Continuing Care – the Equally Important 3rd Phase of Addiction Treatment & Recovery
Continuing care – the equally important and often neglected 3rd phase of addiction treatment.
This sentence in Abigail Sullivan Moore’s January 20, 2012, article, “A Bridge to Recovery on Campus,” appearing on NewYorkTimes.com, really grabbed my attention:
“….Until recently, public policy focused on prevention and treatment. “We never talked about recovery as a kind of separate entity — it was almost like treatment was the end in and by itself,” says R. Gil Kerlikowske, director of the White House’s Office of National Drug Control Policy, which is joining with the Department of Education to urge colleges to consider recovery programs.” [A Bridge to Recovery on Campus]
Addiction treatment is more than a 28-day stay in rehab. It requires continuing care. Why? Because the person is treating a brain disease, and the brain cannot heal from addiction in just 28 days.
The common perception is that finally getting a loved one with a drug or alcohol addiction into a 28-day residential treatment program will take care of the “problem” and that all will return to “normal” as soon as treatment is done. Unfortunately, ALL is not well, nor does it return to “normal” for some time.
In fact, the American Society of Addiction Medicine (ASAM) states that effective addiction treatment should follow a disease management approach and include: 1) detox/stabilization, 2) rehabilitation (rehab) [what the majority think of as “treatment”], and 3) continuing care. Often, people engage in a combination of treatment options during rehab, but it is important they continue these in order to “re-wire” / heal their brain. In other words, engage in “continuing care,” aka after care. This is referred to as “being in recovery.”
Why Continuing Care?
Because addiction – whether it’s an addiction to illegal or prescription drugs or to alcohol — is a chronic, often relapsing brain disease. The very nature of this disease is that it causes chemical and structural changes in areas of the brain that are vital to a person’s ability to think straight, behave normally and act responsibility. Of course the addict/alcoholic can make great progress in a 28-day residential treatment program — no doubt about it. Additionally, 28-day programs, also known as rehab, are but one of the ways a person goes about beginning their recovery, which is defined as abstinence AND an enjoyable life. Other options include: cognitive behavioral therapy (CBT), medications to curb cravings, a 12-step program such as AA or NA, mindfulness programs (for example, yoga), spiritual and/or religious programs or activities, healthy nutrition, exercise, group meetings, counseling, intensive outpatient (the person does not live at the treatment center but attends treatment programs at the center during the day and/or evening), and others. [And, please know, that if there is a dual diagnosis, treatment must also include treatment of the mental illness.]
However, healing the brain takes time, which is why continuing care – the 3rd phase in the disease management approach — is so equally important to recovery. 21st century brain and addiction-related research now shows that treating addiction must follow the same treatment protocols as treating other diseases, such as cancer, diabetes or heart disease.
Just as a person with diabetes, heart disease or cancer has a continuing care program/plan to help them continue their recovery once the acute care/rehab treatment (e.g., surgery, radiation, chemo) is complete, so too must the alcoholic / addict.
Now back to the article, “A Bridge to Recovery on Campus” — it was marvelous to read there are such comprehensive continuing care kinds of programs on college campuses for students wishing to continue their education after detox and rehab. Again, quoting from Ms. Moore’s article, “But students at Rutgers, Texas Tech and Augsburg have been breathtakingly clean, with abstinent rates averaging in the mid- to high 90s.” Those are HUGE, SIGNIFICANT abstinent rates and point to the importance and of having on-going, long-term support programs and activities to carry treatment into long-term recovery — in other words, continuing care.
So please, pass this article along!
Lisa Frederiksen
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