Return to reality – Now what?

02/09/14 2:11 PM

Smoothing the transition from treatment to daily life

For almost all families, 28 days in treatment passes far too quickly. It seems like you’ve just breathed a sigh of relief that your loved one is safely stashed away, and bang! It’s discharge day!


Now the hard work of recovery begins.


Contrary to popular belief, 28-day inpatient treatment at a center is not a cure for addiction. In fact, it’s only the beginning of the hard work of recovery. The hardest work – and the biggest barrier to sustained sobriety – is in transitioning back to daily life. Many recovering addicts and the people who love them forget this fact – or have never been told – and assume that life will return to the way it was “pre-problem,” now that the problem is “fixed.”


But the worst thing you can do is act like nothing has happened. Addiction is powerful. It changes – and damages – important relationships. But recovery is equally as powerful in its capacity to transform individuals.  Life, as you once knew it, is over. Everyone involved must be prepared to support post-treatment recovery and rebuild relationships.


Let’s look at some of the questions and challenges our clients and their loved ones raised with us, when adjusting to the “new normal” life after treatment.

For the addict

What to say to people who know they went to rehab.

  • Anxiety and discomfort about facing their loved ones now that their chemical dependency is out in the open.
  • Not knowing how much to disclose and whom to disclose it to. There is a tendency to overshare because part of treatment is talking to peers about using behavior.

What to say to people who thought they were on vacation.

  • Anxiety and discomfort about facing their loved ones if the reason for their absence was not fully disclosed to everyone. In treatment, the addict is taught they have a disease, but almost all people have shame over both their inability to control their use and conduct while using.

Concern about being judged, stigmatized, and labeled.

  • This is real, which is why attending support groups is important because everyone there has the same problem. Support groups offer a concrete way the person in recovery can rebuild self-esteem.

An unrealistic expectation that they can immediately repair past damage to relationships.

  • A good therapist, recovery coach, or sponsor is needed for advice.

Is there a support system in place before your loved returns from treatment?


An unhealthy desire to hit the ground running and to prove themselves.

  • This common problem can easily lead to relapse.
  • Setting up a schedule is a good way to prevent work from becoming the new “ism.”

Concern about social and work functions that involve alcohol.

  • Support is needed to skip all non-essential functions and to take a non-drinking partner if attendance is required.

Are you prepared to refrain from drinking in front of your loved one and taking the alcohol out of your house?


Embarrassment about needing to prioritize recovery.  

  • These feelings reflect the addict’s shame. Be a positive supporter of putting recovery first.

For the addict’s friends and loved ones

Confusion about how to support the individual.

  • Ask! This is an ongoing and evolving concern that is often best talked out with a skilled addiction counselor or recovery coach.

Uncertainty about trusting them.

  • One advantage of regular drug testing is that it increases the confidence level for family members and helps deter use.

Who is going to “bell this cat”?  Will the treatment center, your addiction specialist, or you initiate this conversation?


Lingering emotional wounds or unprocessed resentments from past behavior.

  • These are not going to simply evaporate through superficial “forgiveness sessions” at a family program.
  • Wait for stable recovery to take hold before bringing these up with your loved one (preferably with a counselor present).

Reservations about including them in social functions where alcohol may be served.

  • Brain scans show environmental “cues” can trigger urges, so this concern is valid.
  • Why take unnecessary risks? Options are to give a pass, suggest you all go to an alternative activity, or if it’s a must-attend, you refrain from drinking as well.

Lack of education/understanding addiction as a disease concept.

  • You don’t know it all after a few days at the family program.
  • Ongoing education about the disease is a high priority to avoid mismatching expectations and reality.

Unrealistic expectations that the individual is cured.

  • You need a good grounding in the stages of recovery; this takes many months.

Yes, there are different markers for progress, do you know what they are and what level your loved one is at when leaving inpatient?


Concern about how to cope in the event of a relapse.

  • This should be addressed during inpatient treatment.

Is there a written relapse plan in place?

Picture this!

Remember seeing the ad where the high school kid with cancer has a bald head and all her friends shave off their hair to show solidarity? Well, keep that image in mind. We are all in this together.

Plan ahead!

A common theme is that this transition can be smoothed with thorough preparation and planning. Having a solid, workable, well-informed, and practical plan in place before someone returns from treatment can substantially increase the likelihood of successful reintegration.


The plan should address the needs and challenges of both the family and friends and the returning individual, keeping in mind that mismatched expectations are common but avoidable through clear and open communication of the issues faced by both parties.

Professional help

Above all, find a qualified addiction specialist for support – someone you can call with questions and can help you prepare a recovery plan and contract.


For additional information on putting a plan in place for post-treatment recovery, see the following articles:

Case Management for Families Dealing with Addiction Recovery: Dual-Track Method

Financial Managers and Dysfunctional Clients


Leave a Reply