Alcohol addiction, stages of recovery. Stages of Recovery Treating Long-Term Withdrawal Symptoms

Complete restoration of the personality of a drug addict or alcoholic cannot happen in one day. Exist certain stages of addiction treatment, which together lead to recovery in all areas: biological, social, mental and spiritual. Completing rehabilitation in our center allows the patient to completely change his thinking and get rid of the obsession with using mind-altering substances. Only complex treatment leads to this result.

5 stages of treatment for drug addiction and alcoholism

The first stage of recovery from addiction is detoxification of the body. It can be completed in our clinic under the round-the-clock supervision of certified specialists. The remaining stages of addiction treatment take place in the rehabilitation center. Each of them has its own therapeutic value and is aimed at achieving certain goals.

Entry and motivation

The purpose of this stage is to introduce the addict to the therapeutic community from the inside. It is very important for a drug addict or alcoholic to realize their external and internal losses that have arisen as a result of active use. Addiction has isolated most people, so they must once again learn to interact with others. The normal daily routine is gradually restored, appetite appears, and familiarization with the rules of stay occurs. The newcomer is supported by a more experienced resident (mentor), and the therapist highlights the main goals and objectives of the further treatment plan. Entry lasts about 2 weeks, depending on the mental state of the patient.

Basic stage

During this period of treatment, the patient lays a strong foundation for further sobriety. It lasts from 60 to 90 days. The person works with powerlessness over the addiction, learns to accept support from more experienced group members, practices the principles of honesty and openness to new things, and takes on a variety of roles in the therapeutic community. The goal of this phase of addiction treatment is to take responsibility for your recovery. Working through the first three steps of the 12-step program helps to cope with emotional instability.

Preparation period

Upon completion of the basic stage, the drug addict or alcoholic discovers the true problems that led him to use. A person begins to understand that life reconstruction is not a one-day process. At this time, it is extremely important not to interrupt treatment, since the burden of guilt and depression can provoke a breakdown. Preparing to leave the center is accompanied by intense family work. At this stage, the rehabilitator learns to show concern for others. He gets the right to be a mentor and shares his experience of being in rehabilitation. In 1-2 months the patient is ready to enter society.

Ambulatory treatment

A three-month stage during which addiction shows all its insidiousness. The first 30 days of being at home are associated with euphoria; during the 2nd month, in most cases, a crisis of denial and resistance occurs, and only in the 3rd month does the person’s condition stabilize. The stabilization process is underway on an outpatient basis: the patient lives in the center 3 days a week, continuing to receive support and new knowledge, and 4 days at home. During this period, the therapeutic community becomes a kind of family for the addict.

Post-rehabilitation stage

Taken together, all stages of addiction treatment take from 3.5 to 9 months. After undergoing such rehabilitation, a person is completely transformed and becomes a mature person who does not need drugs or alcohol. Call us at our contact numbers and we will tell you more about our therapeutic community and recovery program.

Although the nature of alcoholism has been well studied by specialists, it is difficult to treat for at least two reasons.

1. This is a disease in which there is no criticism of its presence or it is very superficial, despite the obvious harmful consequences. After all, craving for alcohol is one of the main signs of alcohol addiction. Therefore, very often patients do not want to be treated.
2. There is no universal “pill” for alcoholism, similar to, for example, insulin, which saves the lives of diabetics.

Think about the terrible numbers of official statistics on alcoholism in the Russian Federation:

• the presence of 5% of alcoholics and 10-11% of drunkards only according to state medicine, and how many people receive drug treatment in commercial medical centers on anonymous terms in order to avoid drug registration?
• How many people, in principle, do not seek such help for various reasons (fear of losing their job, ending up in a mental hospital, homeless people, and so on)?

In fact, the statistics of drunkenness and alcoholism are at least two times higher in sad terms. This means that every tenth resident of our country has serious problems with alcohol, and every fifth will develop them in the near future.

Alcoholism

This is a serious disease, and its treatment is difficult work. But recovery is possible and even inevitable if all instructions are followed and the need for treatment is realized by the patient himself and his immediate environment. True treatment for alcohol addiction is impossible without creating changes in the psychological, social and spiritual spheres of the patient, which requires the help of all his loved ones to create motivation and conscious activity, although medications for alcohol addiction also play an important role.

Picture of addiction

Most alcoholics behave in approximately the same way at the beginning:

At first they drink only on major holidays with friends, and allow themselves too much after persistent persuasion, then they become “friends” by the presence of a bottle and persuasion is no longer needed, after which they themselves are the initiators of various events, but certainly with drinking.

Reasons to drink

there are a wide variety of:

• salary,
• prepaid expense,
• end of the working week,
• chance meeting,
• business trip,
• the need to relax.

Such a person’s social circle includes new people and they, as a rule, like to drink; sober friends first fade into the background, and then are completely forgotten. Such a person no longer expects to communicate with friends without alcohol.

He may say that he drinks out of necessity, “it’s inconvenient to refuse,” “I need to treat him,” “tradition,” without noticing and not wanting to admit that there are more and more such reasons, unjustified reasons.

While waiting for a drink, a person’s behavior changes. A drinker or drinker noticeably perks up, becomes more cheerful, fusses more, trying to finish things off as quickly as possible in order to sit down at the table and drink quickly. There is only an approving attitude towards everything that is or may be connected with the consumption of alcoholic beverages.

Alcohol addiction

Such a person jealously protects his drinking buddies. He not only does not recognize them as alcoholics, but on the contrary finds many positive qualities in them. What prevents this is perceived from the negative side. Even a novice alcoholic hates talking to others about his regular abuse, defending his “rights” to drink in every possible way.

The feeling of coziness and comfort comes to him precisely in a state of intoxication. In a sober state, a drinker always lacks something, he is not at ease.

“Facts” about the benefits of alcohol are invented and presented as evidence: doctors recommend it in small doses, it relieves feelings of fatigue and emotional stress, increases performance, and so on. Such a person cannot be convinced that alcohol does more harm than good. There is a restructuring of life values ​​and moral principles. Everything that promotes drinking is assessed only positively, and everything that hinders it is assessed sharply negatively.

Work, family, children, family responsibilities interfere with drinking and become a burden. Each dose of alcoholic drinks affects and gives euphoria only for a certain period of time, so you have to drink more often.

For an alcoholic, the taste and even the type of alcohol are not important; the strength of the alcohol consumed is much more important. Even slight intoxication creates an irresistible attraction that an alcoholic, unlike a drunkard, cannot control.

This alcoholic craving usually arises only from a certain triggering intoxication, for which a certain dose of alcohol is needed, and everyone has their own portion. Almost every alcoholic assures that he “knows his limits,” but once he starts drinking, he can’t stop.

Symptoms

• Nausea and vomiting disappear when taking excessive doses of alcohol. The amount of alcohol consumed increases by 2-5 times. Drinking sessions are becoming more frequent. A hangover syndrome (alcohol withdrawal) occurs. It is different from a simple hangover after drinking too much alcohol. Weakness and malaise in this case are transformed into complete weakness.
• The symptom of shaking hands is replaced by tremors of the whole body. In alcoholics with a hangover, headaches, unlike a simple hangover, do not develop as often. It can occur due to head injuries or exacerbation of hypertension. Another symptom is prolonged insomnia, with characteristic manifestations in the form of nightmares and sweating.
• Hangover syndrome is dangerous because the consequences of chronic alcohol intoxication manifest themselves in damage to all organs and systems without exception. This is evidenced by exacerbations of existing diseases or even the emergence of new ones (pancreatitis, pneumonia and others).

Attention!!!

Severe alcohol withdrawal is often the “turning point” when an alcoholic can be persuaded to seek medical help for the first time. If a person feels comfortable, at best he will say that “we’ll go get checked someday” or refuse the conversation altogether.

The influence of addiction.

Let's try to see how much time a day it takes us to perform certain ordinary daily duties?

Let's say I draw this approximate picture:

• work (plus travel to work) - 10 hours,
• sleep - 8 hours, household chores (cooking, shopping, raising children) - 3 hours,
• leisure (TV, computer, reading) - 3 hours.

Total -24 hours. How does an alcoholic's time management change? Addiction “eats up” more and more time that a sober person devotes to doing important things. Behavior at home, work, and relationships with loved ones suffer. Even an alcoholic’s sleep may be longer, but it is physically incomplete and more reminiscent of anesthesia. That is, alcoholism impoverishes the usual role repertoire in all spheres of life, from the most subtle (leisure time and communication within the family), then work (where a person is increasingly either hungover or drunk) and ending with the most biological (sleep, sex , food).

That is, a person has a lot of sober and independent time. An alcoholic practically does not have it. Moreover, his roles are mixed - he allows himself to go to work drunk, and does housework as frivolously as if he were spending his leisure time. After all, a sober person at work doesn’t love, for example, his cat? And for a patient with alcoholism it turns out something like this. In the stage of mental dependence (the beginning of the formation of alcoholism), the patient does not yet develop work-related problems, since he can abstain from drinking at work. But he is always looking forward to the evening when no one will interfere with his drinking. But in the family, problems already arise when every evening you have to see a constantly drunk husband or wife. In patients suffering from alcoholism, the psyche gradually begins to change, everything goes backwards.

In the first place is alcohol and everything connected with it. For example, a patient works as expected all week and looks forward to the weekend. But not to go fishing or to the country, to spend more time with my wife and children, to do household chores, but to indulge in alcoholic libations! With the onset of the first day of the work week - Monday, an alcoholic in an absolutely broken state goes to work, already dreaming of an evening when he can get over his hangover, and on the weekend again “have a blast.” What does this mean? Yes, that only one “drip” is good for breaking a binge and relieving a hangover. But for real recovery from alcoholism, anti-alcohol treatment in the form of “filing” and “coding” is not enough. Due to the fact that the goals and objectives in the life of a patient with alcoholism are violated and disintegrate in all areas of spending time, a mandatory condition for recovery will be undergoing rehabilitation with psychotherapy and developing sober leisure skills. Preferably with the help of loved ones. Even if a person has completed a short course of withdrawal from hard drinking (for example, in a hospital) and received anti-alcohol treatment for a specified period, his condition is very unstable. Addiction penetrates deeply into the psyche and continues to lie dormant there. Part of the psyche becomes “empty” for a long time, “dead” - having not yet learned to live soberly. Therefore, many who have undergone such treatment for a long time complain of a feeling of melancholy, emptiness, and loss of meaning in life. If a person does not work on himself at this time, he feels that he has received only “hopeless sobriety,” and this is a sure path to a breakdown.

Even if a person tries to formally continue a sober life, he will perceive the usual home and work environment as a depressing routine and desire inside for his treatment to be “appreciated” by others as some kind of feat, and immediately. He can also perceive any approval at this time as recognition of his own “heroism”, consider that he has “already recovered” and try to “thank” himself a little with alcohol. And with established alcoholism, the transition to “cultural drinking” is impossible in principle, and everything usually ends in an even more severe binge and a feeling of greater emptiness after leaving it.

Attention!!!

The “point” of detoxification and prescription of anti-alcohol treatment is a convenient moment to obtain consent from the patient for the need for further psychotherapeutic and rehabilitation work, and regular visits to the doctor. Therefore, specialists in “helping professions” (psychotherapists and psychologists) begin to work with patients even during the “dig out” after heavy drinking. At the same time, you can use 100% the property of alcoholics, which is more developed in them than in mentally healthy people: due to the constant chaos of life, alcoholics have better short-term planning skills. But they require skillful external leadership.

Funnel of addiction.

This is a loop, a “vicious circle” of breakdowns and exits from binge drinking, with which the biography of most alcoholics is so rich. Why does this happen and what can be done about it? We understood from the previous chapters that alcohol affects all components of a person’s life without exception - physical, mental, social, spiritual. This already speaks to the need for comprehensive treatment, and not just a “drip” or “filing” as a way to recover from alcoholism.

The first use of alcohol by a person does not yet indicate the development of addiction, but shows us the person’s psychological readiness for regular alcohol consumption. Then comes the so-called “deaf period” with a gradual increase in quantity and dosage. This first forms a psychological dependence (craving), and then a physical one (hangover).

Problems appear (physical, psychological, social, spiritual) on an increasing scale. But, as we understand, there is also the opportunity to seek medical help. And here there is one important secret of recovery. According to experts, about 50% of patients agree to maintain sobriety after withdrawal from binge drinking. Of these, approximately 35% agree to undergo discharge or outpatient anti-alcohol treatment (various options for “filing” and “coding”) Of these people, only 1% agree with the need to work with people in “helping professions” and undergo it. Their remissions are the longest and most persistent compared to those who are going to rely on “willpower”, which is overestimated in our society, or hope for the miracle of “coding”.

For the last two categories, the picture is much more predictable. After some time, such a person tells himself and others that he is “already healthy” (and many people around him believe). Then he tries to allow himself to drink “culturally” or “under special circumstances” (which is basically impossible). He does not undergo psychotherapeutic work and evaluates many, in principle, ordinary life events as reasons worthy of drinking alcohol.

He has not been involved in rehabilitation and does not quite know how a sober life is led (he has very simplified ideas about it). He does not understand that life goals should not be replaced (even with the help of sobriety), but rather realized, and does not have a long-term plan for their implementation. As a result, it usually ends in a more severe breakdown, prolonged binge drinking and yet another expensive treatment.

Attention!!!

In order to treat alcoholism with the least losses, it is best to stop the “funnel of addiction” either at the “deaf stage” (domestic drunkenness without the development of addiction, measures are mainly educational), or at the stage of the first problems arising after the elimination of binge drinking (referring the person to psychotherapy and rehabilitation measures) .

Stages of recovery.

Recovery begins with the start of treatment. A few words about the treatment of alcoholism in a clinical setting. If the patient retains sufficient intellectual abilities, successful treatment of alcoholism is possible on an outpatient basis, without hospitalization. However, the risk of loss of mental potential and personality destruction due to alcoholism is very high, and if possible, it is always better to begin treatment in a specialized drug treatment hospital. After all, even among normal, healthy people, not everyone is able to find creativity in themselves and develop it. Family plays a huge role in recovery. Often the patient’s relatives are sure that only a doctor should be involved in treatment. However, as experience shows, family and friends surrounding an alcoholic are codependent people. These people should also actively

participate in the treatment process, read the necessary literature, communicate with psychologists, understand the symptoms of the disease and support the patient during treatment. Quite often it happens that even after successful completion of treatment, the family treats him as an alcoholic. It is important that changes on a subconscious level occur not only in the person who has given up, but also in his loved ones. Otherwise, old habits will contribute to a breakdown. It is necessary to understand that alcoholism is a chronic disease, therefore it will not completely disappear, but will exist either in the form of exacerbations or remissions. The attitude and willpower after successful treatment allow the patient to remain in a state of remission indefinitely.

Inpatient treatment for alcoholism has the following advantages:

• isolation of the patient from most external factors influencing the treatment process.
• depriving the patient of the opportunity to obtain alcohol.
• providing a full range of necessary medical care.
• continuous monitoring of the patient’s condition to make the necessary adjustments to treatment.

In an inpatient setting, it is possible to carry out all the necessary diagnostic procedures for a complete examination of the patient’s condition. Based on them, the most appropriate individual course of treatment is selected. The procedures for anti-alcohol therapy are fully controlled, and if necessary, the course of treatment is adjusted. Inpatient treatment is extremely necessary in severe cases. These include, for example, the presence of third or second degree alcoholism in the patient, and the identification of serious concomitant diseases.

Delirium tremens and other manifestations of conditions close to critical also require treatment in a hospital. It is inpatient treatment that can guarantee the safest passage of the most painful stage of giving up alcohol, while the period of overcoming the consequences of binge drinking (withdrawal) is reduced, and you can begin treatment measures faster. This enhances the effectiveness of the treatment course. Despite the achieved reduction in treatment time, the required stay in a hospital for alcohol dependent patients cannot be less than 5 - 7 days. Naturally, increasing the duration of inpatient treatment increases its effectiveness and has a beneficial effect on the patient’s condition. To overcome the consequences of heavy drinking, the necessary detoxification procedures are carried out.

Typically, for alcohol addicts in a hospital setting, 2-3 droppers are prescribed daily. At the first opportunity, a set of tests is carried out. First of all, they check the liver, kidneys, and cardiovascular system.

Blood tests are prescribed - general, biochemical, urinalysis. The patient and his relatives undergo the necessary additional consultations with

Doctors - specialists. A psychiatrist - narcologist, based on the obtained “picture” of addiction, prescribes and implements a treatment program together with the patient, involves a psychologist (psychotherapist) in the treatment process, issues instructions and recommendations for the patient’s loved ones. Specialists provide assistance to the patient in independently understanding the causes the occurrence of the disease, actively involve the addict in the processes of resolving these problems. For this purpose, individual and group motivational classes are conducted. This significantly increases the patient’s conscious ability to resist addiction, and the effectiveness of anti-alcohol therapy increases.

After completing a course of inpatient treatment, the patient is not left alone with his problems. The attending physician directs him to comply with the rehabilitation therapy program and draws up anti-relapse instructions for relatives to prevent a possible breakdown, and a mandatory consultation plan is drawn up.

Treatment of alcoholism in a hospital setting lays a solid foundation for successfully overcoming harmful cravings, and creates the prerequisites for the establishment of an unlimited period of sobriety. After undergoing inpatient treatment, the patient himself and his family and friends can receive the necessary consultations from a narcologist, psychotherapist, and, if necessary, receive help in a critical situation or psychological support.

Very often in our country, the measure of recovery from alcoholism is compliance with sobriety for a period of one year. And the most common way of prescribing anti-alcohol treatment is also for one year. Is it correct?

There are a lot of such patients; without conducting sobriety tests, you can with a high probability tell how the events of their life will develop further. At the beginning, such “simply coded” patients feel fear of alcohol. This atmosphere restrains the patient and his body gradually begins to recover. Patients feel much better. Numerous days of sobriety do not pass in vain - performance improves. The approval of others causes the return of abilities lost due to abuse.

Acquaintances, observing such a person sober, wanting to provide him with support, often praise him. The “former” alcoholic cannot help but like this and becomes his vital necessity. In reality, this achievement of his in the struggle for sobriety is nothing special; the immediate superior can only note that now the patient can “work like everyone else.” But especially at first, everyone claims that this is good, because before this was impossible. They nobly strive to demonstrate to the alcoholic that he can experience the life of a full-fledged person. This is undoubtedly correct. That is, in such a patient the fear of drinking alcohol is deeply hidden, it is turned into feelings of rejection, disgust, hatred, thanks to this the patient’s well-being and attitude towards others are at their best. This combination creates the illusion of “flight.” Those who have embarked on the path of sobriety often recall the feeling of joy of their first months without alcohol. At this time, “forgotten” mental sensations appeared again, headaches stopped bothering them, blood pressure normalized, and what they used to consider incurable disappeared.

And most importantly, control of sobriety allowed me to restore self-respect. Relationships in the family and at work have changed for the better. It’s strange and sad, but these positive aspects of the struggle for sobriety in life provoke breakdowns. The fact is that a person who has fallen into the insidious network of alcohol addiction develops an altered value system. Such a person will never be able to fully receive joy from what he has and has achieved - he will always be missing something in everything. Can you guess what? That's right, sensations that sobriety cannot give...

If a patient strives to learn the science of sobriety and works on himself, seeks help, searches for his spiritual path, participates in rehabilitation programs - he knows this, and with this knowledge he is armed and reliably protected from breakdowns. But, think about it, how many of the millions who come to a narcologist for one year of sobriety do this? The prices for alcoholism treatment procedures are not scary. They filed, coded, the relatives and the patient himself calmed down, a year will pass (or maybe even less) - the period of sobriety will end...

So what is next?

That is, in the treatment of alcoholism, at least 6 stages of recovery of varying quality can be distinguished:

1. “transition”, recognition of alcohol problems, willingness to seek medical help.
2. physical stabilization (from 3 to 10 days from the start of treatment).
3. early recovery (3-6 months of sobriety) - unstable stabilization.
4. average recovery (up to 18 months of abstinence) - restoration of mental and social functions impaired by alcohol.
5. late recovery (from 3 to 5 years of sobriety) - stable remission.
6. spiritual growth and purification (lifelong). That is, in the proper treatment of alcohol addiction, we slowly and gradually move from physical to mental, then to social and spiritual growth.

Attention!!!

Achieving any of these stages already contributes to a person’s recovery from alcohol addiction. Do not be overly afraid of relapses - this is the nature of all chronic diseases. A patient with alcoholism is not “crazy” from an everyday point of view, and with modern medical capabilities, even in difficult cases, achieving the highest stage of recovery is a completely realistic, although not the most quickly achievable goal.

Stages of recovery Stages of recovery used in a rehabilitation program. The separation of stages helps to improve the assessment of the patient’s condition by workers and by the patient himself in the recovery process. So that there is no confusion. The stages of rehabilitation may differ from the stage of recovery.

Stage 1 “Transition”.

First stage includes work on recognizing powerlessness over the problem of alcoholism and drug addiction, recognizing the loss of control over the problem.

Many, even admitting their powerlessness over the problem, try to control their use by reducing the dose, setting the time and timing of possible use. Even when entering rehabilitation, the addict is motivated not by complete recovery and stable remission, but by reducing the dose for further use.

This stage ends with the recognition of powerlessness over alcohol and drugs, and the lack of desire to control drug use. An addict who seeks help does not always have an idea why he lost control, why drug use cannot be stopped, and why all attempts to overcome cravings ended in failure. Our task is to help in realizing the problem and accepting it as something that has already happened. In AA communities, these symptoms are called fatigue fatigue. It is important for us that sobriety is not just a healing of wounds, but a way of life.

Stage 2. "Stabilization"

Stabilization. Healing from damage caused by use.

During the second stage - stabilization— we already understand that we have big problems with mind-altering substances, and that we need to completely stop using them, but we are not yet able to do this. During stabilization we are recovering physically from the effects of drug use. Withdrawal syndrome lasts individually for each person; for some it may take a month, and for others much longer. This period is the most difficult, as there is a struggle with oneself, how to resist the first glass or injection.

At this stage, after the body has recovered from withdrawal, addicts experience mental distress and emotional mood swings. This stage is one of the most important in the rehabilitation process, for which maximum resources are involved. Work with psychologists, group therapy, and occupational therapy.

Stage 3 Early recovery

The third stage is early recovery: this is a time of internal change. At this stage, we learn to live in society and feel comfortable abstaining from psychoactive substances. The craving for alcohol and drug use weakens, and we delve into the problem that led us to addiction and how it affected us.

We learn to overcome feelings of shame, guilt and remorse. The task of this stage learn to cope with your problems without turning to drugs. Early recovery ends when we are ready to begin applying what we have learned to improve other areas of our lives.

Stage 4. Average recovery

During mid-recovery, the fourth stage, we learn how to repair past damage and find balance in life.

We learn that full recovery means “applying these principles (the sober living skills we learned in early recovery) in all we do” (in the real world of everyday life). During the period of average recovery, repairing relationships with people becomes a priority. We overestimate our significant relationships, particularly with family and friends, as well as our careers. If we find ourselves unhappy in any of these areas, we accept it and plan to do something about it. In AA terms this is called “making amends.” We realize that we have harmed other people. We want to take responsibility and do everything we can to make amends. Average recovery ends when we achieve a balanced and stable life.

Stage 5 (not for everyone)

During the fifth stage - “late recovery”. Our task is to focus the children’s attention on overcoming obstacles to a new “sober” life, which were formed since childhood. Long before a person became addicted. Many drug addicts come from dysfunctional families. (Families where parents did not fulfill their parental responsibilities).

Due to the lack of proper upbringing, the child was not able to acquire the standard skills in order to be happy. The purpose of the center, if necessary, is to show a person about possible adult problems caused by growing up in a dysfunctional family, and to help to recover in this area, to resolve current problems, despite the obstacles caused by how the parents raised them.

Stage 6: Maintenance

The final part of recovery is “maintenance.” Those undergoing a course of recovery from drugs or alcohol receive the necessary information on how to move on with their lives, how to overcome obstacles and maintain sobriety. At the final part of the recovery process, the addict’s task is to put all the information received into practice. Constantly working on oneself and current problems makes it possible to become more resistant to the problems of alcoholism and drug addiction, and the ability to self-develop in society.

STAGES OF RECOVERY table

Stages of recovery	Main theme
Transition	Stop trying to control your alcohol or drug use.
Stabilization	Healing from damage caused by use
Early recovery	Internal changes (changes in thoughts, feelings and actions related to alcohol and drug use).
Average recovery	External changes (correction of lifestyle disorders caused by addiction and development of a balanced lifestyle).
Late recovery	Outgrowing the limitations of childhood
Maintenance	Living a balanced life and continuing to grow and develop

Additional: growing up in a dysfunctional family This is a small society in which strict parenting is encouraged, strict rules and destructive behavior are encouraged. In such a family there is no respect, no recognition of merit, no encouragement of the individual. The final part. Socialization. We hold various events that help you plunge into real life without drinking alcohol and drugs; Below is a video of an excerpt from the event at the New Hope Center now called “Helping Hand.”

Stages of recovery from addiction according to T. Gorski.
Gorsky, using his own experience of clinical observations and therapeutic work with patients addicted to drugs and alcohol, offers the following stages of recovery from addiction, based on an understanding of motivational readiness for change. This understanding allows for more careful and adequate planning of the therapist’s joint work with the addicted person.
1. Transitional stage begins when a person acquires negative experience of drug addiction and problems associated with drug use. At this time, the addicted person begins to unsuccessfully try to gain control over his use. Attempt
establishing control over use or change your
situation related to drug use in any way –
symptom of fundamental intrapsychic conflict of the addict
person associated with the problem of personal identity.
At this stage, the drug user loses the illusory belief that he is a normal person capable of controlling his behavior and drug consumption. This occurs as a result of the fact that all attempts to prove to oneself and others the ability to control drug use are unsuccessful. The main reason for the impossibility
stop using drugs in the transitory stage - then
the illusory belief that there is a path of controlled consumption.
2.Stabilization stage. During the stabilization stage, which occurs when the addicted person comes to understand the need to completely and permanently stop using the drug and stops it, the patient experiences withdrawal and is faced with a number of medical problems that he needs to solve. At the same time, he learns how to cope with the mental state associated with the need to immediately obtain a drug.
At the same time, the crisis of motivation to seek medical help and recognize oneself as sick stabilizes. The patient learns to identify and manage symptoms. Narcologists often underestimate the need to help the patient manage these processes, focusing solely on detoxification and drug therapy. The patient feels unable to cope with stress and symptoms of addiction after detoxification, which impedes the recovery process.
Severe stress, failure of psychological and social support and stress-coping behavior characteristic of drug addicts hinder the effectiveness of attempts to cope with symptoms. At this stage, a return to anesthesia in order to relieve distress. This period lasts from 6 weeks to 6 months. During this time, the patient needs to manage the symptoms, both with the help of corrective therapy and on his own. The main reason

impossibility of abstaining from drugs during the stabilization period –
weakness of skills to cope with stress and manage one's condition.
3.Early period of recovery. Early recovery marks the need to establish a drug-free lifestyle. People in recovery must learn to understand the nature of their addiction and the recovery process. During this period, it is necessary to stop all contact with people who use drugs and begin to build new socially supportive connections necessary for the long-term recovery process. This is usually a very difficult time for drug addicts who may never have had strong connections with people leading a drug-free life. In this regard, during this period, those recovering should be included in the therapeutic environment and psychotherapeutic programs of cognitive development and change, as well as emotional and behavioral training. This period lasts from 1 to 2 years. Basic
the cause of a breakdown during the period of early recovery
is a poverty of social and psychological coping skills
life stresses and socially supportive environment, skills
recovery (overcoming the disease) necessary to build
drug-free lifestyle.
4. Late period of recovery. Throughout late recovery, the individual continues to make changes toward developing a drug-free, effective lifestyle. In traditional psychotherapy, this process is referred to as self-actualization. This is a process of reassessment of values ​​and goals that arise in connection with adaptation to the social environment (family, peer environment, cultural, professional life). During this period, we have to reconsider many values ​​and goals and form new ones.
For many recovering patients, these processes become most relevant in the 3-5th year of recovery. In drug addicts, experiencing this type of crisis may be the reason for a return to drug use. The process of self-affirmation and self-determination can be very painful, since it did not occur in a timely manner in the traditional way and its logical age dynamics are grossly disrupted.
Rather, on the contrary, drug-dependent individuals have developed self-destructive behavior, originating from psychological processes that occurred in childhood, such as physical, sexual or psychological abuse, emotional deprivation or other psychological and social barriers that existed on the path of personal growth. The main cause of failure in the late period
recovery is the lack of skills to cope with stress,
having deep roots in unresolved problems of childhood and
adolescence, in a problem-avoidant behavioral style formed
as a result.

5.Supportive
stage.
The maintenance stage of the recovery process represents lifelong personal growth and development. It includes overcoming the challenges of growing up late and managing everyday life problems. The use of any psychoactive substance, be it a drug or alcohol, resumes the pathophysiological, pathopsychological and social progression of the disease. The main reason for failure during maintenance
stage of recovery is to stop performing maintenance
programs and meeting against this background with big life changes.
6. Point in recovery. Although some patients successfully overcome all stages of recovery without complications, most people addicted to the drug still face serious problems along the way. A typical mistake of these people is
“setting a point” in the recovery process, when the patient can decide that he is already healthy. Typically, this step is associated with poor development of problem-overcoming behavior and low self-competence, which leads to termination of the recovery program. Risk factors along this path include unexpected encounters with physical, psychological and social problems, a reduced development of the strategy for seeking social support and an underdeveloped social support network. Without continuous development of specific relapse prevention skills, problem identification work, and self-identification (the basis of motivational work), stress pressure begins to increase.
The result of ineffectiveness in overcoming the multicomponent and chronic stress of addiction is a breakdown.
Conclusion.
Motivational counseling is a method of work that can only be used if its principles and essence are understood.
An important role is played by understanding counseling as a process.
Of course, technical aspects should also be differentiated. The way the therapist learns to use the method is mainly aimed at understanding the relationship between the patient and the therapist and the ability to create a working atmosphere. Hopelessness, depression and lack of prospects for the future are strong incentives to continue using substances. The feeling of social insecurity experienced by patients is difficult to change.
Therefore, many patients suffering from severe addiction have little faith in therapy. For the therapist, the patient's addiction is, on the one hand, a trap, and on the other, an interesting task, which consists in changing to a certain extent the patient's own responsibility and determination in the process in which they enter together.
Many patients interrupt therapy several times during the difficult process of change. Maintaining faith in the possibility of change, and especially maintaining faith in people, supports therapists and inspires them to find possible solutions to their patients' problems.

If the work of a person providing assistance to substance users is influenced by public opinion, we get a situation that can best be described as second-class assistance to second-class citizens.
Motivational counseling helps therapists avoid treating their patients in this way. Real interest in addiction and the person suffering from or at risk of addiction, and appropriate participation, gives addicted people a chance to live a normal life.
The support of colleagues in this type of work is irreplaceable. Supervision and team relationships are tools for maintaining one's own motivation and awareness of one's own attitude and capabilities.
Literature:
1. Austie: Motivational Interviewina. A Guide to Motivational Counseling. Council of Europe, Pompidou Group.
2. Gerdner A. Lectures. 2000 – 2001
3. Prochaska J., DiClemente C., & Norcross J. In search of how people change:
Applications to addictive behaviors. American Psychologist 47:1102 – 1114,
1992b.
4. Miller W. R. Motivation Enhancement Therapy: Description of Counseling
Approach. Approaches to Drug Abuse Counseling. NIDA. Printed July
2000. P. 99 – 106.
5. Rollnick S., Mason P., Putler C. Health Behavior Change. A Guide for practitioners; Churchill Livingston, 1999, 225 p.
6. Tucker J. et al. Environmental Influences on Relapse in Substance Use
Disorders. The International Journal of the Addictions, 25 (7A & 8A) 1017 –
1050, 1990-1991.
7. Wolff K. & Winstok A. Practical Guidelines For Narcology Clinics in the
Russian Federation. December 2000 – March 2001, 59 p.
Information about authors:
Yaltonsky Vladimir Mikhailovich. [email protected]
Doctor of Medical Sciences, Professor of the Department of Clinical Psychology
Moscow State Medical and Dental University,
Leading Researcher, Prevention Department, National Science Center
Narcology of Roszdrav.
Sirota Natalya Alexandrovna
Professor, Doctor of Medical Sciences, Dean of the Faculty and Head of the Department
clinical psychology of the Moscow State Medical -
Dental University, head of the prevention department
National Scientific Center for Narcology of Roszdrav. [email protected]

PATH TO RECOVERY Action plan to prevent relapse. Terence T. Gorski

Successive stages of recovery.

The developmental model of recovery (for brevity I will call it RMV) is based on the following beliefs:

Recovery is a long-term process and is not easy.

Recovery requires complete abstinence from alcohol and other drugs, as well as active efforts toward personal growth.

There are fundamental principles that govern this process.

The better we understand these principles, the easier it will be for us to recover.

Understanding alone will not lead to recovery. New understanding must express itself in action.

The activities necessary to achieve full recovery can be clearly and accurately described as recovery goals.

It is normal and natural to occasionally get stuck on the road to recovery. Whether you get stuck or not doesn't count as success or failure, but how you deal with difficult parts does.

To learn what recovery is, it is useful to divide the process into stages. We will be exploring six different stages of recovery. I will call them (1) transition, (2) stabilization, (3) early recovery, (4) middle recovery, (5) late recovery, and (6) maintenance.

In the first stage of recovery—transition—we admit that we have problems with chemicals, but we think we can solve them if we learn to control our use. This stage ends when we accept that we have lost control (that we are “powerless” over alcohol and drugs) and that we need abstinence in order to regain control of our lives. We don't yet know why we lost control, or how to stay sober; we just know we can't continue to be who we were. In AA they call it “being tired of being tired.”

During the next stage - stabilization - we already know that we have serious problems with alcohol and drugs, and that we need to completely stop using them, but we cannot do this yet. During this period, we are recovering from acute withdrawal symptoms (the stage of shaking and confusion we experience while our bodies are cleansing). And we are recovering from delayed, or subacute, alcohol or drug withdrawal (a period lasting 6 to 18 months when we feel like we are in a mental fog). At this stage, we learn how to “hold off a single drink (or a single dose of drug) day after day.”

The third stage - early recovery - is a time of internal changes. Here we learn to feel comfortable with abstinence. The physical craving to use substances diminishes, and we learn more about our addiction and how it affected us. We also learn to overcome feelings of shame, guilt and remorse. We become able to cope with our problems without resorting to substances. Early recovery ends when we are ready to begin applying what we have learned to improve other areas of our lives.

During mid-recovery, the fourth stage, we learn how to repair past damage and find balance in life. We learn that full recovery means “applying these principles (the sober living skills we learned in early recovery) in all we do” (in the real world of everyday life). During the period of average recovery, repairing relationships with people becomes a priority. We overestimate our significant relationships, particularly with family and friends, as well as our careers. If we find ourselves unhappy in any of these areas, we accept it and plan to do something about it. In AA terms this is called “making amends.” We realize that we have harmed other people. We want to take responsibility and do everything we can to make amends. Average recovery ends when we achieve a balanced and stable life.

During stage five—late recovery—we focus on overcoming barriers to healthy living that were formed when we were children, before our addiction developed. Many chemically dependent people come from dysfunctional families. Because our parents couldn't do the best job of raising us, we weren't able to learn the skills we needed to be happy. Late recovery ends when we complete three things:

first, we recognize our adult problems as being caused by growing up in a dysfunctional family;

second, we learn how to recover from the inescapable pain caused by growing up in it.

Finally, we learn how to resolve current problems despite the obstacles caused by the way we were raised.

The sixth and final stage is maintenance. During this time, chemically dependent people learn that their illness is present and not in the past. (Pun: alcohol-ism, not alcohol-wasm). We learn that we need constant growth and development of our personality. We recognize that we will never be able to use alcohol and drugs without problems, and that we must pursue a daily program of recovery to ensure that addictive thinking does not return. We live our lives to enjoy our journey through life.

Recovery stage	Main theme
Transition	Stop trying to control your alcohol or drug use.
Stabilization	Healing from damage caused by use
Early recovery	Internal changes (changes in thoughts, feelings and actions related to alcohol and drug use).
Average recovery	External changes (correction of lifestyle disorders caused by addiction and development of a balanced lifestyle).
Late recovery	Outgrowing the limitations of childhood
Maintenance	Balanced life and continuation
	growth and development

Many chemically dependent people ask the question: “What actions of mine can lead to a breakdown?” The answer is simple. You don't need to do anything. Stop using alcohol and other drugs, but continue to live the life you have always lived. Your illness will do the rest. It will trigger a series of automatic (or habitual) responses to life, and this life will lead to such pain and discomfort that returning to use seems like a good option.

Recovery means change. In order to change, we must have goals. It is also useful to have an action plan or step-by-step guide that will show us what to do and how to do it. This book is designed to be such a guide.

Each of the following chapters is a detailed description of one of the stages of recovery. Do not despair. Remember that recovery is a growth process that takes time. It can take anywhere from three to fifteen years to go from stabilized to maintained, depending on how sick you were when you began recovery, how persistently and consistently you worked through your recovery plan, and the type of care you received. from others.

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author Terence T. Gorski

PATH TO RECOVERY Action plan to prevent relapse. Terence T.

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