identify the damaging effects of addiction.

The professional also enables you to address the feelings of denial and find the motivation to actively participate in the recovery efforts. 

Stage 2: Early abstinence 

Early abstinence sets in after you decide to commit to your recovery journey. This stage is associated with positive treatment outcomes [3]. 

Early abstinence is a difficult stage because of the many factors that affect physical and mental health.

Issues such as drug/alcohol cravings, persistent withdrawal symptoms, psychological dependence, and triggers can lead to a relapse.

During this stage, an addiction counsellor will train you on the coping mechanisms that will help you avoid a relapse. 

Stage 3: Maintaining abstinence 

Stage 3 sets in after 90 days of continuous abstinence. For those in residential treatment facilities, you will progress to the follow-up counselling phase of the rehabilitation program as an outpatient.

This stage aims to help you maintain abstinence by avoiding a relapse. Here, you will learn the warning signs and the steps to avoid a relapse.

You will also put into practice the tools and knowledge acquired during the treatment program to lead a sober life. 

Stage 4: Advanced recovery 

You will reach advanced recovery after about five years of abstinence. This is the fourth and final stage of drug and alcohol recovery.

It is at this stage that you'll put into practice the skills and tools you learned during treatment to help you lead a life free of substance use. 

Some of the strategies that can aid recovery include: 

  • Creating long-term goals. 
  • Setting up a consistent, daily routine. 
  • Forming new social relationships with people who don't engage in substance use. 
  • Participating in recreational activities that don't involve substance use. 
  • Finding ways to seek happiness and fulfilment through spirituality, volunteer works, or social activism. 

These strategies are effective at helping you in staying sober. Moreover, when you implement these strategies, you will become a healthier individual with a positive influence on the lives of your loved ones and those in society. 

The national institute on drug abuse also identifies the pathway to recovery consisting of active recovery, middle recovery, and late recovery. A mental illness co-occurring with the addiction can prolong addiction recovery.

In some cases, people cycle to and from the recovery stages because of mental health issues that exacerbate the situation, e.g., depression, anxiety, trauma etc. 

The three stages of recovery from substance use 

The national library of medicine recognizes three stages of addiction recovery. [4] 

They include: 

1. Early stage of treatment. 

At this stage, the client is emotionally fragile. They are ambivalent about quitting alcohol or drug abuse and are likely to resist treatment. Thus, the goal of treatment is to manage cravings, prevent relapse, and achieve abstinence. 

2. Middle-stage treatment. 

The addiction expert helps the client realize how drug or alcohol addiction keeps them from living healthy, fulfilling lives.

As the patient cuts off ties with alcohol addiction, they'll need assistance managing their loss and finding healthy substitutes.

Recovering from alcoholism also means that individual needs guidance on managing their emotional lives. 

3. Late-stage treatment. 

At this stage, less time is spent on substance abuse as more focus is shifted to maintaining abstinence. The patient may focus on their lives by addressing issues that have to do with guilt, shame, self-esteem, among other issues. 

As patients move through these recovery stages, treatment must move with them. Failure to do so may render the treatment ineffective. 

Alcoholic recovery stages 

Treatment from drug abuse or alcohol abuse does not happen overnight. There is no set timeline for recovery as each individual responds differently to substance use.

Recovery may take weeks, months, or even years, depending on the person. 

In the 1970s, psychologists James Prochaska and Carlo DiClemente sought to understand the recovery process [5].  

These recovery stages can also help you understand where a person is in the recovery stage and the challenges that may stand in the way of their subst-abuse-treat (substance abuse treatment). 

The recovery stages coined by James Prochaska and Carlo DiClemente are as follows:  

Stage 1: Precontemplation 

This stage is like the initial stage identified by the national institute on drug and the early stage by the national library of medicine. The patient is not motivated to quit the drug or alcohol use.

Their defence mechanism is high, and some people may even be reluctant to admit that they have a drug or alcohol abuse problem. 

People respond differently at this stage. Some may make excuses for their behaviour. For instance, they may claim that the drinking problem is due to stress from work.

Others may blame others for their drug/alcohol addiction, whereas others may feel discouraged because of the energy required to break out of the drug/alcohol addiction. 

People at this stage can show up for treatment. But in most cases, they do so because a loved one has compelled them to do so. As such, treatment is often ineffective at this stage.

The best strategy is to inform the individual of the damaging effects of drug/alcohol addiction. 

Stage 2: Contemplation 

The second stage in recovery is the contemplation stage. Here, the person is considering treatment for drug/alcohol abuse.

Although they acknowledge that they have an alcohol abuse problem, they are still undecided about whether they should get help or not. 

Some people may try to cut back their alcohol and drug intake. Others may linger at this stage for a long time as they feel hopeless and lack the motivation to fight the alcohol/drug use.

This phase is marked by emotional turmoil. The best way to overcome it is to weigh the pros and cons of drug or alcohol use. 

Stage 3: Preparation 

Stage 3 is for those who move past the contemplation stage. These are people who realize that they do abuse alcohol or drugs.

Many alcoholics who reach this stage may be motivated to take meaningful steps towards recovery. 

The person may still be drinking or taking drugs. But they're likely to tell their friends and family members about their plan to quit drug/alcohol use. 

Addiction experts warn about rushing to treatment at this stage. Running the preparation stage increases the chances of failure.

Instead, this time should be spent creating a detailed action plan and developing strategies that will help you or your loved one overcome alcohol dependence. 

It is essential to seek professional medical advice to get a clear understanding of the addiction issue. A medical professional will provide clarity on the severity of the addiction.

They can also recommend recovery resources to help you or your loved one understand how addiction destroys their lives. This approach may motivate them to proceed to the action stage. 

Stage 4: Action 

At this stage, the person is actively seeking treatment and has decided to pursue sobriety. Treatment facilities will place the person through detox and later on rehab.

There are numerous treatment centres, and the person can choose from various treatment programs.  

These programs include: 

  • Long-term residential treatment 
  • Short-term residential treatment 
  • Outpatient rehab 
  • Individualized counselling 
  • 12-steps support groups. 
  • Group therapy. 

This stage usually lasts from three to six months. There are cases where it can persist for 18 months, but that doesn't mean that the recovery process is over. 

Stage 5: Maintenance 

Recovering alcoholics move to the maintenance stage after completing rehab.

At this stage, the person enjoys the benefits of overcoming drug/alcohol use disorders. At the same time, they are focused on maintaining abstinence. 

At this stage, the person continues to practice the behaviours and coping skills they learned while in rehab. The stage generally lasts for six months to several years. 

Stage 6: Termination 

This is the final stage in recovery. It is also a controversial stage based on the assumption that the addiction has been overcome completely.

The person no longer experiences cravings for drug or alcohol use at this stage. Also, there is no threat of relapse. 

Conversely, many experts in substance use disorder argue that addiction is a chronic condition. They argue that overcoming drug/alcohol use disorder is a lifelong process, and there's always the risk of relapse. 

Some people who achieve long-term recovery are dry drunks. That means that they continue to display the same impulsive dysfunctional behaviours that they did when they were taking drugs/alcohol. 

The process of recovery 

The process of recovery is not linear. There are cases of relapse, and some people move back and forth through the recovery stages. People struggling with drug/alcohol use disorder are likely to relapse.

Almost one-third of people in recovery relapse during the first year of sobriety [6]. 

Relapse does not mean that treatment has failed. Instead, it means that the individual has to overcome the triggers. This may require them to join support groups such as alcoholics anonymous or other self-help groups.

What's more, community resources can help the individual and their family maintain healthy relationships and remain sober. 

The Substance abuse mental health services administration (SAMHSA) recognizes that recovery is different for everyone. It is a highly individualized process with many aspects that can influence it. 

According to SAMHSA, the principles that encompass recovery in alcohol and drug addiction are: 

  1. Recovery can take place in different ways. 
  2. It is empowering and self-directed. 
  3. It's a process of change and healing. 
  4. It's holistic 
  5. Stems from hope 
  6. Helps the individual become part of society. 
  7. It requires support from others. 
  8. Influenced by cultural dimensions. 
  9. It involves transcending stigma and shame. 
  10. Recovery can and will happen. 
  11. Stems from one recognizing the need for change. 
  12. It's a component of overall health. 

When a person relapses, they go back to the pre-contemplation stage. The national institute on drug abuse states that 40 to 60% of people in addiction recovery are likely to relapse [7].

Around 15% return to the pre-contemplation stage when they relapse, whereas about 85% return to the contemplation stage before proceeding to the preparation and action stage. 

It is common for those in active recovery to cycle through these stages of change three or four times before completing the cycle without relapse. 

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How do you recover from alcoholism? 

Recovering from alcoholism is a gradual process. There are no quick fixes to overcoming alcoholism, mostly because of the changes in the brain chemistry that result from long-term alcohol abuse. 

Factors such as effective treatment, a safe environment, and support play a vital role in overcoming alcoholism. 

Successfully completing treatment does not mean that one has recovered from alcoholism. Treatment sets the pace for a life free from substances.

The addiction medicine provided help you manage withdrawal symptoms, making it easier to focus on sobriety. Yet, this does not mean that one has recovered. 

Participating in self-help groups such as alcoholics anonymous or SMART recovery helps keep you on the path of sobriety.

Other proactive measures such as changing your environment, making new friends who don't take alcohol or drugs, and changing your outlook on life will also play a crucial role in maintaining abstinence. 

Recovering from addiction involves many aspects of your life. Factors such as taking up healthy recreational activities, creating a routine and a fitness regime, and eating healthy meals all play a crucial role in helping you recover from alcoholism. 

How can I help a loved one recover from alcoholism or drug abuse? 

It's challenging to help a loved one overcome alcoholism. In most cases, people are in denial about addiction, and trying to get them to rehab can lead to conflicts. 

Luckily, there are ways that you can get a loved one into treatment. You can stage an intervention where you talk to them about their drinking.

You should do this tactfully and with compassion, or else your loved one may feel like you are confronting them. 

How to spot alcohol abuse 

Most people are in denial about their substance abuse. Yet, a disproportionate number of social drinkers exceed the recommended 14 units of alcohol a week [8]. Cases of binge drinking, and alcohol use disorder are also prevalent [9]. 

Binge drinking  

The NHS defines binge drinking as taking more than 8 units in a single session for men. For women, binge drinking takes more than 6 units of alcohol in a single session.

For example, 6 units take 2 pints of beer with 5% alcohol content or 2 large (250ml) glasses of wine with 12% alcohol content [10]. 

Alcohol use disorder  

The DSM-5 defines alcohol use disorder as a persistent medical illness characterized by compulsive alcohol use despite its consequences to your health, personal life, or profession. 

You can take the "Am I an Alcoholic" self-assessment test to learn more. You can take the test [11].  

What to say to a loved one with alcohol use disorder 

  1. Express concern about their alcohol use. You should use "I" statements to express your feelings, concerns, and how their alcohol use has impacted you. 
  2. Express concern for their health. Be genuine in your concern about how addiction has affected their health. 
  3. Avoid using labels such as "addict" or "alcoholic." Instead, focus on their behaviour and avoid labels as they may become defensive. 
  4. Express empathy and understanding. Instead of using blaming statements, be more empathetic. For instance, you can say, "I know you've been having a hard time at work." 
  5. Offer options and avoid demands. Maybe your loved one is concerned about treatment paying. You can offer to support them financially or help them find aid. Present options, for instance, you can say, "I think you should consider talking to a doctor about your alcohol use." 

Tip: It would help if you wrote down the main points that you'll say so that the conversation does not spiral out of control. 

What not to say to a loved one with alcohol use disorder 

First, you should avoid confronting your loved one while they are under the influence of alcohol or drugs. This approach will most likely lead to an unfruitful conversation.

Instead, approach them when they are sober and talk to them in a confidential setting. 

Avoid blaming them for the addiction. Also, you should avoid pointing out the problems you feel trigger the addiction, e.g., unemployment, financial issues, divorce, etc.

Statements such as "Your drinking is putting a strain on our marriage" casts blame on your loved one and could make them defensive. 

Avoid making your loved ones feel guilty or casting blame on them. In addition to this, you should avoid taking responsibility for their mistakes. For instance, do not call their workplace and makeup excuses for their absence. 

Lastly, remember to take care of yourself during the process. Dealing with a loved one who is an addict can take a toll on your mental health.

What’s more, you may struggle with codependency. Taking part in support groups like Al-anon can help you practice self-care. 

Seeking intervention services for substance abuse treatment. 

Abbeycare is a leading provider of addiction medicine and rehab in the U.K. You can contact our Centre for professional intervention services for your loved one.  

The major intervention models are: 

  • The invitation models 
  • Tough love 
  • The Johnson Model of intervention 
  • The field models. 
  • The systemic field models. 
  • The confrontational model. 
  • Crisis intervention 
  • Arise intervention 
  • Motivational interviewing 

Engaging a professional interventionist increases the chances of convincing your loved one to seek recovery. You can contact us or a leading private rehab facility of your choice to learn more. 

Find help today 

There are a variety of treatment options available for you or your loved one. You can begin by consulting your medical provider to determine the best treatment option suitable for you.

Alternatively, you can reach out to us to explore your treatment options. 

If you or your loved one are hesitant to begin treatment, you can seek out local recovery resources such as alcoholics anonymous.

Sometimes listening to the stories of others can give you the motivation to want change, and alcoholics anonymous is the best place to find hope and support. 

Alcohol addiction treatment and recovery is a life-long process. This process requires willingness and determination on your part. You may have to make sacrifices like changing your friends.

But these sacrifices will be worthwhile in the end when you achieve a healthy, fulfilling life. 

Abbeycare Pricing Bot

Last Updated: December 21, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Peter also co-authored the new 6th edition of Drugs In Use by Linda Dodds, writing Chapter 15 on Alcohol Related Liver Disease. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.