The Stages of Recovery

The road to recovery from addiction to drugs or alcohol can be long and hard, even for a motivated person, but those who succeed will generally follow the same road.

No, I am not suggesting that those who are successful in recovery will necessarily enroll in the same recovery program, as there are several effective programs, some of which differ sharply from one another.

Whatever program they might use, if any, most people who are recovering from an addiction will go through the same behavioral stages:

  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Termination or Relapse

Some people are able to transition through the stages of recovery more easily than others. The reasons for this are too involved to spend much time with here. Certainly, motivation has a lot to do with it, but so does the level of addiction, the substance to which the person is addicted, and probably many other factors.

That doesn't matter, anyhow, because it's not a competition. While most people will pass through the same stages of recovery, sometimes more than once, the process is individual, and everyone is responsible for their own recovery.

The stages of recovery are based on research begun in the 1980s and published in 1994 by James Prochaska, John Norcross, and Carlo DiClemente. Their "transtheoretical model" is an approach to treatment and addiction recovery that suggests that effective behavioral change often comes in phases, as listed above.
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The initial model included five stages of addiction recovery. The sixth was added later, and it refers to either the ideal, which would be when the person in recovery can be said to have recovered, or to a relapse, which should not be considered a failure. Relapse is frequently a part of the recovery process.

Precisely where someone is in the stages of recovery is not something that the addicted person is always able to determine on his own. For one thing, addiction affects the way that the brain works.

A recovery coach can often identify the stage that an addicted person is in, and this can be an important component of the recovery process.

Pre-contemplation: The addicted person who is in the pre-contemplation stage of recovery is unlikely to come into a recovery center or join a recovery program unless this is the result of outward pressure, such as a court order. The person in this stage isn't seeking support yet, either because s/he is not yet aware of any deteriorating effects of use.

Contemplation: The contemplation stage is where the addicted person becomes aware that their substance use is causing some problems, either for them or for their family. At this stage, the person is thinking about finding a solution to the problem, although s/he may not have yet acknowledged that the problem is an addiction. Some addicted people spend years in this stage, especially if they aren't aware that help is available.

Preparation: At this stage of recovery, the addicted person is aware of the addiction, and is interested in making a change for the better. Unsuccessful attempts to stop drinking or using have probably already been made. Most often, this is the stage at which the person might decide to visit a recovery center, join a recovery program, or enter a treatment center. They are willing to do something about the problem, and may be thinking about tapering down on their use or to quit cold turkey.

Action: This is the stage at which real change occurs. At the action stage, the addicted person has made a decision to do the work necessary for recovery. This is also a difficult stage, because the hard work has begun. This is where the addicted person is taking real steps to set aside the habits and routines related to drinking or substance use. At this point, the person in recovery is making changes in his or her behavior, modifying responses, and learning the skills necessary to prevent relapse. The recovering person is in contact with a recovery center, attending recovery support meetings, or seeing a therapist at this stage. Typically, this stage will last for up to six months.

Maintenance: In the maintenance stage of recovery, the person in recovery is adapting to, and strengthening the changes that he or she has already made, with the aim of sustaining it, and learning to enjoy life without using. In the maintenance stage, new habits and rituals are replacing the old ones. Relapse is still a strong possibility, however. Someone with a history of long-term substance use disorder is likely to still feel the need to use, particularly when facing triggers, which may differ from one person to another. During this stage, a considerable amount of attention is given to avoiding relapses. In the latter part of this stage, the person in recovery may experience fewer urges to use, but it is not at all unusual for someone to remain in this stage indefinitely, and long-term maintenance is not a failure.

Termination: Although this may be controversial in some recovery programs, some people in recovery reach a point where they have recovered, and no longer feel the need to attend meetings or therapy sessions, although these support services are there in the event they are needed. In the termination phase, the person has fully adjusted to abstinence and is able to maintain control even in the face of triggers.

Relapse: Most people in recovery have to live with the possibility of relapse, which can take place at any time after a person in recovery has stopped using, even after many years or decades of abstinence. Nevertheless, some people achieve termination after one or more relapses. With hard work and the right treatment and support, it is possible for the addicted person to attain complete freedom from alcohol, drugs, or other forms of addiction.

Although the stages of recovery are relatively predictable, the way in which people go through these steps will differ greatly from one person to another. Some people will go through the stages of recovery in a fairly short period of time, while others may be stalled at one of the stages for several years.

In order to move from the action to the maintenance stage, some people will benefit from a sober living home or another form of residential treatment, such as a rehabilitation center. Others might be able to make the transition with the assistance of a support group, such as Alcoholic Anonymous or another recovery program.

Many people live their lives in recovery at the maintenance stage, while others may reach a point where they can maintain control without attending meetings. Success is success, whatever it takes.