Recovering From Alcohol and Other Substance Use Disorders

Substance use disorders (addiction) can cause problems in many areas of your life, from your physical health to your mental well-being. Making the decision to get help is a big step. But recovering from alcohol and other drug use can be an intimidating process. There’s a wide range of treatment options. And this can make it feel overwhelming to find the treatment that’s best for you. 

While you may feel alone in this process, know that millions of people deal with substance use disorders. Alcohol use disorder alone affects about 18 million adults in the U.S. And almost 1.8 million people in the U.S. had a methamphetamine use disorder in the past year alone. 

You don’t have to set out on this journey alone. There are robust treatment programs, both in person and virtual, to help you on your road to recovery. We’re here to guide you through the types of treatment centers and services as well as what to consider when selecting a recovery program.

Addiction treatment levels of care

You have many options when it comes to treating a substance use disorder. Some options offer only monthly, hour-long appointments. Others provide around-the-clock care that lasts for months. Your symptoms and needs may change during your time in treatment. So you may need to complete a series of services over a period of weeks, months, or years to find the stability and comfort in recovery you seek.

Professional treatments should always start with a thorough evaluation that helps you and your care team understand your experience with substances and what you want to achieve. To find the treatment that best fits your needs, your care team will assess:

• Current symptoms to identify intoxication or withdrawal

• Mental health and physical health conditions you may have that could complicate treatment

• Sources of stress and support in your home, workplace, and community 

• Previous experiences with substance use, addiction, and treatment

• Employment and childcare responsibilities

Inpatient and residential care

Inpatient and residential treatments provide 24-hour care from a team of professionals and require you to live at the treatment center during your stay. In most cases, you won’t be allowed to freely come and go during treatment.

Inpatient and residential care could be best if you:

• Are using high levels of alcohol and/or other drugs

• Are at risk of serious mental or physical health harm from substance use or substance use withdrawal

• Have a lot of stressful things in your life and a lack of people to support you to avoid drugs at home

• Haven’t been able to achieve recovery on your own in the past

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• How to recognize addiction: Being able to spot the signs and symptoms of addiction can help you know when to get help — either for yourself or a loved one.

• Medications and therapies for substance use: Therapy or medication may work well alone. But for other people, a combination is the best approach. 

• Alcohol detoxification (detox): You may be able to detox from alcohol at home — with the supervision of a healthcare professional. Learn more about safe detox.

Inpatient programs may take place in locked units of acute care hospitals, where your physical health and medical stability are the top priorities. 

Residential treatments look and feel less like a hospital and more like a home, with some privacy and more freedoms. The staff of healthcare professionals schedule and structure most of your time with activities that focus on recovery.

Inpatient treatments may only last for a few days or weeks. But residential rehabilitation programs — sometimes called residential rehabs or just rehabs — can last up to a year. 

Outpatient care

Addiction recovery services where you live at home during treatment are considered outpatient. You return to your home or work after the scheduled treatment sessions.

Outpatient treatment could be a good option if you:

• Are at low risk of harm from your substance use

• Have many sources of support and few sources of stress

• Need to care for children or maintain employment

Outpatient care is available in many settings, like doctor’s offices, community agencies, and schools. Like inpatient and residential care, outpatient treatment offers a range of options. These differ based on frequency, intensity, and duration of sessions. Some examples are:

• Partial hospitalization programs (PHPs): Sometimes called “day treatment,” these programs provide the highest level of outpatient care. During PHP, you attend 4 to 6 hours of treatment a day for at least 5 days per week.

• Intensive outpatient programs (IOPs): IOPs are the mid-range of outpatient services. They involve 3-hour sessions that occur at least twice per week.

• Standard outpatient: This is low-intensity treatment that you can attend from once each week to once each month, depending on your symptoms.

PHPs and IOPs may only last for a few weeks or months. But standard outpatient care can go on for many years if needed.

Substance use recovery often involves more than one service or level of care. People usually go through the treatment options in stages. So you may start with inpatient or residential before transitioning to different levels of outpatient care. 

Sober living

Sober living or recovery residences work to bridge the gap between inpatient and outpatient care. Sober living houses can provide the needed support and structure that you may not get at home.

Each sober living home is different, but they tend to include:

• Living with a group of people committed to recovery

• An expectation that you’re actively in recovery treatment

• The need for you to work and contribute to bills and chores

• Housemates who work to keep each other focused and accountable

Your residence at a sober living house can last for months or even years. During this time, you can work, go to school, and attend professional treatments, all while receiving the stability and support of others in recovery.

Addiction treatment services

No matter your level of treatment, you’ll have access to a variety of treatment services. A care team can help support your recovery goals. These healthcare professionals can make sure you stay safe through detoxification and withdrawal symptoms. And they can provide therapy and medication support too. 

Detoxification

Detoxification (detox) is the process of the body cleansing itself of alcohol and drugs. Detox is also a set of medical strategies that healthcare professionals use to treat intoxication and withdrawal symptoms. 

Withdrawing from medications and substances can be uncomfortable. And, in some cases, in particular with alcohol or benzodiazepines, withdrawal symptoms can be life-threatening. This is why it’s very important to work with a professional healthcare team through the detox period. A care team has the medications and resources to increase the likelihood of a safe and successful detox.

Detox can take place in a variety of settings, including inpatient and outpatient settings as well as at your home. All of these options can be safe with the supervision of a healthcare professional. Depending on the process and substances involved, detox can take days, weeks, or longer.

Therapy

Therapy is a common part of treatment for substance use. Therapy may look very different depending on the setting. But it usually involves meeting with a therapist to talk about your thoughts, feelings, and behaviors. Counselors, social workers, and psychologists are just some of the professionals who offer therapy.

Therapy can occur individually, with family members. Or it can be in groups with other people who are dealing with similar issues. Sessions vary based on the education and style of the therapist. But therapy usually involves:

• Understanding addiction and what drives your use

• Building motivation to change

• Receiving rewards for drug-free behaviors

• Learning and practicing new coping skills

• Improving problem-solving skills

• Boosting communication skills

Medication management

Medications can be another part of recovering from a substance use disorder. Medication may be used alone or along with therapy and counseling. When medications are used along with therapy, it’s called medication-assisted treatment (MAT). 

Depending on your substance use, medications may help you:

• Manage withdrawal symptoms

• Limit cravings

• Stop using substances

• Prevent relapse and stay sober 

• Address mental health conditions that emerge or worsen with substance use

MAT has been linked to positive outcomes for alcohol and opioid use disorders. These results include improved physical and mental health as well as a higher likelihood of staying in treatment.

To assist with opioid use disorder, medication support may include:

• Methadone

• Buprenorphine

• Buprenorphine / naloxone (Zubsolv)

• Naltrexone (Vivitrol, ReVia)

To treat alcohol use disorder, your care team may recommend medications such as:

• Acamprosate (Campral)

• Disulfiram (Antabuse)

• Naltrexone (ReVia)

Support groups

Support groups aren’t a form of professional treatment for substance use. They don’t use mental health or addiction professionals to run the groups. But support groups can be a helpful addition to other recovery strategies.

Examples of support groups are Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and SMART Recovery. These are led by peers in recovery who use their experiences to guide others through all stages of recovery. Groups can help you connect with others in recovery to build your sober support network.

What to look for when selecting a recovery program

There’s no single best approach to recovery. Treatment is unique and individualized based on your specific situation. Right now, the best treatment program for you could be short-term inpatient detox or long-term outpatient therapy. It could be close to home or across the country. The important thing is your willingness to explore and experiment with treatment until you find a good fit.

That said, you’ll notice that recovery approaches share many strategies and principles. In the end, the best plan is one that helps you safely manage withdrawal symptoms, lets you reach your recovery goals, and sustain your recovery over the long term. 

Here are some points to keep in mind when selecting a treatment program. Each person is different, and it’s important to find the right program for you. However, it’s a good idea to make sure the program can do most of the following things:

• Completely assess your mental health, medical, and social needs at intake

• Offer qualified staff and use evidence-based treatments

• Feel safe and supportive

• Treat the whole you, not only your substance use

• Connect you to follow-up care 

• Provide the types of therapy, medication, and support group services that best meet your needs

• Reassess you often to determine the level of treatment and care you need

Making a relapse prevention plan

Relapse prevention plans are helpful if your goal is abstinence, or not using alcohol or drugs at all. These are written or verbal plans. And they’re great ways to identify triggers and cravings linked to relapse. They can remind you and your treatment team about what to do when you have an urge to use substances.

Your treatment program will likely spend considerable time building relapse prevention plans with you. With this information, you can notice the signs of relapse sooner and take appropriate action.

Support for families and friends dealing with addiction

Watching a loved one struggle with addiction is very difficult. You’ll likely experience a range of emotions. Do your best to stay calm, supportive, and loving to help your loved one recover.

Seeking your own professional treatment can help reduce the distress linked to the substance use of your loved one. And it can give you needed skills to improve communication and set the right boundaries. There are also support groups, like Al-Anon or Alateen, for family members of people dealing with substance use disorders.

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Written by:

Eric Patterson, LPC

Eric Patterson, LPC, has been a professional counselor in school and outpatient settings for over 15 years. Patterson has been cited as a mental health expert in publications such as Today.com, Good Housekeeping, and InStyle.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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