Aftercare Programs for Substance Use Disorders
If you or a loved one has recently been in addiction treatment, you may be wondering how to manage your recovery and stay engaged in the process. Aftercare programs can be useful in providing structure after completing formal addiction treatment, which may be helpful in maintaining long-term abstinence.
In this article, you’ll learn more about what aftercare programs are, the benefits of addiction aftercare, and how to work with your treatment team to create a continuing care plan.
What Is a Continuing Care or Aftercare Program?
“Aftercare,” which is sometimes referred to as “continuing care” is a type of structured care to help a person continue the progress they made after completing a formal addiction treatment program. This may include inpatient or outpatient treatment programs at differing levels of care.2 Addiction aftercare programs may also be considered a form of “step-down” care following a more intensive treatment program like residential treatment.2, 3
Many treatment facilities will offer aftercare planning to help a person transition into the next phase of their recovery. You and your treatment team will work together to create a plan that meets your unique needs. Aftercare programs may include:
- Mutual support groups like 12-Step groups or SMART Recovery.
- Step-down treatment (i.e. going from intensive outpatient treatment to outpatient care).
- Recovery housing.
The goals of aftercare programs can vary from person to person, but generally include:1
- Relapse prevention.
- Continuing to engage in the recovery process.
- Developing new, healthy behavior patterns.
- Connecting people with uplifting and accountable support systems.
- Assistance with challenges related to recovery like employment, housing, and relationships.
Research on aftercare programs is ongoing, but generally shows that longer durations of continuing care may lead to more positive outcomes in the recovery process.1
Benefits of Addiction Aftercare Programs
The most beneficial addiction treatment programs are those that treat the whole person and provide individualized care.18 While there is no set length of time for formal treatment or aftercare programs, research shows that longer durations of treatment may produce more positive outcomes.18
A person’s continuing care plan may need to be adjusted over time as their progress is evaluated by treatment professionals. However, some of the potential benefits of addiction aftercare programs include:
- Relapse prevention in which a person will build on the skills learned in formal treatment programs to help create relapse prevention strategies in social, professional, and home environments.2, 7
- Strategies like attending mutual support groups to help you stay connected to peer supports, your case manager, sponsor, or other positive influences to help you stay engaged in the recovery process.4, 5, 6
- Support for people with co-occurring mental health disorders who may need medication or additional monitoring to help them remain stable during the recovery process.2
- Setting goals for recovery and in personal life and/or relationships.1
- Increased self-confidence and skills related to recovery and/or professional life.1
Do I Need Continuing Care?
If you have participated in any form of addiction treatment, creating a continuing care plan may help you stay more connected and engaged in the recovery process. A continuing care plan can also help monitor changes in your progress so that you and your treatment team can adjust your plan as needed.1, 8, 18
Creating an aftercare plan can also help ensure that there is no lapse in treatment. Discontinuing care or choosing not to create an aftercare plan may leave you at higher risk for relapse or feeling a lack of support.
How to Make an Addiction Aftercare Plan
Toward the end of formal treatment, you may start to focus on creating an aftercare plan with your treatment team including therapists, a psychiatrist, case manager, medical staff, and other members of your treatment team.
An aftercare plan may consider:1
- Your physical and mental health needs like continuing to see medical and psychiatric professionals.
- Co-occurring disorders.
- Need for medication for mental health or chronic physical conditions.
- Substances misused and severity of addiction, which may lead to a more structured or intensive aftercare plan.
- Personal preferences like whether you prefer group settings or not.
- Social support at home, work, and school.
- Your work, school, and personal schedule so that you can attend necessary meetings, appointments, and evaluations.
- Employment needs.
- Housing needs.
- Legal issues related to substance misuse.
Addressing all your needs beyond those in recovery may help you avoid situations that could leave you more vulnerable to misusing substances again.
Types of Continuing Care
Continuing care can take several forms depending on what you and your treatment team feel is appropriate. If you are stepping down from a 28-or 30-day, 60-day or 90-day inpatient program, you may have a more intensive level of continuing care that involves some form of outpatient treatment where you are still regularly monitored, like intensive outpatient treatment (IOP).
If you are stepping down from outpatient treatment, your aftercare plan may be less intensive and not require regular attendance in outpatient treatment programs. What’s most important is that your aftercare plan be continually reassessed to meet your changing needs.
Mutual Support Groups
Many treatment programs encourage participation in mutual support groups as part of your aftercare planning. Mutual support groups are a collective of people who understand the struggle of addiction and share in confidential group settings to help maintain abstinence and sobriety.2
Some of the most common mutual support groups include Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), which are based on the 12-steps and have a spiritual foundation. These groups are self-governing and lead by others in recovery.11 There are also non-spiritual groups like SMART Recovery, which follow a different structure, yet still aim to help people maintain abstinence and live a healthy lifestyle.11
Mutual support groups may be led by trained professionals to help people connect with and relate to others in recovery and understand more about their addiction.11
Regardless of which group you choose to attend, participating in mutual support groups can be an important part of your aftercare plan. Receiving mutual support in recovery has been strongly linked to positive outcomes, particularly when attendance is frequent and for a longer duration of time.6 By surrounding yourself with people who understand the challenges of recovery, you may have more access to a support network when you encounter obstacles in your own journey.
Support for Co-Occurring Disorders
Mental health disorders are quite common. The Centers for Disease Control and Prevention report that over half of Americans will be diagnosed with a mental health disorder in their lifetime.12 Of that group, the National Institute on Drug Abuse estimates that half will misuse substances within their lifetime.13 Since so many people do have co-occurring disorders, it’s important for them to continue receiving care for mental health disorders to help prevent a return to substance misuse.2
Support looks different for each person so it’s important to be evaluated regularly to readjust treatment and continuing care plans. Care for co-occurring disorders may include medication, therapy, mutual support groups, or regular appointments with medical and mental health professionals.
Medication can be an important aspect of ongoing treatment and recovery for co-occurring addiction and mental health conditions. They may help with managing cravings, depending on the substance being misused.19 If you are in the detox phase of treatment, medication may be used to help alleviate uncomfortable or even dangerous withdrawal symptoms.19
If you are already taking medications as part of your treatment plan, it is important to regularly follow up with your prescribing provider to monitor your symptoms, make any needed adjustments, and monitor for side effects.2
Recovery housing provides a healthy, supportive, and substance-free living environment for people to continue the recovery process.14
For people stepping down from more intensive forms of treatment, a transition into recovery housing may be helpful. Additionally, it may help people avoid stressful environments (like a specific house or certain people) that could be a trigger to use substances.13
It may be helpful to have a therapist as part of your aftercare plan, especially if you’ve been working with a therapist in previous treatment. Therapy can help you process your emotions, resolve conflicts, and address potential triggers to misuse substances. Some common therapy approaches include the following:
- Cognitive Behavioral Therapy (CBT): this approach identifies the connections between thoughts, emotions, and behaviors that contribute to substance misuse.15 Cognitive behavioral therapy is one of the most common approaches to substance use treatment and has been shown to be highly effective. One study of the effects of CBT for cocaine use reported 60% of participants were sober after one year of treatment.15
- Contingency Management: an approach to substance use treatment, which uses prizes or vouchers to encourage sustained abstinence, usually verified with a negative urine test—the “contingency” in contingency management.16
- Motivational Interviewing: identifies what stage of change a client is in, and uses the relationship between client and therapist to shape behaviors toward their goal of sobriety.17
What to Do If Relapse Occurs During Aftercare
For many people, relapse is part of their recovery process, but it does not mean that treatment has failed. In fact, relapse rates for substance use disorders are like those for other chronic conditions like diabetes.20
If you notice relapse warning signs like drug or alcohol cravings, or returning to old environments or people you used substances with, it is important to immediately seek help and support. You can seek help within your recovery support network, mutual support groups, a sponsor, doctors, or trusted loved ones.
You can also reach out to the caring admissions navigators at American Addiction Centers (AAC). They are available 24/7 to take your confidential call. You can contact AAC free at . They can help you find the right treatment for your needs and connect you with addiction resources. They can also check your insurance coverage at AAC facilities if you are ready to enter treatment.
If you do relapse, know that it is never too late to start on your recovery journey again. Successful addiction treatment often involves ongoing evaluation of your current situation and may include further rounds of treatment.20 Contact us today if you need help getting back on the road to recovery.