Posted on October 2, 2015 in Addiction Recovery

‘SOBER’: A 5-Point Survival Guide to Your First Year Post-Rehab

Surviving your first year post-rehab can sound as daunting as playing Minecraft for the very first time … without a manual … and in a foreign language. You’re spending much of your time moving, disassembling and putting back together big chunks of your life, like arranging cubic building blocks on a screen. And if the sand, lava and hunger don’t kill you, the post-nightfall zombies very well may.

Thankfully, whereas staying alive in the virtual world of Minecraft requires appraising and navigating an endless series of competing objectives, surviving your first year following inpatient treatment really boils down to achieving one very clear goal: Avoiding relapse. And studies show that the longer you avoid relapse, the stronger your chances of long-term sobriety become.

The following five tips can help you survive your first year in recovery by keeping relapse at bay. They form the handy acronym “SOBER” to help you remember them:

Schedule your daily recovery routine for the next year out, and then stick to the schedule.

The only thing worse than being bored is being bored and newly out of treatment for a drug or alcohol addiction. So get busy being about your recovery. There’s a reason why you followed a daily routine in rehab, so don’t stop doing the good work you’ve begun. Sobriety is a lifestyle, after all.

First, the scheduling: Your daily recovery routine should make time for the basics — all those fundamental components to a healthy lifestyle that you probably ignored when getting high was your biggest concern.

  • Physical exercise
  • Three healthy meals a day
  • Seven to eight hours of sleep every night
  • Work responsibilities
  • Hobby and play time

Then there are the other recovery-specific elements you’ll want to schedule well in advance:

  • 12-step and/or other daily and weekly support groups: Some addiction recovery professionals even encourage a “90-in-90” rule, meaning 90 12-step meetings in the first 90 days after discharge from treatment. This way you’re quickly building up a supportive recovery community to help you stay sober in those critical first weeks and months after inpatient rehab.
  • Daily medication reminders (if your recovery is medication-assisted and/or involves treatment for a dual diagnosis like depression or a generalized anxiety disorder)
  • Regular medical checkups with a doctor who specializes in treating addictive disorders

Next, stick to the schedule. Here, using a smartphone is ideal, so that you can request alert reminders for daily meetings and appointments. A good rule of thumb when setting your alert reminders is this: the less jarring and more upbeat and positive-sounding the ring tone, the better. Spooky, sci-fi music or high-pitched alarm sounds that set your pulse on a high-speed getaway can make the prospect of attending a 12-step meeting seem like even more of a chore.

Sticking to the schedule may also entail having a helpful app like Cassava on your phone. Then, regardless of where you are, you will have access to a comprehensive list of 12-step meetings and other resources.

Own your cues and triggers. This means knowing what they are and how to handle them before they strike. You can do this by brainstorming and recording as many personal cues and triggers as your new sober brain can conceive of. That way they’ll be less likely to surprise you when they do arise. One study found, for example, that “person-specific” cues (memories unique to your personal history) are far more apt to stoke cravings than substance-specific associations (like the presence of bottles or syringes). Another study published this year found that women with substance use disorders are especially susceptible to alcohol-related cues and stress (two big contributors to the cravings that can precede relapse).

So ask yourself what cues and triggers prompted your drug abuse and write anything down that comes to mind:

  • A friend or love interest
  • Difficult emotions
  • Traumatic childhood memories
  • Feeling overwhelmed by stress
  • Lyrics to a familiar song
  • The smells or ambience of a particular setting

Any or all of these — and still others unique to you and your story — may be on your list.

Once you’ve identified as many potential cues and triggers as possible, come up with an “antidote” for each one. Often, a therapist can help in this process. For example, if one of your triggers is a painful emotion, or if you associate your drug use with a particular person, having a pre-scripted, automatic response for when temptation strikes —think of it as a mini, self-pep talk — can help you step back from the edge of a potentially risky fall. In this sense, surviving your first year post-rehab is a bit like being a Boy Scout: you can never be too prepared.

Be prepared for at least a year of crazy emotional ups and downs (a.k.a. PAWS). The reality is that withdrawal hasn’t finished yet. The name for this frustrating state of affairs is “post acute withdrawal syndrome.” Know what you’re in for by educating yourself on the common symptoms of PAWS; these can include:

  • Insomnia — with reportedly a high rate of insomnia occurring in early recovery
  • Anxiety attacks
  • Irritability
  • Sudden mood swings
  • Fatigue
  • Lack of motivation
  • Inability to concentrate
  • Obsessive thoughts
  • Fluctuating energy levels
  • Memory loss
  • Difficulty in solving problems and thinking clearly
  • Depression

One week you may experience the sudden rush of being clean and free of an addiction only to step in a pile of depression doo-doo the next. Simply being aware of what you’re experiencing is half the battle. That way you’ll be less inclined to overanalyze your emotions and attach additional layers of meaning that could lead to relapse. No, you’re not forever doomed to changing your emoticon 20 times a day, or to being the main source of wear and tear to that magnetic mood meter on your fridge belonging to your preschooler. So lighten up: tell yourself it’s only PAWS and that PAWS, too, shall pass.

Enjoy regular opportunities for fun, recreation and relaxation. Your brain on drugs and/or alcohol was a quick-fix pleasure junkie, so enjoying life’s more ordinary pleasures may take some time and a lot of practice. That’s why at least one expert has said effective addiction treatment will “shotgun the addict with fun.” That image speaks volumes, and there’s no reason to run out of pleasure bullets post-rehab. But you’ll need to be intentional at first about trying out some new opportunities for fun, recreation and relaxation. You may even need to make a list — again, think Boy Scout, that you can refer back to every so often.

Remind yourself you’re not immune to relapse. Relapse happens more often than not, and is especially likely during those first precarious months out of treatment. You’re no exception to that rule. For the same reason, relapsing need not be the end of your world or an excuse to jump right back into a bad habit full throttle, which is why having support resources and a plan on hand for when relapse occurs is always a good idea. Many recovering addicts have relapsed multiple times before eventually achieving long-term sobriety. Reminding yourself that you’re not immune to relapse is therefore not a scare tactic. It’s just one helpful way to stay grounded in reality and keep working your program.

One of Great Britain’s former prime ministers, the late Margaret Thatcher, put it this way: “You may have to fight a battle more than once to win it.” It’s no surprise she earned the epithet, “Iron Lady.”

Surviving your first year post-rehab will prove you’re made of the same mettle.

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