What are the Four Stages of Alcohol and Drug Addiction Recovery?

depressed man sitting in a corner. addiction concept

Recovery from an addiction to alcohol or drugs is never an overnight thing. But it can be much swifter than many people could possibly realize while they are trapped in the seemingly relentless cycle of addiction.

It still needs character traits such as courage, honesty, dedication, and self-discipline. But anyone who makes the decision that they really want to stop their unhealthy habit – and stay stopped – can do it.

There are of course different stages in recovery. It is worth noting too that while there is a beginning there is no real end – as recovery is an ongoing lifelong process.

This is why the vast majority of those in recovery from an addiction talk about getting a “daily reprieve” and that it’s “one day at a time.” They speak about being “recovering alcoholics/addicts” rather than “recovered” – even if they have not touched drink and drugs for many years.

But recovery that is kept up on a daily basis is the opposite of addiction. This is because addiction is a progressive illness, so it will get increasingly worse – whereas recovery gets progressively better.

Four stages of treatment

Addiction to alcohol and/or drugs remains a major modern-day problem. According to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, 23.5 million people in America over the age of 12 needed treatment for an illicit drug or alcohol abuse problem.

This was in 2009, and it’s likely the problem is worse now. Thankfully, there are various ways that people can beat an addiction, including behavioral addictions as well.

The most common ways are through a 12-Step group, a therapist, counselor, or coach. There’s also the option of attending a recovery center such as Tikvah Lake, where we have a first-class team of therapists who are experts in helping people move into recovery from addiction.

As a resource for healthcare providers involved with individual drug counseling, four stages of treatment were developed by the National Institute on Drug Abuse, the main federal agency supporting scientific research on drug use and addiction. It’s a model that has proven useful for recovery from addiction.

The four stages of treatment are: 

  • Treatment Initiation
  • Early Abstinence
  • Maintaining Abstinence
  • Advanced Recovery

Different stages of addiction recovery

Here are the four stages of alcohol and drug addiction recovery:

Stage 1 – Treatment Initiation

This stage starts the moment someone seeks help for their drug or alcohol addiction. Usually, people at this point will be sick and tired of feeling sick and tired because of their addiction.

But they will also be apprehensive about quitting and how life will be without what they have used in an attempt to deal with issues such as trauma and other inner pain. As the book Alcoholics Anonymous – mostly known as the ‘Big Book’ – puts it, the alcoholic reaches a point where they are “unable to imagine life either with alcohol or without it.” 

This applies to those addicted to drugs too. But an acceptance that there is a problem is of vital importance – there can be no more excuses or denial if someone wants to get well.

So, when somebody with an addiction problem accepts and reaches out for help, they are beginning the first stage of recovery: Treatment Initiation. They need to realize the damage their addiction is causing to them and those around them too – as well as what is attractive and essential for them regarding recovery.

Stage 2 – Early Abstinence

When someone is showing commitment to getting well, they are in the second stage of recovery: Early Abstinence. For many recovering addicts, this is a difficult stage at first because there needs to be change from an unhealthy habit.

This can mean not having contact with certain people and avoiding some places. It can also mean dealing with physical craving, psychological dependence, triggers, and withdrawal.

This is where it is vital to get support from either a professional with expertise in beating addiction, or a 12-Step support group where there are people with experience of stopping and staying stopped. Some people have professional help and attend 12-Step meetings.

Someone moving into recovery from addiction will be given coping skills that can help them. These will help in the early days, but also some will be part of a new way of living that can be used for the rest of the person’s life.

There is also likely to be encouragement and support to take up some exercise, perhaps meditate, and to eat regularly and healthily.

Stage 3 – Maintaining Abstinence

Group of multiracial people playing at Rock Paper Scissors game. Students from different culture having fun outdoors

After 90 days of not drinking alcohol or using drugs, the person will shift to the third stage of recovery: Maintaining Abstinence. For someone in a residential treatment center, this is typically when they will move to the outpatient counseling phase.

The key thing at this stage is to maintain abstinence by avoiding relapse or a “slip”. The person will learn about warning signs and triggers that can lead to relapse.

These include:

Sadly, relapse can happen at any stage, but if the person vows to learn from it and start their recovery again all is not lost. It is likely that valuable aspects of living life on life’s terms will be learned – which can significantly help the person avoid relapsing in the future.

Stage 4 – Advanced Recovery

When someone has been clean and sober for around five years, they will be able to start the fourth stage of recovery: Advanced Recovery.

Although recovery is ongoing for the rest of someone’s life, the person should now be back playing their part in society and the stream of life. They will be able to be a responsible and trustworthy friend, partner, colleague, and parent.

Because recovery is ongoing for the remainder of someone’s life, most people who found recovery through a 12-Step group will continue with meetings. They will keep a sponsor and chat regularly.

In fact, going to meetings is part of their recovery journey – to help others at the meetings, especially “newcomers”, who they can sponsor and guide through the 12 Steps. They can also be there for anyone who happens to be struggling for some reason or going through a difficult patch in life.

This might be the person themselves at some point. Even with all the tools of recovery at hand and after achieving many years of recovery, life can still throw things at us that are unsettling – such as a relationship break-up, an illness or a bereavement – that may require some additional support to navigate.

Anyone who has achieved their recovery through a therapist will often continue to see the therapist but might cut down on how frequently they meet for sessions. Others will go their own way if they feel ready.

It’s important to maintain recovery though. This means using all the tools that a person now has for living life on life’s terms. It also means keeping up with things such as eating healthily, meditating and exercising, ideally every day.

Recovery from addiction is much more than staying clean and sober. It means having a healthier life – one with meaning and happiness.

How Tikvah Lake can help

At Tikvah Lake Recovery Center, we can help anyone who’s suffering from an addiction. Our friendly, expert team will ensure all our guests get the support and care they need and deserve.

Our fully personalized treatment programs offer various therapies proven to help with any problem. So, if you or someone you care about are struggling, please get in touch with us today to find out how we can help.

David Hurst - Tikvah Lake Recovery

About David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

Reader Interactions

Leave a comment