The Five Stages of Rehab

Making the decision to enter rehab is not an easy one. It takes a lot of strength to realize help is needed to end the cycle of addiction. The journey through rehab takes you to four different stages of recovery. By progressing through each stage of rehab, you learn how to live life clean and sober.

The National Institute on Drug Abuse developed the four stages of rehab. The stages were created for the organization’s “An Individual Drug Counseling Approach to Treat Cocaine Addiction” material to help healthcare providers deliver high-quality counselling. The four stages of rehab include: treatment initiation, early abstinence, maintaining abstinence, and advanced recovery¹1.J. Soames, 5 Stages of Treatment – Substance Abuse Treatment: Group Therapy – NCBI Bookshelf, 5 Stages of Treatment – Substance Abuse Treatment: Group Therapy – NCBI Bookshelf.; Retrieved September 29, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK64208/.

The 5 Stages of Rehab are:

Treatment initiation

The first stage of recovery is initiated when you seek help from drug and alcohol professionals. In the beginning, you will most likely want to give up on recovery and return to drugs and/or alcohol. You may also believe your drug and/or alcohol problems are under control and not a detriment to yourself and others. Denial is common and a difficult issue to overcome in the early days of recovery. Relapse is at its most common and deadly during this initial 28 day period and all too often individuals will may find themselves kicked out of rehab during these early tumultuous days.

Early Abstinence

The second stage of rehab begins once you make the conscious decision to continue recovery from substance misuse. Early abstinence is a difficult stage as you go through different phases within the stage. You may experience symptoms of withdrawal, mental and physical cravings, triggers that may tempt you to relapse, and psychological dependence on drugs and alcohol. A trained addiction specialist will teach you to cope with these issues. You will gain tools on how to live a sober lifestyle through Psychoeducation.

Continuing Abstinence

The early abstinence stage lasts for around 90 days. Once you complete this time period of sobriety, you will enter the continuing abstinence stage. Individuals in residential treatment may move into the outpatient portion of the program once entering the continuing abstinence stage. A main focus of the state is to avoid relapsing.

A trained counselor will help teach you how to prevent relapsing. You will also learn ways to use the tools learned in previous stages to cope with other areas of life and remain sober. New coping skills will be learned allowing you to build a clean lifestyle, healthy relationships, and developing other good habits. The continuing abstinence rehab stage starts around three months into the recovery program. It takes about five years of sobriety before moving onto the final stage.

Advanced Recovery

Recovery from drug and alcohol addiction does not occur overnight. It takes five years of abstinence for an individual to move into the advanced recovery stage. All of the tools, knowledge, and skills you learned in rehab and counselling can now be used to create a long-lasting lifestyle.

You will be able to remain sober and possess the skills to be a healthier person. In addition, the tools and knowledge gained from the earlier stages of rehab will help you to be a better parent, person, and/or spouse. Recovering from drug and alcohol addiction is more than just remaining sober.

Bridge to Normal Living

In late‐stage treatment, former addicts begin to learn to engage in life. Often this is referred to as crossing the bridge to normal living. As individuals begin to manage their emotional states and cognitive processes more effectively, they can face situations that involve conflict or cause emotion. Many individuals find a period in Secondary Rehab or a Sober Living²2.A. B. CEO Worlds Best Rehab Magazine, What Happens After Rehab | Making the Bridge to Normal Living, Worlds Best Rehab.; Retrieved September 29, 2022, from https://www.worldsbest.rehab/what-happens-after-rehab/ environment helps greatly with making this transition.

Problems with the Stages of Rehab

There are no formal diagnostic neurobiological indicators that can diagnose levels of substance misuse or accurately gauge severity of addiction and any hypothesized neurobiological changes that may occur in individuals cannot be used to delineate the stages of addiction hypothesized by the researchers. Clinicans often suffer from a cognitive bias referred to as “the clinician’s illusion” where clinicians who most often see extreme cases assume generalizations based on these extreme aspects of behavior and apply them to all cases³3.S. B. Patten, The “Clinician’s illusion” and the epidemiology, diagnosis and treatment of depressive disorders – BMC Psychiatry, BioMed Central.; Retrieved September 29, 2022, from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1969-3.

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