What happens after drug rehab? (for families)

The first step is to determine if your loved one is serious about sobriety. Worrying or constant monitoring doesn’t help. But, pretending everything is OK, because you want it to be OK, is even more harmful.

Walk the thin line of being supportive, yet aware and ready to speak up. A relapse doesn’t mean failure, but it can’t go unaddressed.

Page Contents: Warning Signs | General Recommendations | More Treatment | Sober Living | AA/NA Meetings | Relapse | Rebuilding after Addiction | Forgiveness | Talking about Recovery |

What are warning signs to watch for after rehab?

1. Are they asking for money?

• Part of the recovery process is stepping up to take responsibility. This includes maintaining a job or committing to school (or both).
• More than likely, they manipulated you in the past to get what they wanted. Putting an end to this is a huge part of their (and your) healing.
• Things like paying for the first few months of sober living can be helpful, but don’t be afraid to verify where the money is going. You can ask for account passwords, call the company, get copies of the bill or pay directly without completely take over their finances for them.
• Ultimately, giving your loved one money shouldn’t be the norm.

2. Are they reverting back to their old schedule?

• You’ll almost always notice suspicious behaviors before you confirm a relapse.
• If they’re staying out late, sleeping in, not coming home or avoiding family dinners, it’s time to reach out.
• At the very least, these types of behaviors show the person is letting their healthy lifestyle slip.
• More likely, they’re back in addiction and it’s controlling their life and dictating their schedule.

3. Are they hanging around the same people and places?

• If they hang around the same people and go to the same places, they’ll be constantly reminded and tempted. Relapse is only a matter of time unless something changes.
• Life after rehab should include new friends, meetings, a sponsor and hobbies.
• If you don’t see them changing where they spend their time, know they’re probably not serious about recovery and act accordingly.

4. Do they change the subject when you ask about their recovery?

• Addiction is often a source of shame, but recovery should come with pride and accomplishment.
• While recovery doesn’t have to define them, they should be happy to tell you they’re still on the right path.
• If they’ve slipped back into addiction, they won’t want to talk. It’s embarrassing, and they probably feel guilty. Most people would rather change the subject or walk away rather than lie.
• Don’t stop asking just because they shut you down. In fact, address that specifically.

5. Have they stopped actively working on their recovery?

• Recovery is a life-long commitment.
• Even people that are 10, 20, 40 years sober go to support meetings and see therapists. (That’s why they’re still sober).
• If your loved one isn’t following the recommendations, it’s a sign they’re still stuck in manipulation and denial.

What are the general recommendations after rehab?

• 30 meetings in the first 30 days
• A sponsor by day 45
• Outpatient treatment for at least 5 months
• Sober living for at least 1 month, ideally 6-12 months
• Continuing all medications until stopped by a professional

These aren’t hard rules, but they are good goals. You should see your loved one actively working on their recovery after rehab.

Why do they need more treatment after rehab?

The positive reinforcement of regular therapy allows them to learn to voluntarily abstain from drug or alcohol use without constant supervision — until the risk of relapse decreases.

Try to hold your loved one accountable for a minimum of 2 months of outpatient treatment at least weekly, starting immediately after they leave.

Meeting regularly with a therapist is the best way for anyone to remain in a good place mentally and think clearer about their life and issues.

When emotional situations come up — such as a death in the family or marital struggles — look to resume outpatient treatment right away.

Therapy should be like going to the gym. It’s something we can do regularly (weekly or bi-weekly) forever as a safety net.

What is sober living?

Sober living is a house specifically for those coming out of drug or alcohol treatment. It’s an ideal blend between treatment and the “real world.”

They generally have normal responsibilities and freedoms, but with accountability measures like required meeting attendance, random drug testing and sober live-in mentors.

Does my loved one need to go to sober living?

Even if you plan on your loved one moving back in, sober living is almost always a better next step. The same triggers and opportunities to use still exist at home.

Structure and accountability are critical in the beginning, and it’s not healthy for your relationship if you’re serving that role.

Plus, you may have your own feelings of anger, distrust or co-dependency to work on.

You both may be anxious to get them back home, but taking a little extra time can make all the difference.

The longer sobriety is maintained, the more natural it becomes. Most relapse occurs within the first six months.

Why do they have to go to meetings?

Support groups like AA and NA provide emotional support, reduce isolation and serve as a reminder to remain active in their sobriety.

Even just the effort of attending is something to feel good about. Meetings are free and readily available, so there’s no excuse not to go.

What should I do if I notice a relapse?

Address any warning signs you see as early as possible, but be sure you’re addressing specific behaviors rather than general fears about them relapsing.

• Allow them to open up to you.
• Help them be honest with themselves
• Encourage them to contact their support network.

Don’t come at them with anger and judgment. They already feel depressed and embarrassed about slipping.

Do they need to go back to rehab if they relapse?

Relapse means gaps exist in your loved one’s recovery that need to be addressed. More treatment is always required — no exceptions or excuses.

However, this doesn’t mean repeating the full process. It could involve things like seeing a therapist weekly or getting back on anti-depressants.

If you know any details like how long they’ve slipped and what drugs they’re using, you can call the main JourneyPure number to get advice on your specific situation.

What if they’re angry or annoyed when I address the relapse?

Don’t let them brush off the topic. Push past denial or excuses.

A relapse can be as a temporary setback and learning experience. But, if they refuse further treatment, go back to setting boundaries. Put your foot down and require them to take sobriety seriously.

How can we rebuild after addiction?

When you see they’re serious about recovery, work on healing. Healthy relationships are built on honesty, communication and accountability — qualities that were likely lacking before.

After the initial wave of emotions, make an active choice to forgive and rebuild, but keep your expectations realistic. It’s not healthy for you to be their only support or to expect them to assure you that they’re OK every day.

Continue your own social life and interests to avoid unhealthily obsessing or relying on them.

Will I ever be able to forgive them?

Forgiveness isn’t something you do for your loved one. It’s about letting go of your anger and judgments to allow yourself to heal. Forgiveness doesn’t excuse or erase their actions.

In order to forgive, you need to acknowledge the reality of what occurred and how you were affected.

• Think about the specific incidents and behaviors that angered you.
• Accept that these things happened.
• Accept how you felt and how you reacted.
• Feeling is the first step to healing, but then you need to let these thoughts and emotions go.

It may help to focus on your personal growth from these experiences. Not only did you survive their addiction, perhaps you grew from it. What did you learn about yourself or about your own needs and boundaries? You should be proud of your strength!

You can even give some purpose to your experiences by helping other families in your support group, social circle or on HopeTracker that face the same struggles.

What if they’re not sorry?

As part of their recovery, they should be reaching out to make amends. Forgiveness is easier if you feel they are genuinely sorry, but even if they don’t express it, they feel shame and sorrow for hurting you. You can forgive even if they aren’t sorry or continue to struggle.

Do I have to tell them I forgive them?

You don’t have to say anything to your loved one to forgive them, but you should express these feelings if you’re trying to rebuild your relationship.

Say the words, “I forgive you” and add as much explanation as you feel is merited. Then, you have to live it. Recognize when you’re feeling or responding out of resentment and actively redirect yourself to peace and acceptance.

Can we talk about their recovery?

Hopefully, your loved one is talking openly about their recovery. If not, don’t assume they’re OK because there hasn’t been an incident. If you feel suspicious or curious, ask (without judgment). It’s better when the conversation stays open.

When they talk, be sure to actively listen. If they feel you’re dismissing them, resentment and distance will build.

If you have a hard time letting go or bringing up the topic, try family therapy — even just a few sessions. If they used insurance for rehab, sessions together could be free or already part of outpatient treatment. Or, use your insurance. With no insurance, look to religious leaders, community health centers or therapists with costs based on income (sliding scale).

That said, they need to solve issues without putting the burden on you. If they reach out to you struggling or for advice, you can direct them to their sober network. ”I’ve been told to suggest you call your sponsor, therapist or sober friends to help instead.”

Also, be sure to talk about things other than recovery too!

How often should we talk?

It’s OK to continue to take some space. Try sending a text saying your thinking of them or a funny picture instead of bombarding them with calls. Establish a weekly talk time (or date night), so you both have the same expectations.