Stages of Change During Recovery From Drug Abuse

Change should come from within, so said a famous saint. And the words of wisdom hold true in case of drug abuse for sure. For most people who have been unwillingly dragged to a rehab or a therapy center, the moment of epiphany comes only when they realize that they are the agents of change.

Unlike most physical ailments that could take anywhere between a week and a month to get completely healed, substance abuse, especially if one has been into it for years, can turn into a bane of one’s life. More importantly, while a detox could get the drugs off one’s system, it is harder to get him or her off drugs even after a detox therapy.

Estimates point out that nearly 50 to 90 percent of people suffer from a remission or relapse post detox and rehabilitation. The numbers are considerably higher for people who have only undergone a detox. This is because unlike most physical ailments, substance abuse is keyed in to the brain.

When one experiments with speedball, cocaine or lysergic acid diethylamide (LSD), there are imprints left in the key areas of the brain associated with memory and reward. As a result, an individual is reminded time and again of the euphoric delights of ecstasy. However, once the individual realizes that he or she is the agent of change, it is easier to curb negative behaviors and the chances of remission.

Six stages of change have been underlined by Prochaska and DiClemente in their transtheoretical model that explains the changes in the behavior of substance users pre- and post-therapy. The stages or phases of change that a user could go through are underlined below

    • Pre-contemplation: It is the state wherein the substance user is yet to be made aware of the existence of a problem. Most people who use drugs, especially teens, are not ready to acknowledge that they have a problem. They are consistently living in the denial mode. Similarly, adults who fail to seek treatment for their drug-induced behavior and justify their drug addiction as a means of getting over their existential woes are in the pre-contemplation phase.
    • Contemplation: This is the phase when the individual becomes aware of the pros and cons of his or her drug abusing behavior, such as homelessness and unemployment. However, he or she is still uncertain about investing time and energy in the treatment due to the unpredictable results. Therefore, the desire to change over a period of time comes only after weighing all factors.
    • Preparation: In the stage of preparation, users are mentally prepared for undergoing treatment and are ready to own the responsibility for the consequences. This stage opens the door to undertaking a life-changing decision by making all preparations. Now, the individual finally enters a program, whether it be a 12-step program or an inpatient program for detoxification, therapy and counseling.
    • Action: The action stage arises when the person knowingly practices behavior with or without the help of family and peers that is steered towards a life without substance abuse. In order to ensure mental, physical and emotional recovery, users engage with addiction recovery programs. By now, the patient is aware of the triggers responsible for motivating the practice of substance abuse. It is a test of his or her willpower. Apart from the regular visits to a counselor, one could fall back on the means that have been tried and tested, such as “journaling” or engaging in “strenuous exercises” to defeat the urge. Legendary rocker Eminem reportedly ran 17 miles each day to ensure that he stayed clean. For many, exercise is one of the best way for staying sober, as it gives a significant “endorphin” rush.
    • Maintenance: The longer one stays sober, the lesser are the chances of witnessing a relapse. One can remain sober by maintaining the lifestyle and behavioral changes, such as regular exercise, dietary changes, positive thinking, etc. And, as mentioned earlier, users are comparatively aware of the triggers and are in position to safeguard themselves from them by undertaking precautionary measures. An earlier study with regard to alcohol abuse found that the chances of a relapse decreases drastically after one manages to stay sober for five years. The studies on the remission in the case of alcoholism have suggested that after five years of abstinence, the risk of relapse is around 15 percent.
    • Termination: During the stage of termination, a user is extremely clear about his objectives and is ready to bear any kind of loss to stick to his or her commitment to sobriety. He/she considers it an impossible idea to return to his/her former lifestyle and behaviors.

Road to sobriety

Drug addiction can be treated with a great degree of efficacy, be it through inpatient therapy or a rather flexible plan for rehabilitation. Being aware of the problem is the first and foremost perquisite for treatment. Thereafter, one prepares for detox, wherein the accumulated toxins are removed gently. Interventions like experiential therapies could also be a part of the treatment. As this period is marked by the high chances of a relapse, guidance of an expert is a must. Avoiding the trigger patterns, reminding oneself to stay strong in the face of temptation and engaging in behaviors that preempt a relapse ensure a successful recovery.


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