Anyone who has been through addiction treatment will tell you that one of the scariest moments is the second they stepped out the front door of the facility and walk alone back into their old environment. I’ve watched thousands take that step. Some were giddy while others had that ‘deer in the headlights’ look about them. What they all shared was an overwhelming fear of relapse and a determination to beat their demons and live a happy life free of drugs and alcohol. There was no way of telling at the time who would relapse and who would not; only the fact that a small percentage would continue on their path to recovery uninterrupted.
This is just one of the many undeniable truths regarding what happens after addiction treatment. All too often the perception of treatment is that it’s the end of something; when in reality it is the fragile beginning of a whole new life, fraught with insecurities and vulnerabilities. In over thirty years of treating addicts, not once did I meet one who wanted to return other than to say hello or encourage others.
The reasons for such a high relapse rate are many. In past articles I’ve gone to great depths explaining the genetic influences, not treating the brain, addict’s mental and physical conditions, ineffective treatment protocols, the insurance industry’s oversized influence on treatment and a host of other reasons why recovery can be so challenging. However, if I had to pick one reason why so many people relapse, it would have to be the short amount of time addicts have in treatment.
Philosophically speaking, two of the primary goals of every addiction treatment facility are to:
1) Gain the commitment from each and every addict individually to stop abusing drugs, alcohol and end their self-destructive behavior.
2) Help the addict build the foundation that will support a lifestyle free of these negative attributes while promoting recovery.
Although these goals don’t appear to be all that lofty, achieving them is a completely different story. What people on the outside rarely see is the addicts’ progression through the stages of treatment. They start out in detox where they are slowly weaned off of drugs or alcohol while often experiencing painful withdrawal symptoms. They are physically sick in an unfamiliar setting surrounded by strangers. Days later, sometimes longer, when they are admitted to the treatment center, their minds are still cloudy while their bodies adjust to their drug free state. At this point their brains are not capable of normal function. As hard as the staff at the treatment center tries, nothing sinks in during the first couple of weeks. Sure, they go to meetings, cognitive therapy and so on, but nothing really registers until their third week.
So with that being said, the reality is that most addicts only get a couple of weeks of effective addiction treatment. That is simply not enough time to reinforce a commitment of abstinence from drugs, alcohol and destructive behaviors much less built a solid foundation for a happy and productive lifestyle. Unfortunately, the vast majority of treatments centers do not have aftercare programs to address these shortcomings.
This is why, now more than ever, a comprehensive aftercare program that acts as an extension of addiction treatment centers and a precursor to recovery homes is essential to the success of anyone’s recovery.
Think of it as if you were building a house. Imagine two addicts who have just completed treatment walking out of a center. Each is dressed like a construction worker with a tool box in one hand and a set of blue prints in the other. The addicts have been taught how to use a few of the tools in the box very well, but are not sure what can be accomplished with most others. They look at the plans they were provided in treatment and have a general idea as to the house they want to build, but are vague on the details as to how to build it.
Now they stand at a crossroad, one chooses to ‘go it alone’ while the other seeks help at a ‘comprehensive aftercare program.’ At the end of ninety days, both addicts have built their house. Let me ask you something, how do you think the house built by the person who ‘goes it alone’ will look compared to the person who sought professional help in a ‘comprehensive aftercare program’? Which one has the strongest foundation? More importantly, how long do you think each house will stand?
When I explain it this way most people get it. There is no substitute for quality professional help especially when you are faced with a life changing situation. Considering that recovery is not fully stabilized until four to five years of sustained recovery, good aftercare programs become all that much more vital to a successful recovery.
Expect a comprehensive aftercare program to do much more than filling in the blanks. It goes without saying that they need to fulfill the obligatory services and so on. But more importantly they will function as an extension of addiction treatment; they pick-up where the treatment center left off. Using my previous example, a comprehensive aftercare program will teach addicts how to use all the tools at their disposal and help them build a foundation to support a sustainable drug/alcohol free lifestyle.
It wasn’t all that long ago when addiction was accepted as a chronic disease. Because it is centered in the brain, there is no cookiecutter therapy that works for everyone. I’ve always viewed addiction as a mosaic with the potential of many contributing factors; which is why all treatment needs to be individualized to the addict’s needs. However, there are commonalities that are just too big to ignore.
A great example would be nutrition. Drugs and alcohol abuse causes major nutritional and brain chemistry imbalances that often can make cravings intensify. Most people don’t even know that we our behavior. Nutrition plays a major role in the health of our gut. Combine all of this with a western diet full of processed foods, GMOs and calories but low in nutrition and you have a recipe for relapse.
Comprehensive aftercare programs are in front of this. They will have an Amino acids (the precursors to neurotransmitters a.k.a. our ‘happy brain chemicals’) therapy that will restore balance in the brain chemistry. In addition, they will teach addicts nutritional basics and make recommendations for supplements that you just cannot get through food.
Exercise has been a pet peeve of mine for quite some time. I cannot stress upon you just how important exercise is – regardless if you are an addict or not – for both your physical and mental health. Take a twenty-minute walk; go for a bike ride or a long swim. You will notice a change immediately. You’ll feel lighter on your feet and clear minded. Good aftercare programs will provide some form of daily exercise while furnishing a tailored plan that an addict can take with them and apply throughout their life.
Most comprehensive aftercare programs are based in the 12 step program and include a spiritual and emotional growth component. They may also include life skills training to help addicts find jobs and patch up broken or damaged relationships with friends and family.
Addiction has evolved. In the last twenty-five years addiction has taken on a whole new face constructed with new and more difficult challenges. Yet due to forces outside of their control and through no fault of their own, treatment centers can struggle to meet the new challenges and provide addicts with everything they’ll need for a successful recovery.
There is a mountain of scientific evidence that tells us that the longer a person stays in a treatment environment the more likely it is that they will have a successful recovery. We know this to be true and why comprehensive aftercare programs have become essential to successful recoveries. These programs not only reinforce what has been accomplished in treatment but also pick-up where they left off. They provide the tools and a strong foundation for a sustained recovery.
John Giordano, Doctor of Humane Letters, MAC, CAP, is the
founder of ‘Life Enhancement Recovery Center,’ an Addiction
Treatment Consultant, President and Founder of the National
Institute for Holistic Addiction Studies, Chaplain of the North Miami
Police Department and is the Second Vice President of the Greater
North Miami Chamber of Commerce. He is on the editorial board
of the highly respected scientific Journal of Reward Deficiency
Syndrome (JRDS) and has contributed to over 65 papers published
in peer-reviewed scientific and medical journals.