ladder climb kemet healthAnyone who has ever made and broken a New Year's Resolution can appreciate the difficulty of behavior change. Making a lasting change in behavior is rarely a simple process, and usually involves a substantial commitment of time, effort, and emotion.

Below is the 'roadmap' to recovery. These stages were developed by Prochaska and DiClemente in the late 1970’s after observing the experiences of smokers. They studied their decision making process, and discovered that people would quit when they were ready to do so.

I want to share this with our readers to provide a concrete blueprint as to how recovery unfolds. Just to be clear, this is a model and not a theory.

  1.   Precontemplation: Not ready for change. “Denial.”

  2.   Contemplation: Ambivalent and uncertain about change. Testing the waters of recovery.

  3.   Preparation: Prepared to experiment with change (entering treatment.)

  4.   Action: Definitive commitment to specific changes (roughly 4-6 weeks into treatment.)

  5.   Maintenance: Sustained periods of change that were previously made. 

  6.   Relapse: Regressing to one of the first two stages.     

Of course, there is no universal model as to how recovery works, and people can spend the better part of their lives stalled between stages, or one step forward followed by two steps backward. It can take an addict several years to go from Stage 1 to Stage 5, if not an entire lifetime, in some rare cases. The crux of recovery is that we have morphed into a 'have now' society. For most people, change occurs gradually, and it is the concept of 'gradually' that grows weary with many patients who expect a more immediate result very early in their recovery.   

During the Pre-Contemplation stage, the addict is oblivious to change, much less recovery. Change is the furthest thing from their mind. At this time, he or she is consumed with obtaining their next 'fix' and not getting any kind of help. It’s in this stage where denial plays a big role in a person's addiction. How can you pursue help if you don't think you have a problem to begin with? What motivates most opioid addicts to eventually entertain treatment is being sick of dealing with withdrawal. This is where Contemplation can kick in.

With Contemplation, you are still ambivalent towards change, but a crack has developed in your denial armor. During this stage the addict begins to weigh the pros and cons of continued use.  If Contemplation is allowed to ferment long enough, it can lead to Preparation.

Preparation is when people are ready to take action within the next 30 days. People start to take small steps toward the behavior change, which they believe can lead to a healthier life. During this step, they might start researching treatment facilities and or even take the additional step of entering treatment. 

Oftentimes people get ahead of themselves and enter treatment prematurely. This is where it is crucial to having a strong counselor at your back to reevaluate your intentions. Are you in fact ready for this level of change? For the right reasons? If you don’t have a counselor because you haven’t actually started treatment, you must have a healthy support network to have your back once you do.  

Action is when change starts unfolding, albeit with small steps. Many people falsely believe that action begins from the day they enter treatment. False. Action kicks in about 4 weeks into treatment, after overcoming the pitfalls of Preparation. 

In the case of the opioid addict, this is when things start to feel good. Your appetite is back, you’re sleeping better, you have fewer cravings, and Suboxone has normalized. Maybe you start treating yourself to the occasional Starbucks latte. That might not seem like a big deal, but every one of those lattes is well deserved, and a good reminder of how far you have come. It’s also a good habit to help combat random cravings. 

Change begets change. You have weathered the storm, so you start feeling optimistic about your recovery. It’s amazing how this taste of optimism, the idea that this whole recovery thing might actually work, can fuel a lifetime of recovery. What’s even more amazing is how your addiction can evolve to make your recovery addictive, not only for yourself, but to those around you who might be stuck in one of the earlier stages.  

Maintenance is the ultimate goal. Maintenance occurs when people have sustained their behavior change for over 6 months, and intend to continue maintaining the behavior change. People in this stage work to prevent relapse to earlier stages.  

Ultimately, you have to remain as even keeled as possible during these life/recovery stages.  Never too high or too low. Fortunately, you have the rest of your life to perfect this balance, and I assure you that it will come if you let it. I have seen this transformation first hand, and it is a beautiful evolution.