Completing a rehab program is often the first step in recovering from an addiction disorder. Leaving inpatient rehab can be intimidating, but it represents a major milestone in your recovery journey.
What to Expect When Leaving Rehab
Leaving an inpatient rehab program, even when you feel genuinely ready for the next step in the recovery process, can be both rewarding and intimidating. Every person’s experience is different, however some people experience the following:
More Personal Pressure
Inpatient rehab programs are helpful at first because they put you in a physical environment where you have no access to substances, eliminating a lot of the temptation to use. Once you leave, at least some of the pressures these programs isolate you from will start to return. This is why continued addiction support is important when you leave rehab. Therapy and support groups can help you handle many of the stresses that weren’t present in inpatient rehab.
Less Constant Care
Once you leave inpatient rehab, you’re unlikely to be surrounded by addiction treatment professionals on a daily basis. This isn’t to say there is zero care available to people once they leave rehab, but it’s less intensive. You may also need to seek out help much more, whereas it was just always present and accessible in inpatient rehab. This makes it even more important for you to have thought in advance and have a plan in place about what you want to do to maintain your abstinence once you leave rehab. Do you want to continue to go to a day program? Do you want to attend regular groups? Do you want to maintain a relationship with a peer specialist, therapist, counselor or other behavioral health professional? Planning ahead can make the transition easier.
Addiction treatment can unfortunately be expensive.  Many people who had to go to inpatient rehab may have also lost their jobs or may face difficult questions when they return to work. They may owe money to friends and/or family, or to the health care system for their treatment. Many guides have been written to help people in addiction recovery find financial stability which is essential in helping support them as they also work to maintain their abstinence.  Many inpatient rehab centers also have case managers and social workers that can assist patients in financial planning in preparation for returning to the community.
Greater Access to Drugs & More Frequent Triggering Events
Once you leave inpatient rehab, there is a greater temptation to return to the same places/environments and to hang out with the same people around whom you used to use. These triggers can make it easier to relapse. Planning ahead about how you are going to avoid the people and places that are triggering is an important thing to do prior to leaving a rehab facility.
Stigma around rehab and recovery
In a quality inpatient rehab program, medical professionals and patients understand how complex and difficult substance use disorders are. In the real world, people are unfortunately often less empathetic. Depending on your environment, it may be hard to discuss rehab with people in your life who may not have been through it or may have preconceived notions about rehab care and substance use disorders. You may be made inappropriately to feel ashamed or embarrassed about talking about your rehab experience.
It can be helpful to prepare yourself for these conversations ahead of time: who do you want to talk to openly about your stay in rehab? Do you feel comfortable sharing it widely, or do you perhaps prefer some privacy? Who do you feel comfortable disclosing your substance use to? Do you have someone – or perhaps multiple people – who you feel comfortable opening up to and utilizing for ongoing support?
Tips for a Successful Transition Out of Rehab
Here are some tips on how to successfully transition out of inpatient rehab:
Build a Positive, Supportive Network Around Yourself
Addiction recovery is not a process you should go through alone. There will be times where recovery feels difficult or even impossible. Having people you can trust, who are willing to help you, can be critical to preventing relapse. Before leaving inpatient rehab, try to identify at least one person – or ideally, multiple people – who you can rely on for support. This can include friends, family members, or medical and/or mental health professionals. It can also include support groups or individuals who consider themselves part of the recovery community.
Avoid Relapsing, but Don’t Catastrophize
If you’re in recovery, relapsing is common, and is part of the overall process. A relapse doesn’t erase the progress you’ve made. Instead, it just means you used drugs and that you have more work to do on your recovery. You still learned the skills you did in therapy, and you still have the relationships you built to help you in your recovery. If you do have a relapse, acknowledge it and return to care, either through behavioral health or to a medical professional. If you feel comfortable, try to disclose a relapse to a friend or family member so they can also help support you in returning to care and recommitting to recovery.
Adhere to Your Treatments
Once you feel solid in your recovery, it can be tempting to give up on therapy, support groups, medications, and the other routines that you have had in place. This is potentially ok – as you become more solid in recovery, you may not need therapy as often, and you may not even need to be on lifelong medications. However, there is also the risk of stopping these supports too soon and relapsing. If you do decide to discontinue certain groups or therapies or to stop medications, talk to your doctor before doing so. A gradual taper of medications as opposed to an abrupt stop may help prevent a return to use. It is probably better to go slow than to go too fast and risk a relapse. Life is long, be patient with yourself and with your recovery.
Manage Your Expectations & Use All Available Resources
When you leave inpatient treatment, you may have to manage your initial expectations about the type of life you’ll be able to live, at least in the early stages. Relationships that were damaged when you were actively misusing substances may take time to heal, and some may not be repairable. You may need to find entry-level work and rebuild toward the positions you know you’re qualified for.
This isn’t to say you can’t set goals and you shouldn’t seek to thrive. People in recovery can and do find immense success and live vibrant, happy lives. But this can take time and effort, and not everything about the modern world is designed to give people in recovery the most fair chance of succeeding.
Manage your expectations, but also don’t give up. Set realistic, incremental goals that build toward bigger things.
Some important support options to think about when you exit inpatient rehab include the following:
Therapy & Counseling
Regardless of your particular type of substance use disorder, therapy and counseling are always part of a recommended treatment plan. The specifics will vary, but most doctors recommend a person recovering from SUD at least receive some type of behavioral therapy, generally cognitive behavioral therapy (CBT).
CBT is a type of therapy that focuses on rebuilding the way you think about and otherwise approach the topic of drugs and drug use. You pinpoint what motivates you to misuse drugs and how to focus those feelings in healthier ways or even avoid those thoughts altogether when possible. CBT can be delivered one on one or in a group setting, depending on what works best for you.
Medication (When Applicable)
Many types of SUD can potentially be partially treated through Medication for Addiction Treatment (MAT). These treatments use medications, which will vary depending on the drug you struggle with and which specific issues you have with those drugs, to help you better avoid drug use.
Some of the most well known treatments for opioid use disorder are methadone and Suboxone. Alcohol responds well to Naltrexone, Acamprosate, Disulfiram and Topiramate. If you are interested in MAT upon leaving inpatient rehab, talk to your medical team before your discharge to discuss what medications might be available to you when you leave to maintain your recovery.
Regular Medical Checkups
Regular medical checkups are just a generally good health habit, but they are an especially good idea for people who have regularly used substances. It is important to have a doctor that you see relatively frequently particularly in early recovery so that you can monitor for signs of relapse, maintain any medications you are taking and generally be connected to more support.
Support Group Sessions
Addiction support groups can be a great way to connect with people who have similar issues to yourself. These people can often support you in ways that even loved ones who listen closely to you or addiction treatment professionals who study addiction for a living can’t because the people in these groups actually lived, and often continue to live, with addiction.
The ideal group for you is going to vary. Many people choose 12-step programs like Alcoholics Anonymous, but these types of programs don’t work for everyone. If you found one type of program wasn’t to your liking, look into other types of programs. Every support group has a unique approach to recovery help, and it’s worth trying several to find the one that most suits you.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More
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