Aftercare

Early stages of addiction treatment provide life-saving help. Many programs provide around-the-clock care for weeks. The addicted person has access to medications, counselors and peers who are all focused on eradicating addiction and restoring the person to mental and physical health. When an addict leaves these programs, he or she may be out of the crisis stage of addiction but much work remains to be done. The recovery is still quite new, and the addicted person is vulnerable to peer pressure, depression and stress. All of these factors can lead to relapse. Often, this relapse can occur almost immediately after the person leaves the treatment facility. In fact, some experts find that the first hour after the addict leaves the facility is when the addict is the most vulnerable.

Having an aftercare plan in place before the addict is ready to leave the treatment facility is one of the best ways to help the addicted person move forward with therapy. There are many forms of aftercare available, and some addicted people benefit from using many of these methods at the same time. By ganging up approaches, the addict is able to create another protective environment so the recovery can strengthen and grow.

12-Step Meetings

Many inpatient alcohol treatment centers encourage patients to participate in 12-step programs. Alcoholics Anonymous and Narcotics Anonymous are just two forms of 12-step programs available. In fact, there is a program available for almost every addiction that exists today. The concept behind a 12-step program is quite simple and powerful. The addict is asked to:

  • Admit that he or she is an addict.
  • Acknowledge that addiction can never truly be cured and that treatment must continue for the rest of the person’s life.
  • Give up control of the addiction to a higher power and appeal to that higher power for help.
  • Make amends for past transgressions.

As part of a 12-step program, the addicted person is given a “sponsor” who is available around the clock to provide mentoring and support. This sponsor is also a recovering addict, not a therapist, so the sponsor can also work as a sort of role model and living proof that the program works. Then, the addicted person is asked to attend multiple meetings and listen to stories of recovery from other addicts. The addicted person may also share stories and ask for support.

As noted in a 2009 report in the Journal of Addictive Diseases, some studies have found that 12-step programs were quite effective. Others researchers have come to the opposite conclusion. However, the study suggests that addicts who participate in many meetings, as opposed to just a few, have higher success rates. This may mean that addicted people must attend multiple meetings each and every week in order to feel the true benefit of a 12-step program.

Ongoing Individual Counseling

People recovering from addiction may still need help from an addiction counselor on an ongoing basis. In these counseling sessions, the addicted person has an opportunity to talk about stresses and crises that have occurred during the month, and the counselor can help the addict brainstorm solutions to those problems. Some counselors also encourage the addicted person to talk about the addiction in emotional terms, figuring out why the person became addicted in the first place and helping the addict move past those issues in the future.

Some addicted people need medications for many months or years to help them move past withdrawal symptoms. Recovering from cocaine addiction, for example, can cause severe depression that can persist for months. An addiction counselor may be able to write prescriptions for antidepressant medications that can help ease those problems. Recovering from heroin addiction can be particularly tricky, and some addicted people need to use synthetic drugs to help repair the damage. Again, an addiction counselor can provide those medications and make sure the addicted person is using the medications properly.

Some addiction counselors also require addicts in recovery to submit to ongoing drug testing. This sort of testing may seem intrusive but it does help the addict stay honest. There’s no possibility that the addicted person can take drugs without the counselor knowing about it, and this may keep some addicts away from a relapse. If they do relapse, even if they won’t admit it in conversation, the counselor can recommend more inpatient treatment sessions for the addict in order to start the recovery process once more.

When it comes to effectiveness of counseling programs, once again, more is better. According to a 1996 study published in the Journal of Substance Abuse Treatment, higher attendance in counseling sessions resulted in lower relapse rates. Addicts must keep all of their appointments, even if they’re feeling better, in order to feel the benefit of these programs.

Group Counseling

Many counselors combine one-on-one sessions with group sessions. For example, some counselors offer group sessions where all of the addicts the counselor is treating come together to discuss issues and coping skills. Unlike a standard 12-step meeting, a group counseling session is moderated. The counselor sets the tone for the meeting and may ask the group to answer specific questions or deal with specific issues. If the conversation becomes destructive, the counselor can step in and provide guidance. Addicted people are allowed to learn from one another but a non-addicted person remains firmly in control.

Other counselors ask the addict’s family to attend group sessions along with the addict. Here, all family members have a chance to discuss the addiction, and they all work together to think of ways to help the addict in recovery. Families with destructive communication methods or a history of abuse may benefit from these sessions, as the old problems are worked through and the family learns new ways to move forward. According to the same study in the Journal of Substance Abuse Treatment, an addict’s attendance in these sessions didn’t result in a lower relapse rate, however, so families shouldn’t consider family counseling the only form of counseling needed. The addicted person may need time and space to discuss issues outside the realm of the family in order to truly improve.

Sober Living Facilities

For some people in the early stages of recovery, the thought of returning to their old homes is simply too much to bear. They may be surrounded by friends or family members who still use drugs or alcohol, or they may live too close to places that encourage relapse. A person recovering from a gambling addiction may not want to return to a home with a robust connection to the Internet, for example. For these people, a sober living facility provides a good alternative.

A sober living facility is an extension of inpatient addiction rehab. Here, the addicted person is surrounded by other people in various stages of recovery and all are asked to abide by a strict set of rules. While those rules can vary quite a bit from facility to facility, most sober living facilities require residents to:

  • Abstain from using any form of alcohol or drugs. Even people recovering from gambling addictions or other compulsive addictions must abide by this rule.
  • Share a room with another addict in recovery.
  • Leave the facility only for work or addiction counseling sessions. When the resident leaves, he or she must formally check out.
  • Perform a series of chores to maintain the home.
  • Attend a weekly in-house group meeting to discuss the sober lifestyle.
  • Attend a specified number of 12-step meetings each week.
  • Pay rent on time.

Residents can stay in these facilities for months or even years, although insurance programs may only pay for a short period of treatment. Paying rent doesn’t ensure that residents can stay in the facility either. People who break the rules in a sober living community are asked to leave immediately. A resident who has lived at the facility for many weeks and is secure in recovery ensures that the rules are followed. It’s rare for a sober living facility to have any trained personnel on staff. Residents monitor and support one another in this model.

A 2009 study in the Journal of Psychoactive Drugs found that sober living communities are quite effective. Of 46 residents studied over six months, 39 percent reported that they were employed at some point during the previous month. This suggests that the facilities did help patients get back on their feet and return to a more predictable lifestyle. It’s important to note, however, that the addicts are often living in the facility of their own free will and they can leave anytime they want to. It may take some encouragement to entice addicts in recovery to stay in these restricted environments.

How Families Can Help

People recovering from addiction have many options when it comes to aftercare, but they must be encouraged to use the services. Having options available isn’t helpful if the addict chooses to ignore those options. To gain the most benefit, the addicted person should use the resources as much as possible. The person should attend many meetings, schedule many therapy sessions, live in a community for many months and follow up with group counseling as much as possible. This can all seem like a lot of work, and some addicted people may tire of the constant demands on their time and energy. This is when family members and friends can help. They can remind the person to attend meetings or they can offer to drive the person to those meetings. They can ask gentle questions about the therapy’s progress and call the addicted person on the day of the next appointment to give words of encouragement. This sort of social interaction can help spur the addicted person to move forward with recovery and stay on the right path. According to a 2004 study in the journal Addictive Behaviors, people who had social support like this were 76 percent likely to stay sober six months after leaving an inpatient program. People who didn’t get this support only had a 40-percent likelihood of success.

Families who perform a successful intervention and start the addict on the path to recovery should consider themselves partners in that recovery with the addict. They can’t simply walk away once the addict enters the doors of the treatment facility. They must help the addicted person create a long-term recovery plan, and then they must ensure the addicted person follows through.

tactic-article