Models of Phases of Recovery From Substance Abuse

It's helpful to for healthcare professionals and patients to think of addiction recovery in phases. Real life recovery does not necessarily follow these models exactly. But thinking about them within specific models with graduated or sequential stages gives us a conceptual framework with which to think about addiction recovery. Some models may be more accurate that others. The important part is how well the model helps patients and healthcare providers cope with addiction recovery -- usually by helping us simplify our essential understanding of addiction.

Three Stages

• As with the narrative of many events, addiction recovery can be broken into early, middle and late or beginning, middle and end phases. Addiction can be organized into a number of three-stage models. In one three-stage model, the early stage is cessation: stopping the abuse of the substance. The middle stage is a stabilization. Coping with the absence of the drug is done, for the most part. The focus turns to creating good health and putting the active addiction behind us. Late recovery involves an ongoing pursuit of understanding and healing the initial causes of addiction from physical diseases to early childhood trauma.

Four Stages: Road to Recovery

• Another iteration of the previous model has an additional step at the beginning. As the saying goes, "Admitting you have a problem is the first step." It's a critical step, too. Addiction generally results in a number of problems. If you are trying solve problems that are the fallout of substance abuse, but assign the source of the problems to something else, it doesn't address the true problem. It only fixes symptoms of the problem. Once substance abuse has been identified -- if it is a problem -- you can move on to early recovery as describe in three stage model.

Five Stages

• Other models begin with admission. A five-stage models proceeds as admission, compliance, defiance, acceptance, surrender. Compliance is complying to abstinence. Defiance is very similar to denial. It is a partial denial about the nature of addiction. It is a mental and emotional resistance to abstinence and the implications of addiction. Acceptance is coming to grips with your addiction and abstinence. Surrender can be thought of as a permanent acceptance of the conditions of addiction and recovery.

Twelve Step

• The 12-step processes used in Alcoholics Anonymous is perhaps the best-known recovery model. It has been adapted and applied to other addictions and compulsions. The 12-step program begins with admission of a problem. It is a faith-based program. It roughly follows the four-step narrative. The AA 12-step program focuses on relinquishing power to god. In middle recovery, it focuses on spiritual growth and making amends for damage caused by the addiction. In late recovery, it focuses on reaching out to other alcoholics.