Drug rehab aftercare — also called continuing care, or simply aftercare – is a crucial component of successful rehabilitation of substance use disorder. Sadly, for a long time, there has been a misheld belief that completing an addiction treatment program is sufficient for a lifetime of sobriety. There is a significant body of research showing that not only is substance use disorder a chronic and relapsing condition, which may require several treatment programs, but that rehab aftercare is a critical element of a treatment program. This blog explains why.

What is Drug Rehab Aftercare?

Drug rehab aftercare refers to ongoing professional support once you’ve completed an inpatient treatment process. It is a critical component of addiction treatment, like relapse prevention, identifying barriers to long-term success, and follow up visits. Sadly, though, studies show only 17 percent of individuals completing an inpatient treatment program, or intensive outpatient treatment, go on to receive continuing care.

As substance use disorder is a chronic, long-term condition, organizations like the American Society of Addiction Medicine, the Department of Veterans Affairs, and the American Psychological Association all recommend ongoing care, like an outpatient treatment program, Alumni program, regular check-ups, or transitional housing.

You may have also heard of drug rehab aftercare called continuing care, lower-intensity treatment, aftercare, or step-down care. Research shows that aftercare, like drug rehab aftercare, has several benefits, including:

• Promotes abstinence
• Reduces the risk of relapse
• Solidifies the gains in treatment
• Ensures clients follow through with discharge recommendations
• Prevents the worsening of substance use disorder
• Reduces societal costs associated with returning to use

In summary, aftercare, like participation in a 12-step group, increases recovery capital — a measure of recovery success. Other forms of recovery capital that are crucial to success include engagement in mutual-aid groups, recovery community organizations, and other forms of support that promote recovery such as employment, housing, and pleasurable activities.

What Are the Important Components of Aftercare?

The key components of aftercare include:

Relapse Prevention

This involves identifying barriers to success like triggers. This may be people, places, and things that may reactivate a memory or increase stress levels and the likelihood of retiring to use. It should also include a record of what actions you’ll take if you feel triggered, like calling your support network, visiting your therapist, returning to rehab or an outpatient program, and asking for help.

Recovery Activities

Part of reducing the risk of relapse is engaging in recovery-related activities, like going to 12-step meetings, regularly attending the gym, talking to a counselor once a week, meeting up with friends in recovery, seeing your sponsor and working through the steps, and visiting a recovery community organization for social events and support.

Support Network

Building social support networks is a critical step in long-term recovery success. This can include trusted friends and family who know you’re in recovery, a sponsor, a supportive partner, mutual-aid groups, like AA or SMART Recovery, church, a home group, a therapist, mentor, and/or drug and alcohol counselor.

Coping Strategies

Like recovery activities, coping strategies are the things you’ll do to maintain your sobriety. They could include the skills you learned in rehab, like meditation, deep breathing, yoga, working out, taking a walk with a friend, setting boundaries, not overworking, eating well, and effective ways to communicate at work and manage your stress. Aftercare plans will help to reinforce those skills and teach you new techniques and skills.

Types of aftercare programs

Most rehab centers offer some kind of aftercare program or referral to a continuing care service. Like:

Alumni Programs

Many treatment centers have alumni programs in which former clients return once a week to check in with their counselor, meet other residents they attended treatment with, and attend recovery support groups and meetings. They could also include social events and even Facebook groups to always have a source of support.

Sober Living

When some people finish treatment they aren’t quite ready to return home. This is where a sober living home would be appropriate. Recovery residences are a great way to live in a supportive community with other people in recovery. It teaches you how to live every day, maybe even while returning to work, with the support of a structured home and other sober people going through the same experience. Think of it as a way to practice your new sobriety skills before returning home. Sober homes may have a counselor, peer mentors, recovery meetings, drug testing, and other support services like employment or educational support. You may also be asked to participate in household responsibilities and house meetings.

Transitional Housing

typically for people returning to the community after incarceration, or from a period of homelessness, transitional housing helps individuals seeking recovery to transition back into the community. Like a sober living home, transitional housing will include structure, like meetings, drug testing, and people in recovery, and it may also include a legal clinic, benefits support, low barrier employment opportunities, and partially-funded accommodation.

Support groups

Also called mutual-aid groups, these groups offer a supportive recovery community in the form of regular recovery meetings, including SMART Recovery, 12 Step groups like AA or NA, Women for Sobriety, Refuge Recovery, Recovery Dharma, Phoenix (a sport-related recovery group), Celebrate Recovery (Christian-based), Wellbriety (Native American/Alaska Native), and more. Support groups could also include group treatment sessions at your rehab on an outpatient basis.

Individual Counseling & Therapy

You may meet with a counselor from rehab or find a therapist in your local community. This will give you space to process life outside of a treatment center, like challenges, stressors, and how to deal with triggers. Unlike recovery meetings, therapy is 100 percent dedicated to you so you can work on whatever you find helpful. Your counselor or therapist may also suggest different support strategies and coping skills.

Case Management

Case managers can help to coordinate care and services during and after treatment. This could include finding a therapist, and mental health providers, connecting you to social services like housing and health insurance. Think of case managers as your advocates working on your behalf to get you set up for success in your recovery. They also have the experience to navigate healthcare, legal, criminal justice, and child welfare systems, which may be challenging to navigate alone, especially in early recovery.

Recovery Coaching

Coaches are like recovery mentors, but not therapists, or a sponsor. Coaches help to create and sustain the motivation to achieve certain goals, like maintaining recovery, finding a dream job, or even working on buying a home. Coaches are like cheerleaders and serve as a great source of support and accountability to keep you on track in your recovery.

Recovery Community Organizations (RCOs)

RCOs are a hub of recovery activities within your local community. You’ll find recovery meetings, peer support programs, social events, referrals to services, legal clinics (like an expungement service), and more. To find your local community organization, visit Faces and Voices of Recovery Alliance for Recovery Centered Organizations, the Peer Recovery Center of Excellence, or your local health department for a list of RCOs near you.

Peer Support Services

Many RCOs have peer support services and due to an increase in federal and local funding, many health departments also have qualified peer support workers. A peer support person has been through a training program and is registered by the state to provide peer support services. Unlike a therapist (although some therapists are in long-term recovery), peers have lived experience of recovery and have also faced many challenges that you may face in your journey. They can help you create a recovery plan, navigate challenges, attend meetings, cheerlead, and connect you to local services and resources. Visit Recovery Link or WeConnect Health, to find an online peer across the US, the Peer Recovery Center of Excellence, your local RCO, or your state health department for a list of certified peers near you.

Recovery Cafes or Sober Bars

believe it or not the non-alcoholic drink market is booming and lots of zero proof venues are full of people in recovery. They offer a cafe environment, or even a sober bar, where they serve nonalcoholic drinks only. While this could be triggering for some people, especially in early recovery, many people in recovery love the social atmosphere of these cafes and NA bars. It can be a fun place to socialize, meet new people in recovery, and more. Check out Sans Bar for more information or Zero Proof Nation to locate a non-alcoholic global map and to find more information about a sober hangout near you.

Are There Free Aftercare Programs?

Many recovery aftercare programs are low cost or free, including:

• Peer support services
• Recovery Community Organizations, like the Alano Clubs
• Recovery meetings / mutual-aid groups, like AA, or SMART Recovery
• Some transitional housing programs, like Oxford House

Generally speaking, drug rehab aftercare programs associated with a treatment center often an additional fee, unless it is a nonprofit rehab, or government funded. It may also be worth asking the treatment center if they have a scholarship or sliding scale payment option for aftercare.

References

1. Dennis, M., & Scott, C. K. (2007). Managing addiction as a chronic condition. Addiction science & clinical practice, 4(1), 45–55. https://doi.org/10.1151/ascp074145
2. NIDA. 2023, September 25. Treatment and Recovery. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
3. Dennis, M. L. et al. (2005). The duration and correlates of addiction and treatment careers. Journal of Substance Abuse Treatment, Volume 28, Issue 2, Supplement, 2005, pages S51-S62.https://www.sciencedirect.com/science/article/pii/S0740547204001382
4. McKay J. R. (2021). Impact of Continuing Care on Recovery From Substance Use Disorder. Alcohol research : current reviews, 41(1), 01. https://doi.org/10.35946/arcr.v41.1.01
5. Majer, J. M., Jason, L. A., & Bobak, T. J. (2022). Understanding recovery Capital in relation to categorical 12-Step involvement and abstinence social support. Addiction research & theory, 30(3), 207–212.  https://doi.org/10.1080/16066359.2021.1999935
6. McKay J. R. (2009). Continuing care research: what we have learned and where we are going. Journal of substance abuse treatment, 36(2), 131–145. https://doi.org/10.1016/j.jsat.2008.10.004
7. National Institute of Drug Abuse. (2014). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). https://archives.nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf