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The Stages of Recovery

Addiction is a serious disease that affects the lives of millions of people globally. While each case of addiction is unique within itself, there are many similarities that addicted individuals face from day to day including grief, denial, and a mere desire to get well. The progression that those who suffer from substance abuse will take through the recovery process, though unique for each individual, will generally include similar stages along the way. What each stage of recovery means to each recovering addict may be very different, but the progression is very much the same.

Addicts go through a series of stages of recovery characterized by:
  • Acknowledging a problem
  • Taking steps to change
  • Investigating treatment & recovery options
  • Taking action to get help
  • Overcoming physical dependence symptoms through detoxification
  • Learning how to live without drugs or alcohol during early recovery
  • Maintaining sobriety through support, follow-up treatment and aftercare programs

It's important to note that there are no set timeframes upon which an individual should progress through each of the stages of recovery. For some, merely acknowledging a problem can take months or every years and rehabilitation could also take months; for others, the process may go much more quickly. According to the National Institute on Drug Abuse, "individuals pass through the stages at their own pace, the stages are overlapping rather than discreet, and individuals may slip back at points and need to rework issues from previous stages."

Stage 1: Acknowledging a Problem

The first stage of recovery involves overcoming denial and acknowledging that there is a problem. For many, drug addiction isn't viewed as a problem until they are confronted by a loved one, friend or family member about the lifestyle changes that have taken place as a result of the substance abuse. Whether the addictive behaviors of an addict are pointed out by a loved one, or the problems is recognized after health, financial or legal problems have arose as a result of the substance use, this first stage of recovery is vital.

Denial is a psychological defense that humans use to protect themselves from the reality of a problem. It is a way of disavowing or distorting the variables associated with the problem at hand so as to reduce the emotional repercussions that would otherwise result with acceptance. As soon as an addict is will to recognize the behaviors that are causing problems and accept that such behaviors are symptomatic of addiction, a progression towards a willingness to change can finally take place - and it's this progression that marks the first stage of recovery.

Stage 2: Taking Steps to Change

The paradigm shift which takes place when an addict decides to take action against his or her addiction marks the second stage of recovery. This shift may include:
  • Learning more about the addiction and the impact that addiction has on lifestyle and social status.
  • Learning more about how the addiction impacts the lives of those who love and care for them.
  • Developing an understanding of how addiction affects health.
  • Learning more about recovery and the steps that can be taken to evoke change.

Studies show that the majority of those who enter treatment for substance abuse do not do so on their own. Generally, health problems, legal mandates, work related mandates or family members are responsible for evoking the need for treatment in those who are addicted.

Stage 3: Investigation

During the third stage of recovery, the individual will investigate various treatment and recovery options to gain an understanding of "what's next" in the process of recovery. During this time, the individual will explore various concepts of moderation and abstinence to better understand how recovery can be achieved. Many say that recovery actually begins here, with the investigation stage in which the individual explores treatment, recovery and sobriety in search of answers. Many will:
  • Talk with family or friends about the options available to assist them in getting sober.
  • Reach out to a doctor or healthcare provider regarding their addiction.
  • Seek guidance from peers.
  • Research treatment options online.

Stage 4: Taking Action

Following an investigative stage in which the individual will take a look at his or her options for treatment, recovery will progress to a period of diving in and taking action. During this time, the addict may make the decision to go into treatment or to make an attempt to quit "cold-turkey." The action phase is another critical step in the recovery process characterized by:
  • Confronting addiction head on.
  • Making a decision to quit either alone, or with the help of a professional treatment facility.
  • Facing fears associated with withdrawal or recovery.
  • Accepting the support of others.

Stage 5: Detoxification

When drug or alcohol use actually stops, the period of detoxification begins. During this time, the user will likely experience an array of withdrawal symptoms. Symptoms of withdrawal vary greatly from one substance to the next. Users may experience:
  • Changes in sleep patterns.
  • Behavioral changes.
  • Mood swings.
  • Changes in social activities.
  • Anxiety and paranoia.
  • Restlessness.
  • Hallucinations.
  • Gastrointestinal upset including diarrhea, vomiting, stomach cramping, nausea.
Detoxification can take anywhere from a few days to a few weeks depending on the substance that the user is attempting to quit, the severity of the addiction, and the method of treatment. When a tapering method is used, the amount of time that it takes to effective, and safely, detox can be prolonged by weeks or possibly months in some cases.

Stage 6: Early Recovery

According to SAMHSA Treatment Improvement Protocols, "in the early stage of treatment, clients may be in the pre-contemplation, contemplation, preparation, or early action stage of change," and regardless of which stage they are in, they are generally ambivalent about ending the use of drugs or alcohol. During early recovery, there is both significant ability to improve and to do well and an equal significance in risk that relapse will occur. Following detox, this early stage of recovery involves learning how to live drug or alcohol free. For some, this phase is the most difficult as it's a time when adjustments are made to living procedures to allow for sobriety. Many can adjust right back to living a normal lifestyle following detox without ever going back to drug or alcohol use - others find that early recovery is both challenging and discouraging at times.

During early recovery, counseling and therapy are generally recommended to help the individual to:
  • Learn how to recognize triggers that could derail recovery.
  • Learn how to avoid obvious triggers and to cope with those which cannot be avoided.
  • Learn how to cope with underlying problems associated with past trauma, health, current issues, etc.
  • Develop stronger decision making skills.
  • Develop a positive attitude toward life without drugs or alcohol.
The early recovery stage can last weeks or months depending on the individual. Some experience challenges such as cravings or lingering psychological symptoms of withdrawal for up to a twelve months following the initial onset of early recovery.

Stage 7: Recovery Maintenance

The final stage of recovery, maintenance, really never ends. This is called "Active recovery" and it's the ongoing time in which the addict has made progress toward recovery, now has the tools and the strength to live sober, and continues to utilize the skills that they learned in order to live a sober lifestyle. During this stage, active monitoring of thoughts and behavioral response will continue to provide a foundation that helps to prevent relapse, but the risk will always be there. Maintenance takes place through continued support, follow-up care, and active involvement in the positive lifestyle elements that were learned in treatment. During recovery maintenance, a continued commitment toward recovery and to building a life that does not include drugs or alcohol will help to reduce the risk of relapse.