Alcohol and Drug Abuse: Stages of Change

Are You Ready to Change?

Are you ready to change?

If you are experiencing alcohol and drug abuse, here is a road map of the first three Stages of Change and things you can do in each stage that will help move you along to the next step in your plan to change your recovery from alcohol abuse or drug abuse.

First Stage: Pre-Contemplation

Pre-Contemplation is the first stage of change for people with alcohol and drug abuse problems.  People in the Pre-Contemplation stage are not considering change.  They do not feel that their use of mood altering substances is a problem.  They are not interested in recovery from alcohol abuse or drug abuse.  It is usually the people close to the pre-contemplator, such as loved ones, employers or friends, who see the problems of alcoholism or drug abuse, not the person with the problem. For people around the pre-contemplator, there are several strategies that may be helpful to try and reach them.  It is of utmost importance to try and maintain an air of civility and trust when trying to talk to pre-contemplators about problems related to alcohol and drug abuse or recovery from alcohol abuse or other drugs.

It is important to try and educate them and provide them with information so that they can reach their own conclusions.  Gently pointing out the signs of substance abuse as well as the effects of substance abuse might be helpful. Saying something like “I am concerned about you because I noticed that your speech was slurred last night and you weren’t able to get up this morning” might be helpful or might be rejected.  Maintaining open and honest communication is crucial to keep the door to change open, but can be difficult, so if such statements are rejected, it might be helpful to get others involved to also gently point out their observations of substance use as well as the impact of substance abuse.  This can be especially difficult if the one you care about has put themselves or others in harms way, is acting self destructively or damaging relationships as a result of their alcohol abuse or drug use.  In these cases, openness, education and trust are not likely to occur and seeking professional treatment with a program specializing in the recovery from alcohol and drug abuse may be the best option.

As hard as it is to see someone you care about cause their own pain and suffering, sometimes life’s naturally occurring lessons are the medicine to help Pre-Contemplators see that they have an alcohol abuse or drug problem. If someone you love is not ready to admit to substance mis-use, it may be best just to stand back and let the consequences of their alcohol and drug abuse fall where they may until they are ready to change and at least begin to think about recovery from alcohol and drug abuse.

First Stage: Pre-Contemplation

Recovery From Alcohol Abuse and Drug Abuse Requires Contemplation

Second Stage: Contemplation Stage

When one is ready to consider change, they have entered the Contemplation stage.  Contemplators are able to acknowledge that the signs of substance abuse might exist, but remain uncertain of the necessity for the kind of changes that will be necessary to enter recovery from alcohol abuse or drug abuse.

For example, following a separation, job loss or worsening medical condition, an individual may be more willing to consider that they have an alcohol and drug abuse problem.  The costs of engaging in the these problematic behaviors are beginning to get to get too high, and as they outweigh the benefits of substance abuse, this will result in causing one to consider new possibilities, including the possibility of entering treatment and pursuing recovery from alcohol and drug abuse.

Second Stage: Contemplation Stage

Contemplation Stage: On the way to Recovery from Alcohol Abuse or Drug Abuse

Early Contemplators are still unconvinced that there is a need to change their alcohol abuse or drug use, but they are considering it. The negative effects of substance abuse have not reached the tipping point yet. Contemplators can benefit from social support from others with similar problems to learn about the positive consequences from reducing or eliminating chemical dependency from their lives.  A Contemplator usually needs additional information to help them make the decision to change their alcohol abuse or substance abuse.  They need to see the benefits of recovery from alcohol or drug abuse.  Sometimes making a list of “pros and cons” over a period of days or weeks can be helpful.

Examining the costs of continuing their alcohol abuse or drug abuse can often help tip the balance.  This stage of self evaluation is critical to reaching a decision about changing and represents openness to self inquiry and discovery.  Oftentimes, people around Contemplators become impatient; remember that the Contemplator has not closed the door to a substance abuse treatment, but needs more information, support or consequences to feel ready to cross the bridge on the path to recovery from alcohol abuse and drug abuse.

The development of a plan to change their alcohol abuse or drug abuse signifies a move into the Preparation for change stage.  Here, the individual has decided a change is needed and is considering what type of  treatment  might help them make that change a reality.  This is a time where one must clarify desired goals and strategies to treat their substance abuse disorder.  For example, if one seeks to reduce or eliminate addictive patterns of behavior, strategies might include changing people, places and things, going to support groups such as AA, seeking professional help, enrolling in treatment  on an outpatient basis, going into the hospital for detoxification or making a long term residential commitment.  There are many paths to recovery from alcoholism and drug abuse.  Support from others can be especially helpful during this time as it requires the individual to make a public commitment to some form of rehab treatment.

Others can also aid in brain storming about possible treatment options and may provide more objective input about the proposed plan for recovery from alcohol abuse and drug abuse, but only if such advice is desired.  As you can see, the consideration of potential options for treatment characterize the Preparation stage.

Third Stage: The Action stage

Third Stage: The Action stage

The Action stage occurs when the individual begins to actually take concrete steps to implement their substance abuse plan to reduce or eliminate chemical dependency.  In the Action stage, barriers and obstacles to treatment are often identified that previously were not seen.  Recovery from alcohol abuse or drug abuse becomes a tangible goal with corresponding behaviors and actions to achieve those goals.

Similarly, having realistic expectations about potential problems to reduce or eliminate alcohol abuse or drug abuse, the need for “baby steps”, and an acceptance of relapse as a necessary part of the substance abuse recovery, can all be very important in maintaining hope and remaining focused on the next indicated piece of the substance abuse recovery plan.

It is in the Action stage that most people seek and benefit from substance abuse rehab treatment.  This is because during this stage, individuals are seeking help not only to reduce or eliminate their alcohol abuse or drug abuse, but also because they need to develop alternative pleasurable activities, learn new coping skills to replace their use of mood altering substances, develop new social support systems, create relapse prevention strategies and revise the change plan as new issues are identified to maintain their plan for recovery from alcohol or drug abuse.

The longer an alcohol abuse or drug abuse problem has gone on, and the more impairment that results from it, the more difficult these behaviors are to change. While the stage of change determines readiness to change, the level of care necessary to effect a positive recovery from alcohol or drug abuse depends on other variables, such as potential for withdrawal, risk for medical complications, supportive vs. toxic recovery environments, potential for relapse, etc.

The higher the severity of such risk factors, the more difficult the alcoholism or substance abuse problem will be to treat. Levels of care for alcohol abuse and substance abuse rehab treatment may be thought of as dosages of treatment, similar to doses of medicine.

The level of care continuum could be conceptualized as follows:

1) A support group
2) Support group + individual therapy
3) Support group + individual therapy + medication;
4) Intensive Outpatient Program, 3 hrs per day, 3-5 days per week;
5) Partial Hospitalization, 4-6 hrs p/d, 5-7 days per week;
6) Hospitalization, 7 x 24, 3-5 days;
7) Residential 7 x 24,  4 + weeks.

Finding the right dose of treatment is as important as readiness to change.

This is because if the dose of substance abuse treatment is too low or too high, it is less likely to result in substance abuse recovery from alcohol or drugs, particularly if the person does not feel the substance abuse intervention matches their substance abuse disorder.

Rule of Thumb

The typical rule of thumb is to provide the right substance abuse treatment dose in the least restrictive substance abuse rehab treatment setting in which an individual can successfully accomplish his/her substance abuse recovery goals.  When you or your loved one is ready for treatment, be sure you find the right dose of treatment in the least restrictive rehab treatment setting.  Our intensive outpatient program has proven to be a very successful outpatient substance abuse  treatment for those who have chosen to pursue recovery from alcohol abuse and drug abuse problems.  Additionally, consumers have reported a high degree of satisfaction with our intensive outpatient program.  Your physician, Employee Assistance Program or Insurer may also be able to offer help to make the decision about an effective form of treatment.

Your life can be better, with you at the helm. Don’t let substances and psychological disorders rob you of  peace, fulfillment and a sense of purpose any longer.  Effective treatment for substance abuse in Memphis, TN is available now.  Call us at 901-682-6136 to schedule an appointment.

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