The first three months of recovery get talked about in two unhelpful registers. Either it is presented as a triumphant fresh start, or as an ordeal to be white-knuckled through. The reality is less dramatic than both and considerably more uneven.
Knowing the shape of it in advance helps, mostly because it stops you interpreting an ordinary hard week as evidence that you are failing.
Acute withdrawal depends entirely on the substance and on how long and how heavily it has been used. Timelines differ enormously between alcohol, opioids, stimulants and benzodiazepines.
One thing worth stating plainly: withdrawal from alcohol and from benzodiazepines can be medically dangerous and in some cases life-threatening. These are not substances to stop abruptly on your own. Speak to a physician or call the Alberta Addiction Helpline at 1-866-332-2322 to arrange supervised withdrawal.
Most people find this stretch physically miserable and mentally narrow. The goal is simply to get through it with support in place.
This is the phase people are least prepared for, because the acute symptoms have passed and they expect to feel better.
Instead many people describe feeling flat, foggy, irritable, and unable to enjoy things. Sleep is often still disrupted. Concentration is poor. There is a persistent sense of something missing, because a substance that reliably provided relief has gone and nothing has yet replaced what it did.
Clinicians often describe this as post-acute withdrawal, and its signature is that it comes in waves rather than improving in a straight line. A good few days followed by a bad one does not mean you have gone backwards.
This phase is where a lot of people relapse, specifically because they feel worse than they expected to at this point and conclude it is not working.
As the fog lifts, what remains is everything the substance was covering.
The relationships that were damaged. The financial situation. The job. Grief or trauma that was being kept at arm's length. Social situations that were always built around drinking, and the question of who is actually a friend.
This is usually the point at which counselling becomes most useful, because there is now enough clarity to work with. Early on, the work is stabilising. Here, it becomes about what the substance was doing for you and what will do that job instead.
Underlying trauma, anxiety or depression very often surfaces in this window, and treating it is part of treating the addiction rather than a separate project.
Relapse rates in the first year are high. This is a well-documented feature of substance use disorders and is comparable to relapse rates in other chronic conditions that require sustained behaviour change.
A return to use is a setback and a piece of information. It usually tells you something specific about what the trigger was and what the plan did not account for. Treated that way, it is workable. Treated as proof of personal failure, it tends to turn into a longer return to use, because shame is an excellent reason to keep drinking.
If it happens, the single most useful thing is to tell someone quickly rather than letting a day become a month.
Structure, particularly around the times of day that were most associated with using. Sleep, which improves slowly and improves everything else. Having more than one person who knows what is going on. Deciding in advance what you will do in the specific situations you know are hard, rather than deciding in the moment.
And some form of ongoing support, whether that is counselling, a group, or both.
Supporting Wellness offers addiction counselling in Calgary, Red Deer and Cold Lake, including for people who are still using and not yet sure what they want to do. You do not have to have stopped before you come in.
The Alberta Addiction Helpline is 1-866-332-2322 for 24/7 support and referral. If you are in crisis, call or text 988.
Related reading: When one family member is struggling, What to expect in your first EMDR session and Paying for therapy in Alberta.
