October is National Substance Abuse Prevention Month, highlighting the role substance abuse plays in individual and community health. In this third article, we will discuss what to expect during recovery.
“I think there is a very common misconception that everything is going to get better quickly once people stop using drugs or alcohol, enter into recovery and get through withdrawal; that relationships and problems can be fixed overnight,” said Caitlin Reider, substance abuse counselor at ThedaCare Behavioral Health. “It actually takes a while to feel better in recovery.”
She outlined the stages of what’s defined as the Roadmap for Recovery:
Withdrawal
0-15 days
During this stage the recovering person will likely experience physical detoxification, along with cravings, depression, low energy, irritability, insomnia and disordered thinking.
Potential relapse factors in this stage may include having unstructured time, nearness of triggers, other using behavior, powerful cravings, using dreams, paranoia, anxiety, depression and sleep problems.
“There’s a common misconception that withdrawal only takes a couple of days, in reality it can take much longer than that,” Reider explained. “The brain is the first organ to recognize it’s not getting those ‘feel good’ chemicals anymore, and a variety of reactions can develop.”
The Honeymoon Stage
15-45 days
In this stage the recovering person often feels really good and may become overconfident, have difficulty concentrating, develop memory problems, have intense feelings, become overly emotional, experience mood swings, and talk about making many lifestyle changes at one time.
Potential relapse factors in this stage include overconfidence, secondary use of other substances, other compulsive behaviors, discontinuation of their structure, resistance to behavioral change, a return to old behaviors/friends/places/lifestyle or an inability to prioritize.
“During this stage, many of the chemicals the brain wasn’t getting during withdrawal increase and the recovering person will start to feel really good and be very motivated,” said Reider. “Sometimes we call it the ‘pink cloud’ phase.”
The Wall
45-120 days
This stage may feature a return to old behaviors; an inability to enjoy normal pleasures, anger, hostility, irritability, aggression, depression, anxiety; cravings and using thoughts may increase. It includes mood swings, isolation, unclear thinking, relationship problems, and feeling “defeated”, with an increase in mental health symptoms, feeling exhausted, sleeping more and having using dreams.
Potential relapse factors in this stage include increased emotions, relationship conflicts, relapse justifications, loss of motivation, lack of vision in recovery, insomnia, low energy, fatigue, exhaustion, dissolution of structure, no longer completing positive behavioral changes, secondary use of substances and increased mental health symptoms.
“This is often the hardest stage to help people through,” Reider said. “Most of the ‘feel good’ feelings from the Honeymoon Stage are gone. It can be a defeating period and is one of the biggest barriers to work through in the beginning stages of recovery. That’s why it is important for people to understand that this phase is part of the normal progression to recovery and that they shouldn’t give up on sobriety during this stage.”
Adjustment
120-180 days
This stage may feature relationship problems, boredom, lack of goals and direction, guilt and shame over past behaviors, job dissatisfaction and relationship dissatisfaction. Underlying psychopathology/trauma/life issues that contributed to the addictive behavior may surface.
Potential relapse factors include developing a secondary addiction, relaxing of structure, and a struggling with acceptance of disease, along with reemergence of underlying psychopathology/trauma/life issues.
“During this phase the person’s brain and body begin to level out,” said Reider. “Sometimes people will start to feel more confident again and won’t maintain their life structure. They often feel guilt and shame and want to make amends for all the things they did to hurt people while they were using. It’s important for the recovery person to know this is normal part of the process of recovery.”
Resolution
Usually occurs after day 180
In this stage the recovering person can develop insights into the underlying problems that contributed to their addiction, develop insights into unhealthy relationships, may experience cycling patterns of addictive behavior and struggle with the “lifelong” concept of addiction. Other dysfunctional patterns may emerge.
Potential relapse factors in this stage include returning to old behaviors, reuniting with using people/places/other triggers, relaxation of their recovery structure and program, and the eventual discontinuation of meetings/treatment.
“By the time a person reaches this stage, a lot of healing has occurred,” she said. “People often start to see improvement in their lives. That’s the Roadmap to Recovery, which typically lasts about six months. I believe it is important for someone entering recovery to understand what they will experience along the way.”
Reider suggests having a strong support system.
“Talk with someone about what’s happening,” she said. “That’s called verbalization and ventilation and it’s why a strong, sober support system is necessary, especially with people who’ve been through recovery themselves. They might offer a unique perspective others may not have.”
In early 2018, ThedaCare launched the opioid awareness campaign developed by the Centers for Disease Control and Prevention, “It only takes a little to lose a lot”. The public will see different forms of campaign presence, including billboards, medication take back boxes, social media and public service announcements across the nine county service area. Goals of the campaign include fewer prescriptions written for opioids, more people accessing addiction and recovery services and ultimately lower rates of hospitalizations, emergency department visits and deaths due to opioid overdose.
If you or someone you know is struggling with addiction, please contact a treatment service such as the Wisconsin Addiction Recovery Helpline through 2-1-1 or ThedaCare Behavioral Health.
About ThedaCare
For more than 110 years, ThedaCare® has been committed to finding a better way to deliver serious and complex healthcare to patients throughout Northeast and Central Wisconsin. The organization serves a community of more than 600,000 residents and employs more than 7,000 healthcare professionals throughout the regions. ThedaCare has seven hospitals located in Appleton, Neenah, Berlin, Waupaca, Shawano, New London and Wild Rose as well as 31 clinics in nine counties. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving our specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a non-profit healthcare organization with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs as well as a foundation dedicated to community service.
Media should call Cassandra Wallace, Public Relations Specialist at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.
