The good news is that inpatient/residential substance abuse counseling is most definitely effective (even if the person didn’t want it to begin with). However, most people struggle during times of transition. Especially difficult transitions include stepping down from one level of care to another or going home from inpatient treatment.
The individual is often feeling so much better, and their family is so happy to see all the wonderful changes, that they underestimate the need for continuing care. I call this a case of “over confidence.” There is a saying in our field called “Pink Cloud Phase.” This refers to a newly sober person’s positive sense of wellbeing and general outlook. They feel so much better, they can’t even imagine going back to drinking or using. They truly like the way they feel now that they’re sober. Unfortunately, there is another recovery saying that goes along with the “pink could phase.” That saying is… “You better have a pink parachute because you are going to come down from that pink cloud.” Not very hopeful, I know!
It’s important to understand that there are phases to recovery just like there are phases to addiction/alcoholism. The first is called “Pink Cloud” and the second is called the “Reality Stage.” This “Reality Stage” is when all the newness of recovery starts to wear off. People stop talking about how proud of you they are, and regular life stressors start to come back. At this point, it’s not about getting sober, it’s about staying sober, which is actually the harder part.
For this reason, I strongly encourage people to create a very strong aftercare plan (even if you’re extremely confident that you will NEVER USE AGAIN!). If you are coming out of detox or residential treatment, you should be planning on being in a Partial Hospitalization (PHP) or an Intensive Outpatient Program (IOP). These are actually my favorite levels of care, because they offer lots of support as you learn to live your normal life and maintain your sobriety at the same time.
If you are coming out of a PHP or IOP then you should be planning on having weekly sessions with a counselor trained in substance abuse and co-occurring disorders. If you have been prescribed any medications, you will also need follow up appointments with your physician or psychiatrist.
I also recommend a recovery monitoring system as well. There are several ways to create a good recovery monitoring system for yourself. Basically this involves creating an accountability system for yourself.
At Hope For Families we often use Soberlink to monitor for alcohol relapses and drug patches to monitor for any kind of relapse on drugs. There are other systems available where the individual logs into a system or calls each day to see if they have been selected for a drug/alcohol screen. These are done randomly and are often used by health care professionals in recovery.
I also have many clients who use Antabuse. This is a medication that doesn’t mix with alcohol and will causes the individual to get sick if they drink while taking the medication.  Lots of people worry that having a recovery monitoring system or taking Antabuse is “cheating”. This couldn’t be further from the truth!!!  Making the choice to use these technologies to support your recovery is one of the smartest things you can do.  This doesn’t mean that you aren’t doing it for yourself, or that you are cheating. On the contrary, it means that you are REALLY REALLY SERIOUS about your recovery.
A good aftercare plan should include outpatient counseling, support group meetings, recovery management, and medication management (if taking prescription medications). Don’t make the mistake of letting your guard down when you are finishing a part of your treatment. This is actually when you are most vulnerable.
If you’re not convinced just yet… Think of it this way: You probably just spent a lot of time and money getting good substance abuse treatment for yourself or your family member. Slacking on aftercare treatment would be like buying a very expensive car and then electing not to do the regular oil changes!