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Steps to Recovery: How to Get Sober and Stay Sober

If you’re thinking about getting help for a substance abuse disorder, you may wonder what the steps to recovery are. While there can be many different steps to addiction recovery depending on who you ask—including the 12 steps to recovery developed by Alcoholics Anonymous—addiction treatment specialists will agree on the following basic steps to successful recovery.

1. Admit You Need Help

This first step can take some people a long time to reach, but it’s the most important thing you can do to get started on your steps to recovery. Many people will not admit they need help until they have a highly threatening situation staring them in the face, such as losing a job, a partner, or one’s health. The sooner you seek treatment, the greater odds you have of getting your life back on track without suffering a major loss or setback.

2. Find the Right Treatment for You

Rehab comes in many different forms. Inpatient rehab centers provide comprehensive treatment while you stay at a facility. If you choose to receive treatment at a residential rehab center, you can think about whether you may want to attend a rehab center near your home or receive treatment in a different city or state for a complete change of environment.

Outpatient treatment provides essential services such as counseling and medication-assisted therapy at a clinic that you would typically visit 2-3 times per week. Whether you choose inpatient or outpatient treatment, the National Institute on Drug Abuse says treatment should last at least 90 days to be effective.1

Finding the right treatment that matches your needs depends on a variety of factors, such as how long you have experienced your addiction, whether you have a moderate or severe substance use disorder, and whether you have a mental health condition such as depression, anxiety, or bipolar disorder. Many rehab centers have programs that treat co-occurring mental health disorders.

Other considerations for selecting a rehab program can include the cost of treatment, the types of insurance a center accepts, the treatment services your insurance covers, whether financial aid or flexible payment options are available, and whether a center holds accreditation. Some centers also offer specialized programs for young adults, seniors, men, women, or LGBTQ persons.

3. Receive a Personalized Treatment Plan

Whether you enroll in a residential or outpatient treatment program, your intake manager or therapist should provide you with an individualized treatment plan. This plan will outline the types of treatment you will receive, the stages of rehab you will undergo, and the estimated length of your treatment program. To come up with this plan, you will be asked about your history of substance use, any trauma or mental health conditions you have experienced, physical medical issues, and knowledge of any family members with a history of addiction or mental health problems. It’s important to be honest when answering these questions so that your healthcare provider can develop the most effective treatment plan tailored to your individual needs.

4. Go Through Detox

The first step of addiction recovery is to go through detox. This starts when you stop your use of drugs or alcohol. During this process, you will experience withdrawal symptoms that can be unpleasant. The severity of your withdrawal symptoms and the length of your detox will depend on the type of substance you are withdrawing from and the degree of your chemical dependency. Withdrawal from alcohol dependence can last anywhere between 2-10 days. Withdrawal from opioid dependence can last 4-10 days for short-acting opioids such as heroin and 10-20 days for long-acting opioids such as methadone.2

To help you through the detox process, your healthcare provider can prescribe medication to reduce uncomfortable withdrawal symptoms. For the treatment of alcohol use disorder, leading medications used to manage withdrawal symptoms include benzodiazepines, carbamazepine, and gabapentin.3 Medications used to treat opioid use withdrawal include naloxone, naltrexone, buprenorphine, and lofexedine.4

If you have a severe addiction or a co-occurring condition, a medically supervised detox in a hospital or residential treatment center will provide 24-hour oversight by healthcare professionals to make sure you get through the process safely and with as little discomfort as possible. If you have a moderate addiction, an outpatient clinician can also prescribe medication to help manage your withdrawal symptoms while you detox at home. It’s critical to be evaluated by a healthcare professional to determine the appropriate detox method for you to ensure your safety.

5. Begin Therapy

Treatment of substance use disorders often involves medication-assisted treatment (MAT). This is when you receive medication in combination with counseling and behavioral therapy to provide a “whole-patient” approach to recovery.5

Medications approved by the Food and Drug Administration (FDA) are used to control cravings for substance use and to reduce the risk of relapse.5 Medications often prescribed to treat alcohol dependence include acamprosate and naltrexone. Medications frequently used to treat opioid addiction include methadone, buprenorphine, and naltrexone.6

Counseling and psychotherapy can take place in one-to-one sessions with a therapist or in group therapy. Some of the more common types of therapy used to help people recover from a substance use disorder include:

  • Motivational interviewing, which involves a therapist helping an individual find reasons and motivation to continue the necessary steps to addiction recovery
  • Cognitive and behavioral therapies, which teach individuals to think and respond in ways that support their growth as a person and their success in recovery
  • Contingency management, which offers incentives and rewards for completing specific steps to recovery
  • Community reinforcement approach, which leverages a person’s relationships, daily activities, job skills, and personal interests to promote lasting recovery
  • Family therapy, often used in treating adolescents as one of their steps to addiction recovery

The types of therapy used for a particular individual are based on a therapist’s assessment of what a person may benefit most from, as well as the therapeutic approaches a professional is trained in. If you don’t feel you are benefitting from a therapist’s approach, you can ask your therapist to try a different treatment approach or decide to work with a different therapist.

6. Build a Network of Support

Developing a network of social support is another of the important steps to recovery. Studies show that individuals who have the support of their peers in recovery experience greater mental health and maintain their sobriety more successfully than those with less social support.7, 8

A person in recovery can develop a network of social support by developing relationships during group therapy, in sober living communities, and in recovery support groups. Family members, friends, therapists, and other healthcare professionals also can be part of this support network.

Mutual help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) provide peer support while teaching their organization’s 12 steps to recovery. AA’s 12 steps to recovery incorporate spiritual principles as part of their guide map to a sober life, but there are other mutual help groups besides those based on the 12 steps. Options include:

Numerous studies demonstrate the significant role a support group can play in a person’s recovery. In fact, some studies indicate that a person attending a recovery support group is more likely to remain abstinent than someone who is receiving medication only or receiving outpatient counseling only.9

7. Participate in Aftercare

Recovery is said to be a lifelong process. It’s not surprising, then, that individuals who receive continuing care after treatment, also known as aftercare, do better in maintaining their sobriety than those who discontinue all forms of treatment.10

Aftercare includes one or more activities that provide continued support in recovery. Examples include:

  • Living in a halfway house or sober house community that provides a drug-free environment with others in recovery
  • Participating in individual or group therapy sessions on a weekly or more frequent basis
  • Attending a 12-step or other mutual help group that provides continued peer support group and education around recovery

If you’re ready to begin your steps to addiction recovery or if you have questions about how treatment works, call our rehab helpline at 888-805-3559 Who Answers? . A treatment specialist will be happy to assist you.

Resources

  1. National Institute on Drug Abuse. (2020, June 3). How long does drug addiction treatment usually last?. Principles of Drug Addiction Treatment: A Research-Based Guide.
  2. World Health Organization (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
  3. Tiglao, S.M., Meisenheimer, E.S., & Oh, R.C. (2021). Alcohol Withdrawal Syndrome: Outpatient Management. American Family Physician, 104(2), 253-262.
  4. American Society of Addiction Medicine. (2015, June 1). The National Practice Guideline For the Use of Medication in the Treatment of Addiction Involving Opioid Use.
  5. Substance Abuse and Mental Health Services Administration. (2021, October 13). Medication-Assisted Treatment (MAT).
  6. National Institute on Drug Abuse. (2019, January 17). Treatment for Drug Addiction DrugFacts.
  7. Birtel, M.D., Wood, L., & Kempa, N.J. (2017). Stigma and social support in substance abuse: Implications for mental health and well-being. Psychiatry Research, 252 1-8.
  8. Stevens, E., Jason, L.A., Ram, D., & Light, J. (2015, October 19). Investigating Social Support and Network Relationships in Substance Use Disorder Recovery. Substance Abuse, 36(4), 396-399.
  9. White, B.J., & Madara, E.J. (2002). A Review of Research on the Effectiveness of Self-Help Mutual Aid Groups. The Self-Help Group Sourcebook: Your Guide to Community & Online Support Groups (7th edition). American Self-Help Group Clearinghouse.
  10. McKay, J.R. (2009). Continuing Care Research: What We’ve Learned and Where We’re Going. Journal of Substance Abuse Treatment, 36(2), 131-145.

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