Alcoholism Recovery Phases and the Unique Challenges of Each

Recovering from alcoholism can be challenging; after all, it is a diagnosable disorder that requires treatment. This means recovery is not as simple as just giving up drinking, it’s a process and has unique challenges inherent along the way.

The process of recovery involves going through different phases and confronting specific challenges within each of these phases. Ultimately, it is a lifelong journey.

The First Phase: Withdrawal

If you have struggled with chronic alcohol abuse and have consumed large quantities of alcohol over time, it is likely that you will go through withdrawal after you initially give up drinking.  According to experts from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (1), withdrawal symptoms typically begin 6 to 48 hours after a person stops drinking heavily, and they include any of the following:

  • Headache
  • Tremor
  • Sweating
  • Nausea and Vomiting
  • Agitation and Irritability
  • Anxiety
  • Difficulty Concentrating
  • Sensitivity to Sight and Sound

In severe alcohol withdrawal, some people may experience brief hallucinations. Others will also experience withdrawal seizures. People with the most severe form of alcohol withdrawal may suffer from delirium tremens, a serious condition that results in ongoing hallucinations, severe agitation, and significant increases in breathing rate, heart rate, and blood pressure. This condition occurs in about 5 percent of people who withdraw from alcohol and begins two to four days after the last drink, according to NIAAA researchers (1).

Withdrawal certainly complicates recovery from alcoholism. Not only is it uncomfortable, but in severe cases, it can be potentially fatal. Professionals from SUNY Upstate Medical University have warned that without treatment, delirium tremens can result in death (2). During the withdrawal phase, it is therefore important that those with severe symptoms receive appropriate treatment. For people suffering from delirium tremens, treatment will occur in a hospital setting, so they can receive needed medications and medical staff can monitor their electrolytes, hydration levels, and nutrition (1).

People who undergo mild withdrawal symptoms can likely be treated at home. They should stay in a dark, quiet environment, drink plenty of fluids, and limit their interactions with others. It may be helpful to check in with a doctor or clinic throughout this period to monitor symptoms and nutrition.

Stage Two: The Abstinence Stage

Getting through alcohol withdrawal can be complicated, but it is only the first stage of treatment. After this stage, people enter into the abstinence stage, where it is necessary for them to continue with professional treatment if they want to recover from alcohol addiction. According to a writer for The Yale Journal of Biology and Medicine, there are several tasks associated with the abstinence stage. These include accepting that you have an alcohol addiction, learning to cope with alcohol cravings without drinking, distancing yourself from friends who are still drinking, practicing self-care and healthier alternatives to drinking, learning about relapse, and beginning to attend self-help groups (3).

One challenge of this phase is that people may experience what experts call “post-acute withdrawal.” Unlike initial alcohol withdrawal, this phase doesn’t produce physically uncomfortable withdrawal symptoms but rather results in psychological and emotional challenges. For instance, people may experience depression, mood swings, anxiety, irritability, low energy and enthusiasm, poor concentration, and sleep problems. Unfortunately, post-acute withdrawal can last for the first year or two of abstinence, and sometimes it will come and go. People may feel discouraged, but it is important to recognize that this is a part of recovery and that it does get better with time (3).

The abstinence phase lasts for two years and begins once a person stops drinking, but it is still important to note that withdrawal is a phase of its own, given the potential severity of this stage. Once you move from withdrawal to abstinence, it is critical to stay engaged in treatment, so you can develop positive coping skills, gain support from others during group sessions, and learn about relapse triggers and how to avoid them.

Stage Three: The Repair Stage

Following the abstinence stage comes the repair stage, which typically lasts two to three years. It is during this stage that people begin to make amends for the damage they caused when they were at the height of their addiction. This can involve addressing financial problems, relationship difficulties, or problems at work that developed because of alcohol (3).

This stage can be difficult, because people may begin to feel guilty, ashamed, or hopeless as they come to terms with the consequences of their addiction. Cognitive therapy may be useful to help overcome guilt and negative thinking patterns. During this stage, people need to practice self-care, engage in support groups, prioritize a healthy lifestyle, repair relationships, and recognize that they are not their addiction (3).

Stage Four: The Growth Stage

After completing the repair stage, those recovering from alcoholism enter the growth stage. This stage begins three to five years after a person stops drinking, and it truly is a lifelong stage. At this stage, a person is ready to process and heal from family issues or past traumas that led to alcohol addiction (3).

Recovering from past trauma is important, but clients should not begin this phase until they truly have strong coping skills, because processing trauma can be difficult. During this lifelong stage, people recovering from alcoholism begin to identify negative family patterns that contributed to the addiction, and they continue to challenge negative thinking patterns, enforce healthy boundaries, and give back to their communities (3).

Another Stage: Relapse

While the previous stages have focused on abstinence, it is also worth noting that relapse can be a part of the recovery process from alcoholism. After all, the National Institute on Drug Abuse reports that the relapse rate for people in addiction treatment is as high as 40 to 60 percent. You should view relapse as a part of the recovery process, instead of feeling you have failed if you encounter a relapse (4).

Relapse typically occurs because people begin to isolate themselves, deny that they have an addiction, stop going to support group meetings, convince themselves that their addiction wasn’t that bad, or tell themselves that they are strong enough to have a drink or two without losing control and falling back into alcoholism (3). If you experience a relapse, it is important to re-engage in treatment so you can continue on your recovery journey. It is also helpful not to view yourself as a failure but rather to use the relapse as an opportunity for growth. The best outcome of relapse is that it can teach you to identify your triggers and learn how to avoid them in the future.

Whether you’re in the relapse stage, the growth stage, or in earlier stages of recovery, the fortunate truth is that there is help every step of the way. You can receive treatment for every problem associated with alcoholism recovery, ranging from withdrawal management services to ongoing cognitive therapy to help you develop healthier ways of thinking and coping. If you’re struggling, reach out for support today.

 

Sources:

  • https://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf
  • https://www.ncbi.nlm.nih.gov/books/NBK482134/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/#__ffn_sectitle
  • https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

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