The value of addiction continuing care is often underemphasized among addiction professionals and treatment clients. There can be lots of focus on initial interventions and treatment levels, with continuing care/aftercare relegated to being an afterthought. But if we really think about what sort of disease addiction is, we should be able to see that continuing care can’t be left out of the treatment equation.
First a little context: what is addiction continuing care? It can refer to a range of addiction treatment and support services that are intended to provide continuing support for disease management after someone has completed an initial treatment. Often that initial intervention is residential treatment, due to its efficacy at providing a comprehensive foundation for long-term sobriety.
Addiction continuing care services are less intensive than typical substance use treatment programs, which target active addictions. They might include periodic check-ups with an addiction medicine physician or personal physician or outpatient services like individual or group therapy. Self-help groups like AA might also be part of one’s continuing care plan, although these more often serve as social support adjuncts to formal treatment services.
That’s a pretty general definition of continuing care. So why is it so important for recovery from drug or alcohol use disorders? There are (at least) three important reasons.
Addiction Continuing Care best reflects the kind of disease addiction is
If you’ve read our past blog posts, you know that addiction is a chronic brain disorder. A substance use disorder isn’t a discrete, time-limited event like a broken bone. People struggle with substance dependencies over long periods of time; many people struggle their whole lives with addiction. It’s well known that relapses with substance use are a defining characteristic of the disease rather than individual personal failures.
If we take the fact that addiction is a chronic, relapsing disease, it’s easy to see the need for a model of care that also extends over long durations. A single treatment intervention is just not adequate for a disorder that recurs over a lifetime as new circumstances and challenges appear.
Addiction is also a disease that can have consequences for other aspects of one’s health. So, for someone with a substance use disorder, it’s important to be continually monitored for adverse health effects related to addiction. It goes the other way too: staying on top of overall health management through regular check-ins is necessary to head off any critical health events that could trigger a relapse with substance use.
Continuing Care reinforces the tools learned in residential treatment
In most residential treatment programs, residents learn about a lot of tools and techniques that can help them remain sober after they graduate from treatment. That knowledge is incredibly important, but knowledge can quickly fade if it’s not put into practice. While residential programs teach people how to apply relapse prevention and non-addictive thinking in their own lives, there’s only so much application that can be done in a limited time frame. For treatment success to really stick, practicing and reinforcing the lessons of addiction treatment over a long period of time is critical.
Without addiction continuing care, someone who has struggled with drug or alcohol use risks forgetting the critical tools they have learned to stay on top of their disorder. Or they might only remember the knowledge in a rote way but forget how to apply it to their own lives. Addiction is a complex disease that can “flare up” under new life circumstances, especially if there are changes to one’s life that are painful or stressful. Continuing care services provide interventions where you and your provider can reflect on lifestyle changes and assess new risks of relapse.
Addiction Continuing Care provides critical social support
Too often people receive an intensive treatment intervention for addiction but never follow up with continuing care services. In addition to the problems we’ve discussed above, this cuts off treatment graduates from one element of social support that is important for sustained recovery. Having a reliable support system can make the difference between someone who gets through a relapse episode back to sobriety and someone whose condition deteriorates into binge episodes or long-term active addiction.
Addiction is also a disorder that creates self-isolating behaviors. There is a kind of feedback mechanism that takes place between substance use and isolating behavior: each makes the other worse. It’s necessary to have support structures in place to cut off that harmful interaction. Continuing care is a way to ensure that anyone who has received treatment will remain connected to some kind of social support. As mentioned above, social support groups like AA are another form that can help prevent addictive behaviors from flaring up.
While we have presented the case for continuing care through a few different reasons, understanding the significance is just the first step. Determining what is going to constitute an effective plan for continuing care is more complex, and it really needs to be customized to the individual’s disease severity, needs, lifestyle, access, etc. Furthermore, these are considerations that are best integrated into the earliest stages of treatment. That is, don’t wait to think about addiction continuing care. Continuing care strategies can be shaped during a residential treatment program.