Recovery

Dr. Sheridan Walter
Dr. Jennie Stanford
Written by Dr. Sheridan Walter on 26 August 2021
Medically reviewed by Dr. Jennie Stanford on 22 November 2024

Addiction recovery is a multifaceted, ongoing process that goes beyond stopping substance use. It is an active process in which people restore their health holistically and build the resilience necessary for this purpose. It consists of creating a meaningful, balanced life, supporting continued personal growth and long-term recovery.

While the National Institute on Drug Abuse (NIDA) defines recovery as a process of overcoming addiction, and Psychology Today views it as the return to health after illness or trauma, these perspectives underscore important but different facets of a broader process:

  • The development of new coping mechanisms
  • Repairing relationships
  • Re-engaging with life in a way that promotes well-being

In addition, addiction recovery has five definitive attributes:

  • It is a lifelong process of change.
  • It is holistic (biopsychosocial spiritual) and goes beyond just abstinence.
  • It is person-centered.
  • It involves learning healthy coping strategies.
  • It has multiple stages.
Key takeaways:
  • Recovery is a personalized, life-long process with multiple stages that focuses on holistic healing beyond mere abstinence, centering on the individual’s overall well-being.
  • Various supportive environments, such as peer groups, faith-based programs, sober living homes, and recovery-specific activities, provide ongoing support for individuals in recovery.
  • Effective sobriety maintenance includes continuous therapy, support groups, life skills development, a solid support network, and customized relapse prevention plans.
Three trees shaped like human heads with varying leaf coverage.

What is addiction recovery?

Most people will have a relatively clear idea of what addiction recovery means to them. Often, this will boil down to someone getting over an addiction and maintaining a sober lifestyle. In reality, recovery is a long, complex process with multiple interpretations and approaches.

For example, the Substance Abuse and Mental Health Services Administration's (SAMHSA) working definition of recovery is "a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential":

  • Health - managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being
  • Home - a stable, safe place to live
  • Community - having relationships that provide support, friendship, love, and hope
  • Purpose - conduct meaningful everyday activities, such as work or artistic projects.

To build on the definition of recovery practically, always remember:

  • Recovery is unique to you, and you control your path.
  • Recognizing the need for change is the first step in recovery.
  • Culture impacts recovery.
  • Peers and friends support recovery.
  • Recovery is evidence-based.
  • Recovery is possible.

Recovery models

Addiction recovery is not a one-size-fits-all proposition. Different models emphasize different dimensions of this journey:

  • Community-based model: Peer-support and community-based models, like 12-step programs, Recovery-Oriented Systems of Care (ROSC), and therapeutic communities highlight the importance of social connections, support networks, and societal reintegration in recovery.
  • The stages and phases of recovery models: White and Kurtz's Transtheoretical and Developmental Recovery Models acknowledge that recovery is a stage-based process with distinct phases, each requiring tailored support.
  • The life course perspective model: The factors affecting the onset of addiction and recovery depend on age and other developmental considerations. This model is a helpful example of how different approaches are needed to help different people achieve and sustain remission.

Can addiction be cured?

NIDA defines addiction as a “chronic disease.” The word to note in this definition is “chronic.” Therefore, addiction cannot be cured in the traditional sense, just like other chronic diseases (like diabetes and high blood pressure) cannot be cured.

Addiction can, however, be treated or managed. According to NIDA, treatment is not a cure. By treating addiction, you can regain your life, as this will enable you to counteract addiction’s disruptive effects.

Effective addiction treatment combines both medication and therapy.

Medications are used (especially for opioids, alcohol, and nicotine) to:

Behavioral therapies help modify a person's behaviors and thought patterns, as well as address triggers that may result in relapse. These include:

A personalized approach, combining both medications and behavioral therapies, is best used for long-term recovery, as it addresses the physical and psychological aspects of addiction.

The recovery process

Behavioral change is a key component of recovery because managing addiction is a continuous process, not a one-time intervention. The Transtheoretical Stages of Change Model helps illustrate how people with addiction progress through different stages of behavioral change during recovery, from not recognizing the problem to actively maintaining sobriety.

Different stages correspond to different recovery approaches.

The stages of recovery that inform the Transtheoretical Stages of Change Model include:

  • Stage 1: Pre-Contemplative Stage - People don’t think about their addiction as a problem and have not yet started to think about change.
  • Stage 2: Contemplative Stage - People start to become aware of the adverse effects of addiction.
  • Stage 3: Preparation Stage - People commit to change.
  • Stage 4: Action Stage - People take active steps to change their behavior.
  • Stage 5: Maintenance Stage- People successfully maintain their sobriety.

Addiction Recovery Support Programs

Part of the recovery process requires accompanying support systems. Treatment is the first step in addiction recovery, with various options tailored to help people achieve remission. These treatment options include:

Professional Treatment Programs:

  • Detoxification is often the first step, which consists of medically supervised intervention to assist with withdrawal symptoms.
  • Inpatient rehabilitation involves treatment in a dedicated setting away from home. It usually involves a 30 to 90-day treatment program and is recommended for people with severe addiction.
  • Outpatient programs offer the same therapy as inpatient care but allow the person to return home. They may also be suitable for those who can’t afford inpatient rehab.

Therapeutic Approaches:

  1. Talking therapies include CBT and motivational interviewing, which are part of individual and group therapies.
  2. Individual and group therapy is usually part of inpatient and outpatient programs.

Medication-Assisted Treatment (MAT):

Post-Treatment Recovery Programs

There are many programs to support sustained recovery after treatment:

  • Recovery-oriented systems of care (ROSC) follow a chronic care model and offer long-term outpatient services, such as recovery housing and coaching.
  • Recovery support services include emotional and practical support through mutual aid groups, peer recovery coaching, and recovery community centers.
  • Recovery residences, also known as sober living homes, are alcohol- and drug-free environments where people can live post-treatment to assist with gradual reintegration into society.
  • Inpeer recovery support programs, those who have undergone recovery mentor and guide others through their recovery journey.
  • Social and recreational recovery programs include social activities in recovery-specific settings, like recovery cafes, sports leagues, and creative arts programs.
  • Education and employment-based recovery services help to maintain recovery through education and support to find employment.
  • Faith-based recovery support provides a recovery pathway guided by religious or spiritual values.

Relapse: A common challenge in recovery

Even with a robust recovery process, relapse is common, and it’s not a sign of failure, but rather it’s a valuable learning opportunity. As previously mentioned, NIDA defines addiction as a chronic condition, and relapse rates for chronic diseases (like diabetes and hypertension) are almost equal. Therefore, setbacks are expected as a natural part of the recovery process.

Relapse should not discourage individuals in recovery. It is, as mentioned, very common, and one can quickly regain control after relapse with the right tools and strategies to assist you.

It is also essential that we acknowledge that while relapse is part of recovery, it can have serious consequences. A report published in 2023 cautions us against normalizing relapses because people often lose their employment, families, freedom, and even lives as a consequence of relapse. This is a sad reality, but taking responsibility might assist in counteracting these adverse effects.

Hanna Pickard, an addiction expert, introduced the concept of “responsibility without blame” in her work. While she doesn’t link this concept to addiction relapse per se, it is still helpful in this context. Essentially, this means that we can hold a person responsible for their actions during addiction without blaming them. 

In doing so, we ensure a compassionate response to relapse. Such an approach is imperative in addressing the stigma and shame that often accompany relapse, and it encourages people to seek support and strengthen their responses to relapse.

Identifying relapse triggers

Relapse occurs because of physical, psychological/emotional, and social factors. For example, relationship problems, issues at work, and isolation, to name a few, can lead to relapses. One of the main reasons relapses happen is the presence of triggers, which are highly individual.

Triggers are specific to each person, but there are a few cross-cutting ones:

  • During the early stages of recovery, withdrawal can cause intense cravings as the body and mind adjust to being drug-free.
  • Depression, anxiety, or unmanaged stress can lead to relapse.
  • Problems with interpersonal relationships—whether with family, romantic partners, or friends—can lead to emotional distress.
  • Being in social settings where drugs are present or around people who use drugs or alcohol can threaten success in recovery.
  • A lack of social support, feelings of loneliness, or boredom can predispose to relapse.
  • Sometimes, people feel they have "beaten" their addiction and may stop attending support groups or neglect coping strategies.
  • Positive events, like celebrations or parties, where the social environment encourages substance use can encourage relapse.
  • Significant change(s), such as starting a new job, moving to a new city, starting a new relationship, or getting divorced can have notable impacts. Both positive and negative life changes can be overwhelming and cause relapse.

Relapse prevention strategies

Although relapse is part of recovery, it is good to have an arsenal of helpful information to prevent relapse from occurring. The following are a few practical strategies to prevent relapse:  

  • Educate yourself about relapse risks and warning signs. Note personal triggers and learn how to manage them.
  • To handle emotional challenges before they escalate, practice specific stress-relief techniques, such as deep breathing, journaling, or talking to a therapist.
  • Schedule daily or weekly self-reflections to monitor your mood, thoughts, and behaviors. Keep a journal or use a mood-tracking app to spot patterns early.
  • List your common triggers (people, places, feelings) and write down actionable steps to avoid or handle each one effectively.
  • Regularly rehearse practical coping strategies, such as mindfulness, grounding techniques, or distraction activities, that help you manage cravings or difficult situations.
  • Keep a list of trusted people you can call when feeling vulnerable. Meet regularly with your support network, even when you're doing well.
  • Review and update your relapse prevention plan. Set monthly reminders to revisit and update it based on any new triggers, experiences, or strategies that work for you.
  • Build a daily routine that supports your sobriety—exercise, balanced meals, good sleep, and activities that give you purpose. Avoid environments that might tempt you to relapse.
  • Attend support groups. Groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and SMART Recovery can provide a safe space for people to talk about past use, recognize and manage cravings and triggers, and access peer support.

Long-term recovery

Recovery from addiction is an ongoing, lifelong process. Long-term recovery does not have a specific time frame. It is often associated with various protective factors, such as participation in a 12-step program, social and community support, and supporting factors like employment, stable housing, friends, family, and a sense of purpose.

Even with well-established support groups in recovery, some challenges may test individuals in ways support groups can’t help with. One of these challenges people may face in long-term recovery is Post-Acute Withdrawal Syndrome (PAWS). A person with PAWS can experience psychological withdrawal symptoms that can last for months and even years after stopping drug use. Thus, addressing these symptoms can significantly improve a person’s chances of long-term recovery if they experience PAWS.

Maintaining sobriety post-treatment

There are numerous resources and strategies that can be implemented post-treatment to help maintain sobriety and ease long-term recovery. Some of these include: [117]

Ongoing therapy

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are two evidence-based approaches shown to help people manage triggers and emotional distress, which helps reduce the risk of relapse and maintain sobriety. CBT helps people change negative thought patterns, while DBT helps with emotional regulation.

Attending support groups

Regularly attending meetings for support groups such as AA, NA, and SMART Recovery leads to better long-term recovery outcomes and helps maintain sobriety.

Life-skills training

Life skills training equips individuals with practical abilities to navigate daily challenges, reducing the risk of relapse. Skills like stress management, effective communication, and problem-solving promote emotional stability, while time management and conflict resolution support healthier interpersonal relationships. Learning healthy routines, job skills, and financial management empowers individuals to rebuild a balanced, sustainable lifestyle, which can be critical for long-term recovery success.

Support networks in recovery

Friends, family, loved ones, communities, and professional support all help maintain sobriety in the long term.

  • Friends and family: Close relationships provide emotional support and motivation.
  • Communities: A robust support system reduces feelings of isolation while promoting social activities that encourage sobriety. Recovery communities or peer recovery support centers offer a safe space to socialize while staying in sober houses (e.g., Oxford House) to facilitate belonging and, in turn, encourage recovery.
  • Professional support: Therapists, counselors, and addiction specialists help patients maintain recovery by addressing underlying issues and developing the necessary skills and strategies for long-term recovery.
  • Peer accountability partners: Fellow peers who have experienced similar struggles can offer insights, encouragement, support, and a sense of shared responsibility. Regular check-ins with accountability partners help keep people committed to recovery goals by encouraging and holding them accountable for their choices.

FAQs

Common FAQs about recovery

How long does addiction recovery take?

Addiction recovery is an ongoing, lifelong process. There is no specific time frame for recovery. If you have an addiction, you will always be in recovery.

Is relapse a part of recovery?

Yes, relapse is a part of the recovery process. Relapse is not a failure and should be viewed as a learning opportunity — one that helps people refine their coping strategies and recovery plans. Addiction is a chronic condition, and studies show that relapse rates are similar for other chronic diseases like diabetes and hypertension. There are strategies to help prevent relapse.

What types of support are available for addiction recovery?

Support for addiction recovery includes inpatient and outpatient treatment programs, which offer structured care and flexibility, respectively. Peer support groups like AA and NA provide a community of shared experiences, while loved ones offer essential emotional support. Continued engagement in therapy, such as CBT or DBT, helps manage stress and triggers to reduce relapse risk.

Can someone recover from addiction on their own?

Yes. While some people do "outgrow" their addiction, others, on the other hand, attempt recovery by themselves. However, professional support and structured programs greatly enhance your chances of long-term recovery.

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Resources:

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Activity History - Last updated: 22 November 2024, Published date:


Reviewer

Dr. Jennie Stanford

MD, FAAFP, DipABOM

Jennie Stanford, MD, FAAFP, DipABOM is a dual board-certified physician in both family medicine and obesity medicine. She has a wide range of clinical experiences, ranging from years of traditional clinic practice to hospitalist care to performing peer quality review to ensure optimal patient care.

Activity History - Medically Reviewed on 20 October 2024 and last checked on 22 November 2024

Medically reviewed by
Dr. Jennie Stanford

Dr. Jennie Stanford

MD, FAAFP, DipABOM

Reviewer

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