You’ve made the decision to get help for a drinking problem, you’ve scheduled your admission appointment to a treatment facility and you’re already beginning to wonder: What happens after alcohol rehab?
Ideally, of course, the goal is to stay sober — but just as treatment involves more than simply putting down the booze, staying sober involves more than not picking it back up again. Yes, that’s the ultimate goal, but in order to remain sober, it’s suggested that alcoholics work on making changes to their lives that can help them stay that way.
So how does that work? What happens after alcohol rehab? Let’s dive in.
What Happens After Alcohol Rehab: What Is Rehab, Exactly?
Before the question of what happens after alcohol rehab can be answered, it’s important to understand what treatment does to set the stage for long-term sobriety. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “Health care professionals provide two types of treatment for alcohol use disorder:
- Talk therapy. A licensed therapist can help people build coping strategies and skills to stop or reduce drinking. Treatment can include one-on-one, family, or group sessions.
- A primary care clinician or a board-certified addiction doctor can prescribe non-addicting medications. These can help people stop drinking and avoid relapse.”
Perhaps most importantly, the NIAAA adds, “these two options can be used in combination and tailored to individual needs.”
The role of medication in the treatment process is known as Medication Assisted Treatment (M.A.T.), and as the NIAAA points out, some drugs — like naltrexone — can help patients control cravings, which are triggers that can endanger those in early sobriety. What’s a craving? The sudden, overwhelming urge to drink, so intense that it can have physical affects on the individual, from sweating to anxiety to near panic. M.A.T. can help reduce or even eliminate those cravings, but “it is important to remember that not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence.”
At the same time, effective alcohol treatment combines M.A.T. with talk therapy, which are “behavioral treatments (that) involve working with a health professional to identify and help change the behaviors that lead to heavy drinking.” Some of those may include:
- Cognitive Behavioral Therapy, which is “focused on identifying the feelings and situations (called “cues”) that lead to heavy drinking and managing stress that can lead to relapse. The goal is to change the thought processes that lead to alcohol misuse and to develop the skills necessary to cope with everyday situations that might trigger problem drinking.”
- Dialectical Behavior Therapy, in which the patient “learns to envision, articulate, pursue, and sustain goals that are independent of his or her history of out-of-control behavior, including substance abuse, and is better able to grapple with life’s ordinary problems.”
- “Coping skills training and relapse prevention primarily focus on identifying high-risk situations for drinking and then building a repertoire of coping skills to help patients approach risky situations without using alcohol,” according to a 2011 paper in the journal Alcohol Research and Health.
There are numerous other behavioral health approaches and psychotherapies that can be utilized, depending on the setting, the patient and the facility, but the end result is always the same: to set in place building blocks of change upon which the patient can build once treatment is complete. In that sense, what happens after alcohol rehab is dependent on the willingness of the individual patient to pursue additional self-improvement.
Why Is It Necessary, and Does It Work?
By this point, you may be wondering: “All I care about what happens after alcohol rehab is that I no longer have a drinking problem. Why is all of this other work involved?” An excellent question, and the Substance Abuse and Mental Health Services Administration (SAMHSA) addresses it directly in the booklet “Treatment Improvement Protocols”:
“Becoming alcohol- or drug-free, however, is only a beginning. Most patients in substance abuse treatment have multiple and complex problems in many aspects of living, including medical and mental illnesses, disrupted relationships, underdeveloped or deteriorated social and vocational skills, impaired performance at work or in school, and legal or financial troubles. These conditions may have contributed to the initial development of a substance use problem or resulted from the disorder. Substantial efforts must be made by treatment programs to assist patients in ameliorating these problems so that they can assume appropriate and responsible roles in society.”
To do this, the booklet continues, treatment facilities, in order to ensure sobriety and help patients change their lives so that they can stay sober, have a number of different tasks to fulfill besides mere abstinence: “maximizing physical health, treating independent psychiatric disorders, improving psychological functioning, addressing marital or other family and relationship issues, resolving financial and legal problems, and improving or developing necessary educational and vocational skills. Many programs also help participants explore spiritual issues and find appropriate recreational activities.”
But does it work? Do these various approaches — hopefully combined in a way to maximize their effectiveness, depending on the facility — set the stage for permanent sobriety? As the National Institute on Drug Abuse (NIDA) points out, “According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning.”
However, the NIDA goes on to add: “individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.”
And while “success” is often viewed in binary terms — complete abstinence or failure due to relapse — that’s not an effective measure of how much alcoholism treatment can help patients change their lives. According to a 2001 study published in the Journal of Studies on Alcohol and Drugs, “During the year after treatment, 1 in 4 clients remained continuously abstinent on average, and an additional 1 in 10 used alcohol moderately and without problems. During this period, mortality averaged less than 2%. The remaining clients, as a group, showed substantial improvement, abstaining on 3 days out of 4 and reducing their overall alcohol consumption by 87%, on average. Alcohol-related problems also decreased by 60%.”
So … What Happens After Alcohol Rehab?
Once treatment is completed, what comes next? You’ve stopped drinking. You’ve begun to open doors toward healing yourself and your relationships, and you’re open to the possibility of additional self-improvement. What happens after alcohol rehab once your 30-day treatment stay is done?
For starters, if you don’t feel like you’re done, you can always opt to enroll in Intensive Outpatient programming, a stepped-down version of the treatment process that lets you continue group therapy several hours a day, multiple times a week, while you ease back into the “real” world. It’s a solid plan that gives you a lifeline to the facility where you’ve received a sober start, and keeps you on familiar footing as you “test the waters” of life without the use of alcohol.
But if that’s not an option, then there are still things you can do to continue your recovery — again, acknowledging that recovery is more than mere abstinence — on your own. Jerry Grillo, writing for WebMD, has a few pointers:
- “Find sober friends,” especially if alcohol was the focal point of your old friend group.
- “Focus on work,” Grillo writes: “Consider your work setting. You may need to look for a new job.”
- “Look for answers. Talking about issues can often help uncover the root of the addiction.”
- “Build a support network. Join a group like Alcoholics Anonymous or Narcotics Anonymous.”
- “Help others. Working to help someone else get sober makes it less likely that a recovering drinker, for example, would binge-drink.”
A reputable and effective drug and alcohol treatment facility won’t just cut you loose once your treatment is complete, either: If the goal of treatment is recovery, then staff members, therapists and clinicians will work with you to draft an aftercare plan that can help you accomplish that goal. They may set you up with outside appointments for therapy, if that’s something you’d like to continue. In addition, if treatment helped you address psychiatric issues like depression or bipolar disorder that were unmedicated before you went to rehab, the staff will help you make follow-up appointments with an outside psychiatrist to continue that dual diagnosis treatment. In addition, those same staff members will help you find a list of 12 Step or other recovery meetings in your area, so that you have a list of times and locations where you’ll find others, like yourself, who are focused on applying recovery principles into their lives outside of treatment.
All of that, of course, can feel challenging and uncertain. As Joshua Laurent, writing for The Fix, puts it, “Like a castaway sent adrift in a life raft with only the barest of essentials, you return to an environment that isn’t very different from when you left, but you recognize just how different you now are, and how easy it would be to return to your addictive behavior. You want to stay healthy, you want to maintain the sobriety and human connection you felt at rehab, but how do you do that when you’re just returning to the same life you had? It can be challenging, but it can also be done.”
In other words: What happens after alcohol rehab is entirely up to you, but the doors to recovery have been opened, the possibilities are limitless and the rewards are plentiful.