If someone in your life is struggling with opioid addiction, it helps if you understand the stages of opioid recovery
It’s impossible to miss the fact that we have an opioid crisis in this country. It’s hard to imagine that you don’t know someone who has been impacted by this epidemic. But, as we start to learn about opioid addiction and recovery, it’s critical to understand how opioid recovery works.
Stages of opioid recovery show a timeline for getting healthy
Stages of opioid recovery were not clear to me when I started my journey. I just wanted to stop using. Why is recovery so difficult, and why do so many people fail? It’s a very complicated question with no easy answer. Studies show that it takes an average of 66 days to form a new habit or behavior. This means that the old behavior has been changed and the new behavior will happen automatically. This research is for habits, however. Addictions are different in ways that make changing behaviors much more challenging. Opioid addiction, for example, is an illness with three components, effecting someone physically, mentally, and spiritually.
Addiction is defined as a chronic, relapsing brain disease, and brain diseases don’t just go away with will power.
For opioid recovery to be lasting, we have to learn to live without using drugs, and we have to learn new ways to cope with life and work and relationships effectively. This would be a lot for anyone to take in and fully digest, and it doesn’t happen right away. Recovery is a never-ending process. There is no cure or endpoint. That being said, when a person stops using opioids or other substances, their recovery grows in 7 stages as they develop healthier versions of themselves.
What are the stages of opioid recovery
Stage 1: The first 30 days
During the first 30 days of getting sober, a person is most likely to be the least comfortable during this whole process. They are getting the drugs out of their system and attempting to recuperate physically. During this time, someone may be in a treatment facility, jail, or struggling through the daily obstacles of normal life. Everything feels uncomfortable and new. This period may include medically assisted treatment, that is medicines that curb the craving, which we will discuss in another article.
Newly sober opioid addicts are just working into a solution. It is not easy — if it were, no one would be struggling with active opioid addiction. Many of us face legal repercussions, damaged relationships, brutalized finances, health issues, etc. Consequences from active addiction are the heavy hitters making for guilty consciences — which have been numb for who knows how long.
The interesting paradox of this stage is that it can also be paired with a “pink cloud.” This is a feeling of euphoria that develops in newly sober people. It can be consistent or come in ebbs and flows. Some people start to have bursts of pleasure as the receptors in their brain kick start.
Stage 2: The first 90 days
Ninety days is a blip in time! We literally have to learn how to live again. I experienced the pink cloud dropping out around this time, so I looked for other things outside myself to make me feel good. This is called cross-addiction and it manifests in many recovering people, no matter what stage they are in. We overuse behaviors or things to make us feel good such as relationships, sex, eating, exercise, body modification, etc. Opioids are a symptom of addiction; and once they are gone, we still want to feel good instantly. This is where a program of recovery comes into play.
Most 12-step programs suggest completing 90 meetings in 90 days to truly create a foundation in a program of recovery. If working a program, the recovering addict is also doing step work, meeting with a sponsor, and establishing a sober support network. These programs offer us a solution to learn how to live again — they are our medication so to say.
At 90 days sober, one recovering addict asked her sponsor: “Why am I not happy at 90 days?” The sponsor shared with her that she was still “crazy” and this was only the beginning. There is so much work to do and the craziness is still there.
Most newly sober people at this stage are busy and can feel unstable! In addition to working a program, they have probably completely a treatment program and made their way back into society by getting a job. Learning to live day-by-day life comes with many obstacles and can be challenging. The pink cloud has probably dissipated and post-acute withdrawal symptoms (PAWs) have settled with annoyances like forgetfulness and trouble sleeping.
Stage 3: The first 6 to 9 Months
This is a very pivotal time, because this is where a lot of relapse happens. I see it when people celebrate milestones. So many people celebrate that 6-month anniversary and then maybe a fifth of those people actually celebrate 9 months. By this point, we’ve made it through some of the most uncomfortable times. Without constant growth, however, a recovering person can become complacent. Some may also challenge whether or not they have a problem, because being sober is starting to feel familiar; therefore, they decide to test it.
Forty-five percent of people suffering from addiction have a co-occurring mental illness.
The sweet spot for identifying these illnesses is six months. At this point, the drugs are out of the body’s system and enough time has passed for new issues to be identified. A mental health assessment can identify other underlying mental illness or emotional problems. This assessment can be challenging for a newly sober individual to deal with. Recovery can feel overwhelming if there is additional questions and stigma about sobriety and needing to take medications. Any of these stages of opioid recovery can include medicines to treat mental illnesses like depression, bipolar disorder, and other disorders. No one should feel shamed about needing medicines to heal.
Stage 4: 1 Year
This is a huge milestone! It’s time to stand tall and let those shoulders fall back — confidence is settling in. A recovering opioid addict has gone through their first year and has established new “firsts.” This means they’ve survived their first sober holidays, family get togethers, established themselves at a place of employment, and ideally have a stable foundation in a recovery program. A common rule of thumb is that a person can start dating after they celebrate a year (dating within the first year is discouraged so a people can focus on themselves). The training wheels come off, and we start to live with a more appropriate understanding of sober life.
Stage 5: 18 Months
It takes an average of 18 months for the brain to heal from active addiction. Chemically, the brain is producing dopamine and serotonin on its own now. PAWs has also subsided and a person should feel good physically. We are experiencing pleasure innately and feeling natural emotions.
Eighteen months is substantial time for a recovering person to rebuild their lives. Consequences have dissipated for the most part. Materials such as cars and new clothes have been earned. We have established ourselves as functioning humans.
All stages of opioid recovery have risks for relapse
That being said, this is another popular time for relapse because of complacency. The first year is marked with milestone festivities and, ideally, many short-term celebrated goals. By now, recovery is a normal part of everyday life in addition to all daily functions such as running a household, working, relationships, and responsibilities. The daily swing of things has the potential to become mundane for those who get too comfortable, and they may go back out.
Stage 6: 5 Years:
They say at 5 years sober you get your marbles back (because you lost them to begin with). A recovering person has learned a lot about what is means to be and stay sober, but there is so much more to learn! My sponsor was huge on emotional sobriety at this point in her journey. This is an important factor of recovery; it means being able to challenge and cope with all the negative emotions that were disregarded when using drugs or alcohol. We have the opportunity at this point to grow internally in a way that was previously unimaginable.
Stage 7: 10 Years and Beyond
Now it’s time to play with those marbles! It is safe to say a new way of life has been adapted. One recovering addict with over 12 years of sobriety said: “It [having more than 10 years sober] makes me work harder for my sobriety … the fact I have been almost 13 years away from using makes me forget a lot of what it’s like to be early in sobriety or struggle to be sober. I rely on newcomers and messages from 12-step fellowships to hear and remember those times, because I can easily let my gifts [of sobriety] become a priority and that can translate into me drinking “responsibly” or using. I remain close to God every morning when I wake up and use my sober support to check in with others and listen to others and not think about myself.”
It is interesting to see how these individuals with substantial time touch on elements of recovery mentioned within the other stages. When another recovering addict was asked what it was like having long-term sobriety they said: “Sometimes it feels like a merry-go-round rather than a roller coaster like my first few years when I couldn’t get a grasp on emotional sobriety. Life still presents its challenges and sometimes I struggle with complacency but I’ve found that the solid foundation I built in early sobriety and the relationship I have with my Higher Power today has allowed me to live a life I never thought imaginable.”
Times of recovery are not set in stone and can take longer or shorter to achieve depending on many factors
Stages of opioid recovery can differ for an individual. We all come from different circumstances, but the issue remains the same. Recovery is not an easy feat to face on a daily basis for the rest of our lives. Recovering opioid addicts face a 60% relapse rate, which is higher than any other substance addiction. That percentage drops to a 15% relapse rate for those sober for 5 years or more. (Note: Within the first week of recovery, an opioid addict faces a 95% relapse rate.) Let it be known that the percentages may lessen, but they never report a 100% recovery rate — never. The statistics are against us, but with deeper understanding and support all around, we will be graced with a greater chance to better those odds.