Most people do not realise that aftercare is a crucial part of the total treatment package. Addiction treatment has three phases.
Phase 1: Detox
The initial phase is a detox which is not always necessary and will usually depend on the type of drug and the duration of drug use. Detox is usually managed within a suitably registered and staffed medical facility. Although most addicts fear detox because they have usually tried and failed repeatedly but with appropriate medical support, it is the easiest part of the recovery journey.
Phase 2: Treatment Program
The second phase of treatment is the actual treatment program. This could be either in an ambulant or clinical setting, dependent on a number of variables that are specific to each client. There are various models of treatment and each facility will claim they have the silver bullet.
Phase 3: Aftercare
The third and most important, yet often neglected phase, is aftercare, also known as continuing care. The key difference is aftercare implies treatment is complete, while continuing care suggests ongoing treatment in a less intensive form.
Whichever term you prefer is not that important. What is important is that clients completing treatment participate in an ongoing program.
Deconstructing Delusional Beliefs in Treatment
An effective treatment program dismantles the delusional beliefs that keep clients trapped in ongoing substance use. In its place, the client should be provided with a user friendly and rational explanation of their substance use behaviour that informs abstinence as the most sensible route out of the problem. Harm reduction may be considered for some clients, depending on the facility’s understanding of addiction.
Irrespective of the treatment model, the real challenge arises when treatment finishes. A treatment program will only provide insight, understanding and introduce resources to sustain recovery. Simply put, treatment provides the tools to negotiate recovery but does not provide recovery.
Why Aftercare is Essential
So what are the benefits of a continuing care aftercare program and how long should someone participate actively in such a program? The first value and this is usually a subconscious benefit Is that aftercare serves as a regular reminder that one has a chronic problem that requires ongoing maintenance. Seeing treatment as an acute intervention, like fixing a broken bone would mean any aftercare is not required once the bone is healed. Understanding addiction as a chronic problem with the ever present possibility of relapse Implies ongoing maintenance and attention to the problem Is required if one is going to avoid regression culminating in relapse. In other words, the process of participating in an aftercare program is probably more important than the actual content of the program.
The second and obvious benefit of an aftercare program is that it can provide support during troubled times. While aftercare may not solve all life’s challenges, it reminds you that returning to substance use is unwise. Added benefits would be a sense of group support, that one is not alone during the dark hours as well as an opportunity for identification, meaning the option of input from other clients on how they have addressed some of the problems. So there is an obvious content benefit to be derived from an aftercare program. This speaks for itself.
Finally, an aftercare program provides a tangible forum where one can actually “do recovery”. In other words, an aftercare program transforms the notion of recovery into an activity. Instead of just thinking about recovery from addiction and hoping it will happen, one can actively participate in the process. The thought becomes a reality.
Types of Aftercare Programs
Aftercare programs vary in intensity ranging from professional support with a strong therapeutic and didactic element, to less structured weekly group or individual sessions to the mutual help fellowships like AA and NA. Which works best for you is your choice but make the choice. Recovery from addiction is an enormous challenge. Without an aftercare support program in place, it is usually a disaster
How long is the after care commitment? Regular attendance at an aftercare program should span at least a 24 month period. Thereafter one can make a sensible choice about what’s the next best thing to do. My experience is that after two years of sustained recovery, which might be punctuated by brief contained relapses, the return to active addiction diminishes dramatically after two years of recovery. So 24 months is the magic number.
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