Addressing substance use disorder through drug and alcohol treatment and recovery
The Substance Abuse and Mental Health Services Administration (SAMHSA), through Center for Substance Abuse Treatment (CSAT) held a National Summit on recovery in 2005. The focus of this summit concerned the movement toward a recovery-oriented system of care. Those who participated in the summit developed a working definition of drug and alcohol treatment and recovery:
“Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.”
Based on this definition, guiding principles emerged to help facilitate movement toward a more integrated evidence-based practice. This practice aims to assist each individual in addressing substance use disorder.
New perspective on recovery
New research shows that recovery is a process of change. We challenge individuals to shift the way they understand, interpret, and define new ways of thinking and behaving. Therapeutic Health Services incorporates a cognitive behavior therapy (CBT) approach in working with each individual patient. This therapeutic model assists the clinician to meet the patient where they are. This helps them understand and process specific stimuli in addressing underlying reasons for substance use. Coupled with CBT is allowing the patient to guide the conversation and addressing specific challenges the individual is facing.
Whether in group or individual counseling sessions, the process is to move beyond the understanding of quitting substance use. Abstinence is an integral part of the recovery process. However, the movement toward significant change begins with the next stage by assisting patients in achieving emotional sobriety.
Physical sobriety and emotional sobriety
In the early stage of recovery, the first challenge is to manage and cope with any withdrawal symptoms. The next step is the recognition of cravings and alternate ways of coping with intense cravings. Finally, individuals must identify those specific stimuli (people, places, things, and events) that lead to cravings. The duration of this early stage is determined by the extent of one’s substance use. In general, this early stage (Abstinence) may last between 3-9 months. For those with mild substance use disorder, it may last 1-3 months. For those with a moderate substance use disorder, may last 2-4 months. And for those with a severe substance use disorder, approximately 6-9 months.
First, individuals achieve physical sobriety (no withdrawal affects, adequate coping skills, and ability to recognize specific stimuli). Then the actual recovery process can begin. In my individual and group sessions the process is typically associated with the idea of self-discovery and mastery. It is the stage where an individual begins to redefine who they are. They come to discover their own unique and specific purpose. Then they can develop ways to begin to be of service toward others.
Here, the individual is assisted in addressing ways to actively listen to their own self-talk. They also develop and incorporate insight into becoming more mindful and coming to terms with their past. They do this while embracing new ways of thinking and living. It is essentially a process of changing the way one thinks. This is done by developing their own values and beliefs in a way that leads toward a healthy lifestyle. This typically takes up to approximately 2 years. The hope is to develop a manageable means of regulating emotional well-being, while achieving relational, physical and nutritional, financial, and spiritual well-being.
Maintenance and enhancement of a sober lifestyle
The final stage that I introduce to my patients (in a group and individual setting) is that sobriety is a process. A process of maintaining the changed lifestyle a person has achieved through the stages of drug and alcohol treatment and recovery. This extends beyond initial abstinence and recovery. Once an individual achieves a meaningful, healthy, and vibrant lifestyle through recovery and treatment, we challenge them to continue to maintain their overall health and wellness. From a treatment perspective, this is accomplished through a conversation of developing an after care plan. This includes a relapse prevention plan.
In all aspects, achieving overall healthy living includes maintaining this healthy lifestyle. Being vigilant of those things that may bring an individual back toward the lifestyle of active use. Therefore, the main point is the developed awareness that drug and alcohol treatment and recovery is more than quitting the substance use itself. It is to assist each individual in addressing how to restore balance in their life and achieve peace of mind.
For more information on drug and alcohol treatment and recovery, please visit our Alcohol & Other Drugs FAQ post.