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Drug and alcohol treatment aftercare: What is standard?

Aftercare & relapse prevention

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) Technical Assistance Publication (TAP) Series 11 :

It is not unusual for addicts to relapse within one month following treatment, nor is it unusual for addicts to relapse 12 months after treatment; 47 percent will relapse within the first year after treatment (Simpson, Joe & Lehman 1986)….Although relapse can occur at any time, it is more likely earlier in the recovery process. At this stage, habits and attitudes needed for continued sobriety, skills required to replace substance use, and identity with positive peers are not firmly entrenched (Nowinski, 1990).

So what role does aftercare play in relapse prevention?

A good treatment center will first stabilize the medical condition of a person addicted to drugs and/or alcohol…and then educate an addict about the physical, mental and emotional cycle of addiction. The education that begins in treatment can be the basis for choosing different behaviors and outcomes after treatment. Relapse prevention techniques that are theory during residential treatment become practice in the real world. Therefore, it is the role of aftercare to support the new habits and attitudes which promote sobriety by keeping people accountable and encouraging positive ACTIONS in early recovery.

Drug rehabilitation and after care programme model

The process of social reintegration can be difficult after inpatient rehabilitation for drug or alcohol addiction. Those in early recovery face many challenges, especially in recurrent thoughts or physical cravings to use drugs or alcohol. Combined with social pressure, exposure to “high-risk situations”, curiosity for testing addiction, and a lack of skills to deal with conflict or negative emotions…aftercare programs are fighting an uphill battle to help addicts stay clean. However, successful drug and alcohol treatment aftercare programmes share some common practices. These can include:

  • creating an individualized relapse prevention plan for each client
  • encouraging involvement in community self-help groups
  • making weekly, bi-weekly or monthly follow up phone calls to track client progress
  • referring clients to psychotherapy (cognitive-behavioral,supportive, insight oriented, family therapy or a combination of therapies)
  • recommending a structured living environment (halfway, 3/4 way or sober houses)
  • recommending voluntary or mandatory drug screening (sometimes court ordered)

New ideas in after care

Treatment centers who are interested in going beyond the standard are finding new and novel ways to check in with patients after their initial “rehab”. These industry leaders are interested in continuing the process of 2-way communication with former patients, to both improve inpatient services and provide aftercare assistance. Some ideas include:

  • Initiating online video or audio meetings with former patients
  • Sending a series of reminder emails re: the personalized relapse prevention plan formulated during treatment
  • Texting clients on mobile phones to encourage recovery progress
  • Using iPhone apps to help clients track relapse triggers, emotions, meeting attendance, etc.
  • Moderating group discussions and/or forums online

Aftercare alcohol drug rehabilitation treatment review

In your experience, do drug and alcohol treatment center provide the standards for aftercare? Are they doing enough? Or are many lacking in follow up services for patients getting out of rehab? What should be the minimum standard a treatment center MUST follow? And what other ideas do you have for drug and alcohol addiction treatment centers looking to improve aftercare? Your input is welcomed here.

Reference sources: Tap Series 11
University of Washington Tech Report

Leave a Reply

6 Responses to “Drug and alcohol treatment aftercare: What is standard?
Beach Comber
11:31 pm November 30th, 2010

Thanks for New ideas in after care.

Rodger Dunsworth
3:29 am December 6th, 2010

Thanks for the blog post. Will read on…

Charles Somer
7:22 pm December 16th, 2010

Many recovering addicts/alcoholics claim that relapse is part of recovery.

I believe the thinking behind it is that you have to revisit the hell that was your addiction to truly recover.

Great blog by the way.


2:49 pm February 6th, 2012

When the patient is addicted to drug or alcohol it affects them both mentally and physically. So if the person gets treated for these addictions there are always chances of relapse. To prevent this rehab centers provides some special treatment programs for their patients which helps them to prevent from relapse.

1:53 am February 7th, 2013

My wife will be coming out of an in-patient rehab tomorrow. I’ve got several concerns.

My first one is that I’m not sure ‘who’ is coming home. Is it the sharp minded woman that I married or something less?

I have anger issues that haven’t been fully resolved. I’m not sure that, after living with the addiction for so long and suffering the consequences, that I will ever be able to blame the sickness and not the sickened. And I don’t want my failings to result in her relapse.

Lastly, if she does relapse, I’m not sure I can handle it. I was raised by alcoholics and I have a ‘revulsion’ to them. I’m not sure I can endure a relapse in a supportive way.

9:31 am February 9th, 2013

Hi Tank. There is a lot to be concerned about, no doubt. Early recovery in addiction can be very volatile. Be sure that YOU have support. Go schedule an appointment with a psychotherapist who can empathize and provide you with direction. Or see a religious or spiritual leader that you trust. Or talk to a close friend or family member. Or reach out to Al-Anon. It sounds like your own personal relationship with addiction could be coloring your expectations and disappointments. But there is hope out there. Remembering that you CANNOT change anyone other than yourself is a good place to start. Best of luck in this difficult and sensitive time.

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