Completing drug or alcohol rehab is a major accomplishment, but it doesn’t necessarily mean that there’s not more work to do. During the weeks, months and even years after completing rehab, individuals in recovery are still at risk for relapse. Having a co-occurring disorder — a mental health condition that occurs along with a substance use disorder — increases the risk of falling back into addictive behaviors and self-destructive patterns. Aftercare programs help minimize that risk, and keep you moving forward on the road to a completely drug-free life.
The quality of the aftercare you receive can have a strong influence on your chances of remaining sober after you finish treatment, according to research conducted by Psychiatric Services. A plan for aftercare should be built into any comprehensive treatment program for Dual Diagnosis recovery. From the time you enroll in rehab to treat alcoholism, drug addiction, depression, bipolar or obsessive-compulsive disorder, your treatment team should help prepare you for the days following your graduation. With the right kind of assistance and therapeutic support, you can maintain your hard-won sobriety and build a solid foundation for recovery.
Addiction specialists now recognize that relapse is a hallmark symptom of addiction. If you have a co-occurring disorder like depression, anxiety or post-traumatic stress disorder, the temptation to revert to substance abuse to manage your symptoms is even stronger. The primary goal of aftercare is to prevent a relapse into drug or alcohol use. By providing continuing counseling, group sessions and other schedule meetings, aftercare programs provide an extra level of accountability that helps insure that the individual has not fallen back on old habit.
Alcohol Research & Health identifies the following components of an effective relapse prevention program:
- Learning about your triggers. There are a lot of environmental, social and psychological factors that can trigger substance abuse. An episode of depression, a flashback to an abusive situation, a conflict in your marriage or a stressful public event may drive you to turn back to drugs or alcohol. As part of relapse prevention, you should learn how to identify these stressors.
- Coping with stressors and cravings. After graduating from rehab, you’ll be faced with a lot of situations that you may not have considered during treatment. Getting a new job, starting a new relationship or moving to a new home may leave you in an emotionally vulnerable state. Counseling sessions and support groups can help you cope with these high-risk situations.
- Thinking through the outcome of a relapse. Many recovering addicts go back to drugs or alcohol with the expectations that these chemicals will make them feel better. In fact, drinking and drugging usually result in unpleasant or dangerous outcomes, such as an overdose, emergent medical treatment, loss of a relationship or incarceration. A relapse prevention plan teaches participants to evaluate the potential outcome of a slip before taking that first drink or picking up drugs.
- Keeping a lapse from turning into a relapse. A minor slip doesn’t have to turn into a major relapse if you seek help immediately and take steps to get back to your program. Because the chances of relapse are so high, it’s important to learn how to cope with the occasional slip if it does occur.
If an individual does relapse into old behaviors, the aftercare program helps them cope and better assess the situation. The peers and professionals who make up an aftercare support team help make sure that if there’s a “slip” that the person doesn’t necessarily have to go back to square one and start rehab all over again.
Help for the Family
Aftercare programs help provide support and instruction for the family members of recovering addicts. Many times there is still a great deal of tension between the individual and the family, caused by events that occurred during the period of drug use. Other times, the individual is struggling to blend back into a “normal life” which is causing stress for the family. In both these cases, aftercare programs provide counseling and advice for the family to help get them through this difficult time.
Aftercare services for family members may include:
- One-on-one counseling sessions for partners, spouses or children
- Group therapy meetings for family members
- Educational programs to provide information on the nature of addiction and mental illness
- 12-step programs like Al-Anon or Nar-Anon for the family members of recovering addicts
Addiction and mental illness can create financial instability in a household as well as emotional conflict. Some families may need assistance with practical needs like job placement, nutritional counseling, childcare or transportation. Others may require education to prevent the younger family members from falling into substance abuse. Creating a healthy home environment for all members of the household is one of the crucial objectives of family aftercare.
A Place to Talk
Another valuable element of aftercare programs is the channel of communication it opens up for the recovering addict. The individual goes through a lot when returning home after rehab. He has to learn new habits, stop hanging out with “drug friends” and work to rebuild relationships and careers. It’s a lot to take in, and the aftercare program is a place to talk through these issues with people who understand and can provide guidance.
In Dual Diagnosis aftercare groups, members provide support and advice about the issues they face in recovery, such as:
- Taking psychotherapeutic medication
- Developing coping strategies for addiction and mental illness
- Building stronger relationships with friends and family members
- Finding and maintaining employment
- Locating resources in the community
The stronger your support system, the better your chances of long-term recovery. Aftercare self-help groups are a key component of your Dual Diagnosis treatment plan.
From the day you decide to seek help for addiction until long after you graduate, 12-step programs offer experience, strength and hope. Many aftercare programs, most notably Alcoholics Anonymous, use the 12-step program structure as a means of staying clean and moving forward. These 12 steps are not for everyone; however, for millions of people around the world, the guiding principles of peer group interaction and “giving into a higher power” have provided relief and accountability for those in recovery.
The benefits of 12-step recovery programs include:
- The opportunity to connect with other recovering addicts at free meetings and events around the world
- Access to motivational speakers and literature to help you reach your recovery goals
- Practical guidelines and strategies for coping with the daily challenges of addiction
- The guidance of a sponsor who can lead you through the 12 steps, providing strength and motivation
Spirituality is strongly emphasized as part of recovery in 12-step programs. Each member is encouraged to identify a higher power of his or her own choosing and to surrender to that higher power as part of the healing process. Addiction is viewed not only as a physical disease, but as a spiritual condition characterized by a lack of meaningful connection to a divine purpose. This focus on spirituality may discourage potential members who prefer a secular point of view. However, the journal Alcoholism, Clinical and Experimental Research notes that an increase in spirituality is associated with longer rates of abstinence in recovering addicts.
After being discharged from an inpatient treatment facility, many individuals with a Dual Diagnosis find that they can make a more comfortable transition if they spend time in a sober living home. These communities offer a structured, secure environment to residents who want to concentrate on their recovery without the temptations and stressors of the outside world. During the aftercare period, a transitional residential community can provide:
- An environment free from drugs or alcohol
- An affordable living situation for recovering addicts who are searching for employment
- Emotional support and encouragement from fellow residents who understand the challenges of Dual Diagnosis recovery
- House meetings to reinforce a sense of fellowship and community
Transitional communities are less structured than most addiction treatment centers, yet they offer enough supervision to provide a sense of safety for those who still feel too new in sobriety to face the pressures of daily life. Residents are expected to adhere to house curfews, attend household meetings and participate in chores. They are also expected to contribute to the house expenses by paying rent or by doing jobs in the community in exchange for their living expenses.
Integrated Recovery Services
Throughout the recovery process, treatment for mental health disorders should be integrated with treatment for addiction to ensure the best outcome. In aftercare, mental health professionals and addiction counselors should continue to work together as members of your treatment team.
Like hypertension, diabetes or arthritis, serious psychiatric disorders are chronic conditions that typically require lifelong treatment. Managing the symptoms of post-traumatic stress disorder, generalized anxiety or major depression requires long-term therapy and pharmacological support as well as the encouragement provided by family members, friends and support groups. Along the same lines, the American Psychiatric Association states that addiction is a chronic, relapsing disease that may never be completely “cured,” only managed from one day to the next. The more resources you have at your fingertips, the more likely you are to make it through those first challenging months of recovery and build a long, fulfilling life in sobriety.
Dual diagnosis treatment facilities in California and Tennessee understand the importance of aftercare, and we help those who leave our facilities find programs that best fit their needs. The care and education individuals receive at our centers help them break the cycle of addiction and get a new start on life.
Further Reading About Aftercare for Drug and Alcohol Rehab
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton