Stages of Change in the Addiction Recovery Process

Recovery is a process that continues after formal treatment ends. The recovery process from drug or alcohol addiction often involves a person making a significant change(s) to improve their quality of life, including overall health and wellness. It can also help teach people to feel empowered in their lives and reach their full potential.

If you or a loved one is starting the recovery journey, or you are curious about what it means, this article will help you understand what the stages of change in the recovery process are, different types of programs and treatment options you may encounter.

What Is the Drug and Alcohol Addiction Recovery Process?

Choosing to enter treatment or begin any kind of substance abuse recovery program can be scary, but it is an important step in changing one’s life. The alcohol and drug addiction recovery process can look different for each person and is based on the level of care determined for a person, so treatment is often tailored to the individual.⁴ Program lengths vary. You may choose a 28- or 30-day, 60-day or 90-day inpatient drug rehab stay or an outpatient rehab program, and you might like to opt for specialized treatment options.

Regardless of the type of treatment or recovery a person chooses, they will likely experience changes as they journey through their recovery. One model that helps to define these “stages of change” is the transtheoretical model of behavior change, which was developed to help people navigate through the process of recovery from addiction.³

While these addiction recovery stages are based in a theoretical model, they have become widely accepted as a means to help people recover and and make behavior changes that may lead to a successful recovery.⁵

What Are the 6 Stages of Change?

The “stages of change”, or the transtheoretical model of health behavior change, suggests that there are 6 distinct stages of addiction recovery that a person goes through when making a change in their behaviors. Research done in the development of this theory suggests that recruitment, retention and progress is improved when individuals are matched with the specific stage of change they are in when making health behavior changes.³ While not specific to addiction recovery, this method may be used to help support the drug and alcohol recovery process. These stages are theoretical in nature and may not look the same for every person. The 6 stages of recovery from addiction are:^3,6

Stage 1: Precontemplation

During this stage, a person often isn’t aware that their behavior is a problem or doesn’t have a strong desire to make a change. If a person is in denial about their substance use or hasn’t yet experienced negative consequences related to their addiction, they may not feel the need to change. A person in the precontemplation stage of change may not be very open to hearing about their behavior or advice to help them recover.⁶

Stage 2: Contemplation

When a person reaches the contemplation stage of addiction recovery, they may begin to see that their addictive behaviors need to change. Perhaps they are noticing negative consequences related to their substance use. The type of change they are thinking about could be any number of things, from complete abstinence to simply cutting back their use. While a person in this stage of change may not be completely ready to stop substance abuse, they may be more open to hearing suggestions about what recovery looks like. It’s also possible that a person could remain in the contemplation stage for a long time as they decide what to do.⁶

Stage 3: Preparation

After a person realizes they want to make a change, they typically start to put a plan into action based on what they noticed during the contemplation stage of change.⁶ Some of the changes a person may plan for in relation to their recovery from substance misuse could be:

• Finding treatment facilities.
• Doing research on how to make a change or what type of changes they want to make.
• Asking for support from loved ones, professionals or support groups.
• Notice what their triggers are and begin to remove them.

As a person plans for changes, they may look for alcohol and drug rehab programs and and recovery options. A few types of treatment for people with substance use disorders include:

• Inpatient – This type of treatment involves living at the facility where you’re receiving treatment. Inpatient drug and alcohol rehab allows you to focus on your recovery without distractions and removes you from environments that may have been contributing to your drug use.
• Outpatient – This type of treatment often includes regularly scheduled addiction counseling appointments a few times a week. Other types of outpatient treatment include intensive outpatient treatment and partial hospitalization. These programs involve visiting a treatment center or hospital for more formal addiction treatment or, when needed, access to medical resources or psychiatric care.
• Dual diagnosis – These programs use an integrated treatment approach to help people who are struggling both with a substance use disorder and a mental and/or behavioral health issue.

12-Step Alcohol and Drug Recovery Programs

When exploring your treatment options, you are likely to come across the concept of 12-Step recovery programs. These programs involve following a set of addiction recovery Steps that help people in their daily lives. Many types of alcohol and drug recovery programs—including outpatient, inpatient and dual diagnosis—use the 12-Step model as an integral part of their treatment approach. In fact, about 73% of drug and alcohol rehabs in a 2016 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) used 12-Step meetings and introduced patients to the philosophy of these programs.¹

12-Step programs help people who are struggling with addiction. These support groups and their recovery Steps provide social support to people when they need it. This support can help people stay off drugs or alcohol and make other positive changes in their lives, according to the National Institute on Drug Abuse.

Some of the most popular groups that offer a 12-Step approach to drug or alcohol addiction recovery include:

• Alcoholics Anonymous (AA) (its Steps, Traditions and Promises can be found in the Big Book, the central text of the organization)
• Narcotics Anonymous
• Cocaine Anonymous

How to Find a Recovery Center

When looking for a recovery center to begin the treatment process, keep in mind that there is no treatment that is right for everybody. You will have the most success when you first educate yourself about available treatment types and then find a program that is tailored to your needs. SAMHSA’s Treatment Services Locator can help you find rehab programs near you.

Stage 4: Action

After a person chooses how they want to make changes and start the recovery process for addiction, they will typically take action. For people struggling with drug or alcohol misuse, this may be entering detox, going to rehab or attending group support meetings. For people who are trying to moderate their substance use, they may make smaller changes to their daily routines or habits.⁶

Taking action is a very important step in the substance abuse recovery process, and it is one in which it’s important to have support as you make changes. It can feel stressful to change, which is why the support a person receives in drug and alcohol treatment can be so important in continuing the process of addiction recovery.

Stage 5: Maintenance

The fifth stage of change in recovery according to the transtheoretical model is about maintaining the progress that resulted from taking action. This could be continuing to practice the new behaviors a person learned during treatment, attending support groups, continuing therapy or counseling and/or remaining abstinent from using substances.⁶

This stage of change can present new challenges as a person navigates life after treatment or without the regular support they may have had previously. Participating in aftercare programs can be a beneficial way to maintain sobriety and continue the process of recovery.

Aftercare Programs

Aftercare programs can offer continued support post-rehab and help you stay committed to the addiction recovery Steps. These programs can include:

• Regular individual or group counseling.
• Support groups.
• 12-Step programs.
• Sober living homes.

Manage Cravings

One of the most effective ways to manage your cravings involves making a concerted effort to avoid the people, environments and scenarios that act as triggers for you. Ideally, you should take the following steps to keep your drug and alcohol cravings under control and reduce triggers:

• Distance yourself from your old drug or drinking buddies.
• Avoid bars and clubs where drug and alcohol use is prominent.
• Be honest about your drug use history when talking to doctors or other healthcare providers about your health.
• Be cautious when accepting prescription drugs from your doctor.

Stage 6: Termination

The final phase in the stages of change is known as termination, or the point when a person’s desire to return to drug or alcohol seeking behaviors diminishes or stops.⁶ While many people may be working towards this stage, it is not common for people struggling with addiction to have their cravings completely disappear. Many people will remain in the maintenance stage for the remainder of the recovery process.⁶

How to Find Drug and Alcohol Addiction Treatment Near Me

If you or a loved one is ready to take action and start the drug and alcohol recovery process, you’ve already started the stages of change and may be looking for treatment options. Treatment varies depending on the type of substance, the presence of co-occurring mental disorders and other personal factors. It’s important to explore your options and choose treatment that addresses your individual needs.

Sometimes one of the most helpful ways to learn about treatment is to speak with someone who understands the recovery process and the types of treatment options available.

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