What To Do After Rehab

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What To Do After Rehab

By Joshua Laurent 10/08/15

10 Ways to keep recovery alive when you step back into the real world.

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What To Do After Rehab
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You hated inpatient rehab at first. You bucked the system and were defiant. The people were nothing like you and you weren’t going to make friends. Then something changed. You opened your mind to the ideas the professional staff were sharing. You recognized your life could be better than what it had been. It turned out, you really had an addiction, as did all of the “different” people around you. Friendship and bonds were formed, healing began. While you missed your real life, you were adapting to life at an inpatient facility. Just as you started to think, “I’m going to make it, I’m going to be OK” they pulled the rug out from under you and sent you home.

Like a castaway sent adrift in a life raft with only the barest of essentials, you return to an environment that isn’t very different from when you left, but you recognize just how different you now are, and how easy it would be to return to your addictive behavior. You want to stay healthy, you want to maintain the sobriety and human connection you felt at rehab, but how do you do that when you’re just returning to the same life you had?

It can be challenging, but it can also be done. Whether you’ve just left a rehab facility, are preparing to enter one or have a loved one somewhere in the process, here’s a list of 10 things that can better an addict’s odds for a successful recovery.

Get a treatment plan and follow it

Just about every inpatient rehabilitation facility is going to put together a discharge plan for patients upon exit from their care. The details can vary extremely, often dependent upon if the facility has a dedicated discharge coordinator, but even without that full-time employee a basic plan can be improved if the patient expresses interest in their post-rehab options. Statistics sadly show that only a minority of patients are successful with their recovery. A patient showing they plan to be in that minority will get more individualized attention to a treatment plan, which can include lists of healthcare providers in the patient’s hometown, along with a list of 12-step meetings and additional recovery literature to review once home.

Evaluate the living situation

Upon returning from rehab as a “new person” it can be jarring to see just how much the people and environment around a patient has not changed during their time away. Is their residence located in a part of town conducive to their addiction? Are they living with people who use? Does the recovering addict have the means to remove themselves from the situation or are they strong enough to stay sober in it? Most inpatient facilities promote a transitionary living situation following rehab to address many of these questions that go unanswered during treatment. An unhealthy environment for someone not strong enough to remain committed to recovery is the surest way to relapse.

Find sober friends

Prior to entering treatment, the addict likely either holed up in a room lost in their addiction or they only socialized with fellow addicts. Both behaviors, post-rehab, are part of a recipe for disaster. The fact is, there are far more non-addicts (called “normies” in most addiction circles) than addicts in this world. Getting to know them, getting to see the choices they make and experiencing life in their world are all key to understanding what a sober existence can look like. 

Find a support group

While the obvious solution is to find a 12-step group that deals with the addict’s individual drug-of-choice, this can also mean simply finding a network of people who can be there when the addict begins to stumble. They are a shoulder to cry on and a face to yell at. It can be existing family and friends, or people from church or even co-workers. The key is to find others, whether they be former addicts or not, who can be there and lend a hand when the possibility of relapse becomes a slippery slope. 

Get a schedule

Most rehabilitation facilities have schedules that must be followed from the moment the patient wakes up in the morning until their head hits the pillow at night, even if it’s as vague as two-hour blocks of “free time.” Weeks of this regular schedule are a big part in stabilizing the addict’s life, and unless they are entering the military upon discharge from rehab, such a structured life is suddenly gone with the return home. Simple things such as grooming/hygiene, meals and bedtime can all be worked into a schedule. If there wasn’t one unaccounted for minute in a facility, there shouldn’t be one upon leaving, even if “watching TV” or “taking a nap” are some of the scheduled activities.

Focus on mental health

While the exact percentage varies among different professionals and their theory-of-the-day, almost all will agree that a majority of people who become addicts have some kind of mental health issue driving them to use. Be it repressed childhood memories or pre-existing mental issues (e.g., bipolar disorder), the addiction is often seen as a symptom of a bigger problem. Address the bigger problem and the symptom, ideally, should be easier to cope with. Working one-on-one with a professional therapist can help uncover not just why an addict started to use, but how to address deeper issues behind the triggering cause. 

Exercise

This is the easiest to start, yet hardest to maintain, piece of the solution on this list. An addict’s body chemistry physically alters through years of abuse, yet simple exercise can release endorphins that allow for a clearing mentally and a slow rehabilitation physically, of one’s body. This goes hand-in-hand with focusing on mental health. Healing the body is just as important as healing the mind. Inpatient facilities usually require residents to take part in some kind of physical activity specifically for this reason. Taking a 20-minute walk every day will do wonders to clear the mind, boost the heart rate and promote overall health. The trick is to make sure that on a rainy day, the walk still gets done somewhere indoors, maybe a mall. It’s not always going to be fun, but it is a vital part of recovery, and it must be adhered to regularly.

Volunteer/help someone else

There’s a bit of a mixed message that comes with recovery philosophy. It says that the user was selfish in their addiction and they need to be selfish to ensure recovery. While it makes sense that only the addict can make the proper choices to stay clean, that selfishness can only extend so far. Giving back to the world, understanding that there is more in the world than just themselves and their problems, along with being part of a community are all crucial for the health of the addict. Nowhere can this be achieved easier than volunteering, or simply helping someone else. Most, if not all, 12-step programs urge “service work” to their members. There are few healthier activities than helping others.

Be wary of rehab friendships

This is one tip often not addressed, but is important to recovery. For many, inpatient rehab is a life-saver and the process of healing around similar people is a powerful event unlike anything most people will ever experience. It’s been compared to being in a foxhole more than one time and in the moment, there are no people more important than those around you at rehab, some of whom seem like they will be great friends for life. Then the real world beckons and it turns out that the only thing you had in common with the 22-year-old college dropout from Alabama or the 56-year-old doctor from Seattle was the rehab experience.

Some relationships can be kept, and some can remain healthy, but the tendency to want to return to that safe cocoon of healing with the same people can do more to speed up a relapse than prevent it. Holding on to the tools you learned at rehab is crucial, holding on to that moment in time and believing that success will only come with that peer group can be damaging, especially when friends begin to relapse.

Stay alert to signs of relapse

Nobody just relapses. A series of events have to occur where the addict finally reaches a decision, in a moment of weakness, that their drug-of-choice seems like the only answer to their woes. Some call this series of events the “pre-lapse” because it is what happens before the addict falls off the wagon and uses again. Stress and bad decision-making is the simple recipe for relapse. How much stress can one handle before snapping? How many bad decisions have to be made before relapse arrives? These answers are different for everyone, so it’s key to understanding individual conditions and respond accordingly. Has the exercising ceased? Are the 12-step meetings a thing of the past? Are fantasies about using becoming more frequent? Have bad influences returned?

Understanding the mindset prior to a relapse is the most important thing to stopping the relapse in the first place. Once it’s identified, an emergency escape plan is needed to avoid relapse. Maybe it’s going to a movie. Maybe it’s a brisk walk with a friend, or finding a meeting to attend. A plan needs to exist when the recognition of a possible relapse rears its ugly head.

Joshua Laurent is the pseudonym of a New England-based writer who has spent nearly 20 years as a journalist for a variety of magazines and newspapers.

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