Beyond 90 Days: How Aftercare is the Key to Curbing Chronic Relapse

Watching a loved one struggle with addiction can be challenging, and not knowing what to do to help them can bring up feelings of helplessness. Many with addiction may start the recovery process only to regress to the point of using drugs and alcohol again, which can lead to chronic relapse. In fact, studies show that between 40-60% of people in addiction treatment relapse at some point during their lifetime.

Successfully completing inpatient treatment is just the beginning of addiction recovery. There are many different aftercare programs and treatments available, and those in recovery need to find the aftercare options that work for them. Those who don’t complete aftercare have a lower chance of success for maintaining sobriety long term and have a higher chance of chronic relapse.

The good news: There are steps people can take to help reduce the chance of relapse, through a variety of aftercare options. Finding the right aftercare is likely going to take some trial and error, but with determination and a drive to stay sober, it is not impossible.

What is chronic relapse?

Chronic relapse occurs when an individual is constantly in and out of treatment and cannot maintain their sobriety for an extended period of time. Several factors can lead to chronic relapse, and those often vary from person to person.

Some of the most common factors that may lead to chronic relapse include:

• Undiagnosed mental health disorders
• Unaddressed trauma
• Lack of support
• Isolation and boredom
• A toxic environment

Recovering individuals who stick with aftercare treatments and programs are more likely to combat chronic relapse and lower the chance of reverting to their old ways.

How can aftercare combat chronic relapse?

Aftercare is the care, treatment, help, or supervision given to persons discharged from an institution. The most effective aftercare options will vary from person to person, depending on what helps them struggle the least with their triggers that may lead to relapse.

Aftercare is presented in a range of options, including but not limited to:

• Intensive outpatient programs (IOP): Treatment programs used to address addictions, depression, eating disorders, or other dependencies that do not require detoxification or round-the-clock supervision.
• Sober living homes: Facilities for individuals in recovery that encourage residents to develop healthy coping skills and habits for when they return home.
• Alcoholics Anonymous (AA): A program with the primary purpose of helping individuals with alcohol addiction achieve sobriety in the form of meetings, resources, and a 12-Step program.
• Individual therapy: A process through which clients work 1-on-1 with a trained mental health clinician in a safe, caring and confidential environment.

In offering aftercare treatments and programs, recovering individuals can follow directions in a safe and confined environment, which is something they likely did not have prior to treatment. Many in recovery become stressed by attempting to balance work, recovery, fun, and relationships. Aftercare not only helps maintain sobriety, but it prepares individuals to handle the stressors of life.

The most important thing to consider when it comes to aftercare options is that the best option for one recovering individual may not be the best option for the next. By listening to patients’ needs and determining what helps them the most, whether that is a general treatment or specific part of a program, addiction professionals can help find the most effective aftercare for each patient

90 Meetings in 90 Days: Building Structure to Combat Chronic Relapse

AA is an effective aftercare program for many in recovery, providing an outlet to share addiction and recovery stories with others who have been in similar situations. One of the first things the program suggests to newcomers is to attend 90 meetings in 90 days, commonly referred to as 90 in 90, to gain the highest level of effectiveness out of the program.

For those getting out of rehab, 90-in-90 can be one of the most effective aftercare options because it allows recovering persons to build a community of like-minded, sober people. By having a support system of people who are also recovering from addiction, those in recovery will be less likely to go back to the environment they were in prior, and their determination to maintain sobriety will strengthen.

The 90-in-90 method is effective for those who are trying to get sober without treatment as it can help them deal with post-acute withdrawal syndrome (PAWS), which occurs when a person's body is heavily saturated with alcohol or drugs. Although their body is not seeking drugs or alcohol, there is a possibility they may be in a mental fog of irritability for 60 or 90 days post-use. Going to meetings every day for 90 days can help manage this fog.

While some people do find lasting recovery through AA alone, many benefit greatly from a treatment program that offers resources that AA cannot provide, such as sober living houses which encourage healthy living practices prior to a return home, or individual therapy to help with potential underlying mental health issues.

The staff at Burning Tree Ranch, a long-term rehab program and addiction recovery center, incorporate aftercare plans from day one for each patient, with a goal of providing continued care by teaching patients structure, accountability, financial responsibility, balance, rebuilding relationships, and integrity with work.

Regardless of the aftercare treatment or program that works best for each person in recovery, it is important to understand that each patient will require personalized treatment to overcome their addiction and to curb chronic relapse.

Meghan Bohlman, LPC, LCDC, EMDR, is the clinical director for Burning Tree Ranch.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Addiction Professional, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.

Reference

Drugs, brains, and behavior: The science of addiction. National Institutes of Health. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery. Published July 10, 2020. Accessed January 27, 2022.