Roadmap to Recovery from Substance Use
undefined7-1
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1
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P
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F
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M
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Stage 1:
Withdrawal
(1-2 weeks)
Stage 2:
Early Abstinence or “Honeymoon”
(following 1 month)
Stage 3:
Protracted Abstinence or “the Wall”
(following 3-4 months)
Stage 4:
Adjustment/Resolution
(following 2 months)
7-2
Question
:
After stopping substance use, how
have your feelings and physical
conditions
changed over time?
1-3
S
t
a
g
e
1
:
W
i
t
h
d
r
a
w
a
l
(
1
-
2
w
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k
s
)
Physical detoxification
Cravings
Depression/anxiety
Low energy
I
r
r
i
t
a
b
i
l
i
t
y
Exhaustion
Insomnia
Paranoia
Memory problems
Intense hunger
7-4
Characteristics
S
t
a
g
e
1
:
W
i
t
h
d
r
a
w
a
l
(
1
-
2
w
e
e
k
s
)
Powerful cravings
Paranoia
Depression
Fear of withdrawal symptoms
Disordered sleep patterns
Unstructured time
Proximity of triggers
7-5
Relapse Risk Factors (for those in outpatient
treatment)
S
t
a
g
e
2
:
E
a
r
l
y
A
b
s
t
i
n
e
n
c
e
o
r
“
H
o
n
e
y
m
o
o
n
”
(
f
o
l
l
o
w
i
n
g
1
m
o
n
t
h
)
Increased energy
and optimism
Overconfidence
Difficulty
concentrating
Continued memory
problems
Concern about
weight gain
Intense feelings
Mood swings
Other substance use
Inability to prioritize
Mild paranoia
7-6
Characteristics
Tiredness and stress due to “Workaholism”
Discontinuation of structure (including treatment)
Overconfidence
Secondary drug or alcohol use
Resistance to behavior change
7-7
Relapse Risk Factors (for those in outpatient
treatment)
S
t
a
g
e
2
:
E
a
r
l
y
A
b
s
t
i
n
e
n
c
e
o
r
“
H
o
n
e
y
m
o
o
n
”
(
f
o
l
l
o
w
i
n
g
1
m
o
n
t
h
)
S
t
a
g
e
3
:
P
r
o
t
r
a
c
t
e
d
A
b
s
t
i
n
e
n
c
e
o
r
“
t
h
e
W
a
l
l
”
(
f
o
l
l
o
w
i
n
g
3
-
4
m
o
n
t
h
s
)
Low energy
Return of cravings
Return to old behaviors
Continued lifestyle
changes
Positive benefits from
abstinence
Anger and depression
Emotional swings
Paranoia or suspicion
Unclear thinking
Isolation
Weight gain
Family adjustment and
conflict
8-8
Characteristics
Increased emotionality
Breakdown of
structure
Behavioral “drift”
Interpersonal conflict
Decreased ability to
feel pleasure
Loss of motivation
Insomnia
Low energy/fatigue
Paranoia
Secondary drug use
Relapse justification
8-9
S
t
a
g
e
3
:
P
r
o
t
r
a
c
t
e
d
A
b
s
t
i
n
e
n
c
e
o
r
“
t
h
e
W
a
l
l
”
(
f
o
l
l
o
w
i
n
g
3
-
4
m
o
n
t
h
s
)
Relapse Risk Factors (for those in outpatient
treatment)
S
t
a
g
e
4
:
A
d
j
u
s
t
m
e
n
t
a
n
d
R
e
s
o
l
u
t
i
o
n
(
f
o
l
l
o
w
i
n
g
2
m
o
n
t
h
s
)
Feelings of accomplishment
Continued lifestyle and relationship change
People in this stage need to shift from learning new
skills to:
Maintaining a balanced lifestyle
Monitoring for relapse signs
Accepting that recovery is a life-long process
Developing new areas of interest
8-10
Characteristics
Secondary drug or alcohol use
Feeling “cured” and relaxing vigilance for relapse
signs
Relaxation of structure
Return to relationships with people who use
substances
Neglect recovery activities, losing the momentum of
recovery
Neglect exercise and other self-care activities
8-11
S
t
a
g
e
4
:
A
d
j
u
s
t
m
e
n
t
a
n
d
R
e
s
o
l
u
t
i
o
n
(
f
o
l
l
o
w
i
n
g
2
m
o
n
t
h
s
)
Relapse Risk Factors
Necessary Lifestyle Balance
W
o
r
k
S
l
e
e
p
R
e
c
o
v
e
r
y
A
c
t
i
v
i
t
i
e
s
L
e
i
s
u
r
e
R
e
l
a
t
i
o
n
s
h
i
p
s
8-12
S
t
a
g
e
4
:
A
d
j
u
s
t
m
e
n
t
a
n
d
R
e
s
o
l
u
t
i
o
n
(
f
o
l
l
o
w
i
n
g
2
m
o
n
t
h
s
)
Question
:
Why is it important to have a
structured lifestyle in the process of
recovery?
1-13
S
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d
L
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l
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Self-designed structure:
Helps eliminate avoidable triggers
Makes the concept of “one day at a time”
concrete
Reduces anxiety
Counters the drug-using lifestyle
Provides a basic foundation for ongoing
recovery
7-14
Building Blocks of Structure
7-15
S
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Scheduling Pitfalls
Unrealistic schedules
Unbalanced schedules
Imposed schedules
No support from significant others
Holidays, illness, and other
changes
7-16
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Slide 7-1—Roadmap for Recovery (1)
This presentation looks at recovery as following a predictable course (like a roadmap) through a series of four recovery stages.
People in recovery are likely to experience particular physical and emotional changes and symptoms in each stage of recovery, and each stage brings particular relapse risks. Families are likely to witness these changes and symptoms.
This does not mean that every person or family will experience recovery in exactly the same way; although the general progression is predictable, every person in recovery will follow his or her own roadmap.
A few people will progress from stage to stage smoothly, many will become “stuck” for a time in one stage, and others will veer off track completely before resuming their progress.
Even though there will be variability, being aware of the stages of recovery can give people in recovery and their family members a basic idea of what to expect during recovery.
Knowing what to expect can help people avoid pitfalls and stay on the road to recovery.
Knowing what to expect also helps family members understand the recovery process and allows them to provide more support for the person in recovery.
This session provides insights into the stages of recovery from substance use, including withdrawal, early abstinence, protracted abstinence, and adjustment. It highlights the physical and emotional characteristics of each stage, along with relapse risk factors. The content offers guidance on navigating feelings, physical changes, and challenges during the recovery journey.
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Presentation Transcript
Psycho-Education for Patients and Family Members Session 7: Roadmap for Recovery (1) 7-1
Recovery Stages Stage 1: Withdrawal (1-2 weeks) Stage 2: Early Abstinence or Honeymoon (following 1 month) Stage 3: Protracted Abstinence or the Wall (following 3-4 months) Stage 4: Adjustment/Resolution (following 2 months) 7-2
Question: After stopping substance use, how have your feelings and physical conditions changed over time? 1-3
Stage 1: Withdrawal (1-2 weeks) Characteristics Physical detoxification Cravings Depression/anxiety Low energy Irritability Exhaustion Insomnia Paranoia Memory problems Intense hunger 7-4
Stage 1: Withdrawal (1-2 weeks) Relapse Risk Factors (for those in outpatient treatment) Powerful cravings Paranoia Depression Fear of withdrawal symptoms Disordered sleep patterns Unstructured time Proximity of triggers 7-5
Stage 2: Early Abstinence or Honeymoon (following 1 month) Characteristics Increased energy and optimism Overconfidence Difficulty concentrating Continued memory problems Concern about weight gain Intense feelings Mood swings Other substance use Inability to prioritize Mild paranoia 7-6
Stage 2: Early Abstinence or Honeymoon (following 1 month) Relapse Risk Factors (for those in outpatient treatment) Tiredness and stress due to Workaholism Discontinuation of structure (including treatment) Overconfidence Secondary drug or alcohol use Resistance to behavior change 7-7
Stage 3: Protracted Abstinence or the Wall (following 3-4 months) Characteristics Low energy Return of cravings Return to old behaviors Continued lifestyle changes Positive benefits from abstinence Anger and depression Emotional swings Paranoia or suspicion Unclear thinking Isolation Weight gain Family adjustment and conflict 8-8
Stage 3: Protracted Abstinence or the Wall (following 3-4 months) Relapse Risk Factors (for those in outpatient treatment) Increased emotionality Breakdown of structure Behavioral drift Interpersonal conflict Decreased ability to feel pleasure Loss of motivation Insomnia Low energy/fatigue Paranoia Secondary drug use Relapse justification 8-9
Stage 4: Adjustment and Resolution (following 2 months) Characteristics Feelings of accomplishment Continued lifestyle and relationship change People in this stage need to shift from learning new skills to: Maintaining a balanced lifestyle Monitoring for relapse signs Accepting that recovery is a life-long process Developing new areas of interest 8-10
Stage 4: Adjustment and Resolution (following 2 months) Relapse Risk Factors Secondary drug or alcohol use Feeling cured and relaxing vigilance for relapse signs Relaxation of structure Return to relationships with people who use substances Neglect recovery activities, losing the momentum of recovery Neglect exercise and other self-care activities 8-11
Stage 4: Adjustment and Resolution (following 2 months) Necessary Lifestyle Balance Sleep Work Leisure Recovery Activities Relationships 8-12
Question: Why is it important to have a structured lifestyle in the process of recovery? 1-13
Structured Lifestyle Self-designed structure: Helps eliminate avoidable triggers Makes the concept of one day at a time concrete Reduces anxiety Counters the drug-using lifestyle Provides a basic foundation for ongoing recovery 7-14
Structured Lifestyle Building Blocks of Structure Treatment Activities Recreational/Leisure Activities 12-Step/Self-Help Meetings School Sports Activities With Friends Who Are Drug Free Time Scheduling Exercise Work Family-Related Events Community Activities Spiritual Activities Island Building 7-15
Structured Lifestyle Scheduling Pitfalls Unrealistic schedules Unbalanced schedules Imposed schedules No support from significant others Holidays, illness, and other changes 7-16
