Why Addiction Recovery Care is Important After Rehab

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A general misconception is that addiction recovery begins and ends in a rehab treatment facility. The reality is that addiction recovery care has many different levels, with rehab being just one step within a treatment continuum.

In this article:

• Aftercare: What Happens After Rehab
• Life After Rehab
• Transitioning to the Next Level
• Step-by-Step Recovery
• Making Long-term Adjustments
• Next Steps

Aftercare: What Happens After Rehab

Aftercare is any form of ongoing addiction support a person receives after treatment. Aftercare helps those in recovery meet their goals and prevent relapse. When getting close to the completion of rehab, a discharge coordinator will work with an individual to create the best plan for the continuation of care upon discharge from rehab. This typically includes referrals to step-down care, such as a partial hospitalization program (PHP) or intensive outpatient program (IOP), or a sober plan that at minimum includes a support group, such as Alcoholics Anonymous (AA).

Rehab as the First Step

Contrary to common perceptions, rehab does not necessarily cure someone with alcohol use disorder (AUD) or a substance use disorder (SUD). Instead, it is often just the first stop for someone with AUD or SUD to address their recovery needs.

Inpatient rehab provides 24-hour, supervised care for someone to safely begin recovery from alcohol or substance use addiction. It is usually recommended for people with long-term or severe cases of addiction. Rehab programs vary in length, from weeks to months, and may or may not include a detox unit to medically help someone detoxify their body from substances first. ²

As such, rehab is often the initial step to addressing your recovery needs, and it lays the groundwork for all subsequent treatment needs. Within a continuum of care, it is considered one of the first points of entry into the treatment system, followed by what is most appropriate for your specific situation.

Most programs will have a discharge coordinator whose responsibility is to connect you to the next level of appropriate care for your specific situation. This is also referred to as the step-down method. The idea is that you would gradually work your way down from the most intense level of care to the least restrictive level of care, such as a standard outpatient program then ongoing weekly therapy. The discharge coordinator can also give referrals for your next steps.

Life After Rehab

The appropriate steps for you after rehab will be decided with your treatment provider but may include the following aftercare options:

• A sober living home
• Partial hospitalization or intensive outpatient
• Standard outpatient treatment
• Individual therapy
• Group counseling
• Family therapy
• 12-step groups like AA
• Non-12-step groups like SMART Recovery

Most aftercare plans are designed to help people maintain sobriety and be placed in the best level of care to suit their needs. In some cases, you may be able to go from rehab straight to intensive outpatient treatment if it’s the most appropriate level of care for you.

Usually, a person will enter a lower level of care, and the rehab facility itself can offer follow-up services, such as an alumni group where people who graduated from the facility can meet up to talk about life after rehab.

Transitioning to the Next Levels of Care

A person just out of rehab is often vulnerable. Being newly sober can create a lot of pressure on you to start navigating the levels of care on your own. If all you get is a referral, the situation might be setting you up for a relapse. For this reason, the wraparound approach is considered the best practice among treatment providers. ⁴

In the treatment community, more emphasis has been placed on this method, which helps address co-occurring problems for a person in treatment.⁴ This means that, while some rehabs might just hand out a referral for someone exiting care, the best practice would be to use a hands-on approach in which one facility makes sure a person gets to the next facility and follows up to assist if any concerns arise.

Treatment providers also operate with the understanding that a person should be placed in the least restrictive level of care possible.¹ This means that you should be placed in a treatment setting that is believed to give you the most benefits and with the least restrictive conditions.

Once you have been placed in the next appropriate level of care, you will continue to work on your recovery. Many programs in both rehab and other levels of care highly recommend connecting with community support and self-help groups, such as AA, NA, or SMART Recovery. From there, treatment goals will be identified in a therapeutic setting, and your program or therapist will help you work toward those goals.

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Non-Treatment Needs

In addition to a discharge coordinator, you might also work with a case manager to plan for life after rehab, though the discharge coordinator might play both roles in some treatment facilities. Many people entering rehab do not have a lot of foundational basic needs met. This means there might be needs related to: ⁵

• Lack of housing
• Lack of transportation
• Inability to properly connect to a supportive recovery environment

These are called non-treatment needs, and if these needs are identified, a case manager will help connect you to appropriate resources to get the assistance you need.⁵ Some of the things a case manager can help assist with include:

• Resolution of transportation issues
• Assistance with finding stable living accommodations, including sober housing if needed
• Help with applications for medical assistance or state benefits
• Access to personal care needs such as clothing and showers

Many of these barriers will be noted, but the ability to properly address them will vary depending on the number of resources that are available within each community.

Step-by-Step Recovery

Stepping down in levels of care during recovery is incredibly important. Research has shown that rehab without proper follow-up care often leads to relapse. As with any medical condition, appropriate follow-up care is needed to make sure concerns are properly addressed, treated, and managed in a way that allows you to have the best quality of life possible.⁶

While your next level of care may vary depending on your specific needs, it can be safely assumed that you will no longer be in an inpatient treatment setting. While rehab gives you a supportive and structured environment, working in an outpatient setting means more personal responsibility for recovery. Some aspects you should identify and evaluate when stepping down from rehab include:

• Strength of support network
• Consideration of mental health needs
• Understanding of triggers

This list is by no means exhaustive, but it shows some of the main factors treatment providers will be looking for when deciding what level of care is appropriate for you in your recovery process.

Making Long-term Adjustments

Beyond therapy, you will experience an adjustment process after successfully being discharged from rehab.⁷ Before seeking treatment, people might have created a routine of securing alcohol or substances. For many, this routine becomes a way of life.

Upon returning home from rehab, your routines will need to change accordingly if you are to be successful. For example, some people in recovery may employ family members or friends to help them optimize their environment to promote sobriety. Others may need to rearrange their schedules to accommodate therapy.⁸ Unhoused individuals might move into a sober living facility where they must abide by strict rules and responsibilities.

Though such changes may prove challenging at first, they can greatly help you transition into daily life in recovery. These are but a few examples of what your aftercare plan may entail, but they point to the importance of having therapeutic intervention beyond rehab to learn how to work and be successful in recovery.

Next Steps

Remember the importance of adhering to the follow-up care that the coordinators in rehab will set up for you, as this is one of the biggest factors that can help you maintain recovery. Many facilities can help you with your treatment goals.

It is perfectly acceptable to call around to find treatment that best fits your needs. You can also call 800-948-8417 Who Answers? to speak with a treatment support specialist who can assist you in your journey toward recovery.

Resources

1. American Society of Addiction Medicine. About The ASAM Criteria.
2. Lesser, B. (2021). How Long Should Rehab Stay Be? How Long Should You Stay in Rehab? | Dual Diagnosis
3. Daley D. C. (2013). Family and social aspects of substance use disorders and treatment. Journal of Food and Drug Analysis, 21(4), S73-S76.
4. Paino, M., Aletraris, L., and Roman, P. (2016). The Relationship Between Client Characteristics and Wraparound Services in Substance Use Disorder Treatment Centers. Journal of Studies on Alcohol and Drugs, 77(1), 160-169.
5. Substance Abuse and Mental Health Services Administration. (2015). Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, 27, 15-4215.
6. Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 3. Intensive Outpatient Treatment and the Continuum of Care. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64088/
7. Melemis, S. M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale Journal of Biology
8. Erlandson, K. M. (2008). Getting sober: A practical guide to making it through the first 30 days. McGraw-Hill.