The importance of continuing care in addiction treatment was sadly, starkly shown in Whitney Houston’s story.

Her death is a reminder of the power of the chronic, often relapsing brain disease of addiction. It also points to the importance of developing a solid “Continuing Care Plan” to follow the acute detox/rehab treatment period in order to help reduce the stress/triggers that leads to relapse. There is the perception that after a 28-day residential and/or intensive care treatment program, for example, “all is well” and life can go back to “normal.” What is missing is the understanding that addiction, like other diseases, requires continuing care. According to the ASAM’s 2009 Principles of Addiction Medicine Fourth Edition, “…effective treatment attends to multiple needs of each individual, not just his or her alcohol or drug use. To be effective, treatment must address any associated medical, psychologic, social, vocational, legal problem, and environmental problems” (ASAM, Principles…, p. 389).  Additionally, the Principles cites one of the key components of “the best treatment programs” is “continuing care” (ASAM, Principles…, p. 351).

Because addiction is a chronic, often relapsing brain disease, there is no way all aspects of healing the brain can be completed in 10, 28 or even 60 days. Yes, a great start can be made, but a continuing care (a.k.a. an after care) plan that extends “treatment” for at least a full year is critical.  The addict/alcoholic’s embedded addiction-related neural networks will be triggered by any number of cues – sound, sight, memory, the smell of alcohol, an emotion, a stressful person or situation. Therefore, planning how to prevent and/or handle such cues is critical. Let’s face it, treatment for a heart disease patient or diabetic doesn’t stop after the person is stabilized, nor is it assumed a patient’s diabetes or heart disease goes away after the rehabilitation effort. Instead, those patients are counseled, provided education and behavioral modification strategies, and then they are given a continuing care plan and follow-up with further modifications, if necessary. This same approach must be used with treating addiction. For as you can imagine by now, healing, developing and changing neural networks takes time.

To be effective a Continuing Care Plan must include specific strategies that outline how the drug addict/alcoholic is going to maintain abstinence. They must go far beyond the “typical” drug testing and 12-step meeting attendance monitoring. They must include plans for how to integrate with the family; for how to deal with the fall-out of not dealing with “life” while in their addiction (e.g., credit destruction, parenting issues, relationships problems, foreclosure, lost jobs, lost friendships — the “life” situations than can trigger a person who is in early recovery (day 29, 30, 45 or 72, for example); for identifying strategies to handle relapse (stress) triggers;  for how they will deal with underlying issues (typically related to the risk factors for developing the disease – mental illness, childhood trauma, to name two); for what the family needs in order to help themselves and in that process, help their loved one. Just as a person with diabetes, heart disease or cancer has a continuing care program/plan to help them continue their recovery once the acute care treatment (e.g., surgery, radiation, chemo) is complete, so too must the alcoholic / addict AND the family member/friend.

Recovery and a life of joy, serenity, productivity, and overall happiness is entirely possible for a person with the disease of addiction. A person can get to and sustain the “good part” when they understand and treat their disease for what it is — a chronic, often relapsing brain disease. Healing the brain (like healing other diseases) does take time, but first and foremost is to remove the substance so as not to kick-start the embedded brain maps that are the disease. And from there… to try the many, many treatment and continuing care options — there is a size that can fit the individual. It is not a one-size-fits-all.

For more information on continuing care plans, click here.

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Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com

Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.

Latest posts by Lisa Frederiksen (see all)

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