By Tiya Stokey, Executive Director, Recovery Works Columbus, a drug and alcohol addiction residential treatment center of Pinnacle Treatment Centers
We get it. You might not love being in treatment for an alcohol or substance use disorder. In fact, your time in treatment might be the toughest time in your life. It’s possible you’re counting down the days until the end of your program. You may have been counting the hours since the moment you arrived. Maybe even the minutes and seconds.
We don’t blame you for that.
Treatment can be hard.
You look forward to the end. Your discharge day. The day you get your life back. The day you get to set your own schedule again, finally. When you get to eat when you want. When you get to go where you want, when you want to. The day you don’t have to go to addiction counseling groups or relapse prevention groups. That first evening you don’t have to go to an AA or a NA meeting. That first night you get to go to sleep when you want – in your own bed – and then get up when you want the next morning.
You’re counting down until that one moment when this is all over and you can get back to your life.
You’re marking time until the end.
Then, one day in group – or maybe in an individual counseling session – you hear the word aftercare. That’s the moment you realize that your discharge date is not the actual end. Slowly it dawns on you: discharge is not the end at all.
Discharge is the beginning.
Because with recovery, there is no true end point.
Life After Treatment
Think about it this way: your time in treatment is relatively short, compared to the rest of your life. There’s no disputing that. Even if you start with detox, go through a residential program, and step down through every level of care there is, the time you spend in treatment is a drop in the bucket compared to the years of sobriety you have ahead of you.
That’s why aftercare matters: it helps keep you sober.
For life.
There’s no guarantee you will be sober for life – that depends on so many factors. It would be impossible to list them all here. One thing we do know, however, is that relapse rates for alcohol and substance use disorders are between 40 and 60 percent. That means that without a plan to address this fact – meaning a solid aftercare plan – your chances of staying sober aren’t very high: roughly 50/50. With a solid aftercare plan, however, research shows that your chances of maintaining long-term sobriety increase dramatically.
The Aftercare Plan
High-quality treatment centers begin work on your aftercare plan as soon as you begin a treatment program, whether you realize it or not. And whether you realize it or not, you begin work on your aftercare plan while you’re in treatment, too.
When you find a stress management tool that works, take notes on it and learn it well – that’s you planning for life after treatment. When you practice trigger management skills in a relapse prevention group – that’s you planning for life after treatment. And when you learn to listen, share, and fully participate in a community support meeting – that’s you, planning for life after treatment.
When you reflect on treatment, you’ll realize that the majority of what you do prepares you for what happens next. All the talk, all the counseling and all the group sessions serve to get you clean initially, of course, but once you’re clean, the focus shifts from getting clean and sober to staying clean and sober.
The way you do that?
With your aftercare plan.
Components of an Effective Aftercare Plan
- Community Support Options. Your plan needs to include times and locations of all the community support options in your area. You may need AA meetings or NA meetings. You may prefer SMART Recovery, Refuge Recovery, or something different. Whatever kind of community support works for you, you should walk out the door of a treatment center with a list of options that are realistic for you.
- Professional Support Options. Your plan needs to include initial appointments with your outpatient therapist or addiction counselor, your primary care physician, and any other healthcare specialists who need to know your recovery status. It’s best to have all these set up before you leave treatment.
- Medication Management. For MAT patients, this is the most essential aspect of your plan. Every detail about location, dispensation, and maintenance of your medication should be worked out before you leave treatment.
- Health and Wellness. Your plan should include a personalized strategy for maintaining the healthy habits you learned during treatment. You need to keep eating well and exercising regularly. You need to know your go-to stress management tools. Also, you should have a list of sober activities or new hobbies to keep yourself busy. This is especially important in the first few weeks after discharge.
- Trigger/Relapse Management. Your plan should include practical tools you can deploy immediately when you get triggered or think you may relapse. These are the sobriety skills you learned and practiced during treatment. Your tools may be exercise, journaling, or meditation. For some people, having the phone number of one recovery peer can make all the difference.
- Alumni Services are also a valuable tool in keeping connected with those who have shared similar recovery experiences. Alumni meetings and other touch points provide members with a way to not only get support but to also be of service to others, an often vital part of a solid recovery program. Recognizing the importance of this connection, Pinnacle has committed to providing both in-person and 24-hour access to support through its Pinnacle Fellowship Recovery App and Fellowship meetings and events.
If your discharge date is coming up and you don’t have an aftercare plan with all the elements above, you should get together with the therapists, counselors, and relevant clinical staff at your treatment center and formulate a workable plan as soon as possible – and you absolutely must have it in hand, in writing, when you walk out the door of treatment.
Why Aftercare Works
Aftercare works because the world you return to after treatment is the same as the world you left when you entered treatment.
When you went into treatment, the chances are your life was unmanageable because of your addiction. While you were in treatment, you worked on yourself. A lot. And if you’re lucky, your family – spouses, friends, the people who matter – know what’s going on and how to support you when you finish treatment. The rest of the world, however, did not have the same experience as you and your family. The world didn’t go to treatment. And that’s the world you have to live in: the same world in which you developed your alcohol or substance use disorder.
To handle that world – without alcohol and drugs – you’ll want to approach it differently than you did before. Your aftercare plan is your template for that. It keeps you thinking about sobriety, it keeps your mind in the game, and it keeps you on track. During treatment, it’s likely you’ll hear recovery peers say “I know I just need to keep working my program,” or “As long as I work my program, I’ll be okay,” or “I’m staying on my program and I feel great.” You learn that my program means all the things you need to do every day – from the little to the big – to stay sober.
When you formulate and follow a good aftercare plan, what you’re doing is working your program. It’s like staying in treatment without actually being in treatment. And since a good aftercare plan always includes community support, you’ll never be alone. You’ll have a safe place to go and people to talk to who completely understand and support your sobriety. You’ll have a realistic chance at living a full, healthy life, free from alcohol and drugs – and that’s the whole goal.