What is Alcoholism Recovery?
What is Recovery?
Recovery is a lifelong process that starts when you decide to stop abusing alcohol. According to the National Institute on Drug Abuse (NIDA), recovery occurs when people begin to make changes that help improve their health and wellness, choose to live empowered, self-directed lives, and make decisions without the influence of substances that help them reach their full potential.1
People may benefit from viewing addiction similarly to other chronic illnesses like diabetes or high blood pressure. Like these illnesses, addiction is a chronic medical disease that can be successfully managed with the proper treatment.2 In recovery, you voluntarily decide that you want to make positive changes to improve your social functioning and overall health.1 When this occurs and you are no longer using alcohol to handle negative feelings and emotions, you are said to be in remission.1
According to a study published by the American Society of Addiction Medicine (ASAM), that surveyed people who have been treated for substance use disorders, there are several key elements for a successful recovery. These include an ability to be honest with yourself, being able to enjoy life without the need to use substances, living a life that contributes to society, your family, or self-improvement, being the kind of person that people can rely on, giving back to the community, and aiming to live a life that is consistent with your beliefs and values through the activities you choose to engage in.3
The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that 4 major areas of your life can help support your recovery efforts. These areas include:4
- Health: Recovery means that you make decisions that are beneficial for your physical and emotional well-being.
- Home: You need a supportive, stable and safe place to live to recover from addiction.
- Purpose: You should engage in meaningful activities and have the means to participate in society.
- Community: You should have a solid sense of social support and have relationships that provide support, friendship, and love throughout recovery.
Principles of Recovery
When it comes to the key principles of recovery, the American Psychological Association (APA) outlines the below 10 principles based on the 2004 National Consensus Conference on Mental Health Recovery and Mental Health Systems Transformation:5
- Self-direction: You are responsible for deciding the best path to your recovery.
- Individualized and person-centered: Recovery is based on your specific needs, strengths, background, and goals.
- Empowerment: Recovery is designed to provide you with a sense of personal power because you choose the options that are best for you and participate in the decision-making process.
- Holistic: Recovery involves all aspects of your life.
- Nonlinear: Recovery isn’t a straight line forward but rather a series of steps in the right direction that can also include setbacks and continual growth.
- Strengths-based: You focus on and develop your individual strengths in recovery.
- Peer support: You rely on the support of others to help you through the recovery process.
- Respect: It is important to be accepted by the community and society during recovery.
- Responsibility: You take responsibility for your self-care and recovery journey.
- Hope: Even though recovery can involve setbacks, you have a positive outlook on the future and believe that you can overcome roadblocks.
Stages of Treatment
Recovery is a process that doesn’t just refer to the stage after treatment is completed. It is the entire process that starts when you admit to a problem using addictive substances, recognize the need for help, and continue to work on sobriety throughout your life.
A manual published by NIDA suggests that there are 4 stages of addiction treatment. These stages are only a theoretical model and individuals pass through their own stages of recovery at their own pace.6 Rather than being well-defined stages, the model is meant to be fluid, with each phase overlapping at various times.6 During recovery, individuals may go back and forth as they rework issues from previous phases.6
The 4 stages include:6,7
- Treatment initiation: This is when you admit the need for help and decide to reach out to your doctor, an addiction professional, or a rehab facility. You may not be sure of how you feel about treatment, but you know that you need to make a change in your life. During this stage, you examine your patterns of alcohol use, the ways addiction has negatively affected your life, and the reasons why you want to stop or cut back on your drinking. You may be assisted throughout this process by professionals who know how to guide people through recovery; and you may begin participating in group and individual counseling to address your resistance to treatment, receive education about recovery, and help you get started on the path to abstinence.
- Early abstinence: This is the phase when you commit to treatment and decide to stop drinking. It can be a challenging phase because you may experience symptoms of withdrawal, which can be unpleasant, uncomfortable, or even dangerous in some cases. Medically supervised detox is often encouraged for cases of severe physical dependence to alcohol. Your doctor or counselor will help determine the level of detox that is appropriate before entering treatment. During early abstinence, you may receive support and counseling to help you deal with triggers and cravings, participate in self-help groups like Alcoholics Anonymous (AA), and receive ongoing education to help prevent relapse.
- Maintaining abstinence: This phase begins after you’ve achieved abstinence and no longer use alcohol. You may continue to work on the underlying issues that led to the addiction, address related psychological issues like anger and codependency, develop improved coping skills, and receive ongoing education, counseling, and support to help you with your new substance-free lifestyle and to prevent relapse.
- Advanced recovery: This is a lifelong phase that begins when you’ve completed treatment. Formal counseling may end at some point in this phase, although many people continue to participate in individual therapy or some form of organized aftercare (like 12-step or mutual help groups) to help maintain sobriety.
Rules of Recovery from Alcoholism
In a paper outlining an expert perspective published in the Yale Journal of Biology and Medicine, the author explains how 5 “rules of recovery” can help a person focus on sustaining recovery in an effort to prevent relapse. Individuals in recovery may find it helpful to incorporate these rules into their life during treatment which include:8
- Change your life: Recovery involves significant adjustments in one’s life so that it is easier to not use drugs or alcohol to cope with negative thoughts or emotions. You do not change your life just by not using— you need to make changes such as identifying and replacing negative or unhelpful thought patterns and avoiding people, places, and things that make you feel like using.
- Be honest: Don’t lie to yourself or others.
- Ask for help when you need it: If you need help, it’s not a weakness to admit that to someone you trust. No one can handle everything on their own.
- Practice self-care: Taking care of yourself and prioritizing your own needs is crucial to recovery.
- Avoid bending the rules: Don’t make exceptions or look for loopholes. This can be a warning sign of relapse.
Does Recovery Mean Total Abstinence?
While some people believe in a moderation approach to alcohol use, the most effective way to achieve and maintain recovery is to abstain from alcohol all together, especially if you have a moderate to severe addiction.9 NIDA suggests that people in recovery often feel that abstinence is a “cardinal feature” of a recovery lifestyle.1 However, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that recovery differs per person and that complete abstinence fails to capture the multidimensional and varied paths to recovery.9
One study suggests that the most successful recovery efforts involve abstinence and more failed remission attempts are associated with moderation.10 The results of another study in the journal Addictive Behaviors found that people of all ages who practiced abstinence reported a significantly higher quality of life and showed that sobriety is the best route for long-term recovery.11
Is Alcohol Treatment Really Necessary for Recovery?
People who are addicted to alcohol cannot typically stop drinking through their own willpower alone. Addiction means that a person has lost control over their drinking and continues to abuse alcohol despite its negative consequences.2 This is where treatment can step in, as it is a beneficial and important component of recovery that teaches people how to live alcohol-free lives.12
Research has shown that one-third of people who receive alcohol addiction treatment have no symptoms a year later, and it also helps many others significantly reduce their alcohol use and have fewer alcohol-related problems.13 Alcohol addiction treatment generally involves a combination of medication, behavioral therapies, and self-help groups like AA.13
If you are concerned about your drinking but you’re not yet sure if you want to enter treatment, consider speaking to a counselor or your primary care physician and have a brief discussion about your drinking habits. This can be a 5- to 10-minute assessment that involves talking about your drinking patterns, receiving advice if you want to reduce the amount you drink, and discussing emotional support networks or treatment options that may help you reach your needs.13 Your doctor can also help formulate a treatment strategy, evaluate your overall health, and determine whether medication may be appropriate for your situation.13,14
. National Institute on Drug Abuse. (n.d.). Recovery.
. American Society of Addiction Medicine. (2019). Definition of Addiction.
. Lee Ann Kaskutas, Dr.Ph., Thomasina J Borkman, Ph.D., […], and Jason Bond, Ph.D. (2014). Elements That Define Recovery: The Experiential Perspective. Journal of Studies on Alcohol and Drugs, 75(6), 999–1010.
. Substance Abuse and Mental Health Services Administration. (2020). Recovery and recovery support.
. American Psychological Association. (2012). Recovery principles.
. Mercer, D. & Woody, G. (1999). Therapy Manuals for Drug Addiction Series: Individual Drug Counseling. U.S. Department of Health and Human Services.
. Center for Substance Abuse Treatment. (2005). Substance Abuse Treatment: Group Therapy. (Treatment Improvement Protocol (TIP) Series, No. 41.) 5 Stages of Treatment. Substance Abuse and Mental Health Services Administration.
. Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332.
. Katie Witkiewitz, Kevin S. Montes, Frank J. Schwebel, and Jalie A. Tucker, et. al. (2020). What is Recovery? Alcohol Research, 40(3).
. Laudet, A. B. (2007). What does recovery mean to you? Lessons from the recovery experience for research and practice. Journal of Substance Abuse Treatment, 33(3), 243–256.
. Subbaraman, M. S., & Witbrodt, J. (2014). Differences between abstinent and non-abstinent individuals in recovery from alcohol use disorders. Addictive Behaviors, 39(12), 1730–1735.
. National Institute on Drug Abuse. (n.d.). Why does a person need treatment?
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for alcohol problems: Finding and getting help.
. NHS. (2018). Treatment: Alcohol misuse.