Stages of Abstinence

This was handed out at a LifeRing meeting in Canada that a friend of mine attended. It apparently was originally intended for counselors in treatment programs. The source was not identified, and I have no idea whether there’ve been studies that support it, but I and many others have found it helpful.

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Withdrawal stage(1 to 2 weeks):  People who drank alcohol in large amounts may have severe withdrawal symptoms. These may include nausea, low energy, anxiety, shakiness, depression, intense emotions, insomnia, irritability, difficulty concentrating and memory problems. These symptoms typically last 3 to 5 days, but can last up to several weeks.

Early abstinence (4 weeks; follows withdrawal):  For people who used alcohol, this period is marked most by the brain’s recovery. Although the physical withdrawal symptoms have ended, the client’s brain is still getting used to the absence of the substance. Thinking may be unclear, concentration may be poor, nervousness and anxiety may be troubling, sleep is often irregular, and, in many ways, life feels too intense.

Protracted abstinence (2 to 5 months; follows early abstinence):  From six weeks to five months after clients stop using, they may experience a variety of annoying and troublesome symptoms. These symptoms–difficulties with thoughts and feelings–are caused by the continual healing process in the brain. This period is called ‘The Wall’.  It is important for clients to be aware that some of the feelings during this period are the result of changes in brain chemistry. If clients remain abstinent, the feelings will pass. The most common symptoms are depression, irritability, difficulty concentrating, low energy and a general lack of enthusiasm. Clients also may experience strong cravings during protracted abstinence. Relapse risk goes up during this period. It is helpful to stay focused on staying abstinent one day at a time. Exercise helps tremendously during this period. For most clients, completing this phase in recovery is a major achievement.

Readjustment (2 months; follows protracted abstinence):  After five months, the brain has recovered substantially. Now the client’s main task is developing a life that has fulfilling activities that support continued recovery. Because cravings occur less often and feel less intense, clients may be less aware of relapse risk and put themselves in high-risk situations and increase their relapse risk.

Avoiding relapse drift:  Relapse does not happen without warning, and it usually does not happen quickly. The gradual movement from abstinence to relapse can be subtle and often underestimated, so it often feels as if it happens suddenly. This slow movement away from abstinence can be compared to a ship gradually drifting away from where it was moored. The drifting movement can be so slow that you don’t even notice it.

During recovery, people do specific things that keep them abstinent. These activities can be called “mooring lines”. Try and see what you are doing to keep yourself abstinent. List the mooring lines in a specific way so they are clear and measurable. These activities are the “ropes” that hold recovery in place and prevent relapse drift from happening without being noticed……

[There followed a chart of a column to list all specific mooring lines (for example, going to gym, reading sobriety stuff, recreational activities, peer support activities et cetera) followed by columns for the days of the week.]

It is helpful to complete your mooring lines chart weekly. Place a check mark next to each mooring line that you know is secure and record the date. When two or more items cannot be checked, it may mean that relapse drift is happening….Use the chart to recognize when you are more likely to relapse and decide what to do to keep this from happening.

6 Responses to Stages of Abstinence

  1. Imogen says:

    What a great idea to put this here, Susan! I have a printout of it next to my computer and i read it most days because I get a lot of reassurance from it that i’m on the right path. It’s such an eye-opener to read all the negative effects alcohol has on our organs and especially our cognitive abilities and emotions.

  2. Pingback: It’s Just a Sip, Right? (Get Better? Or Get Sicker?) | Running On Sober

  3. Pingback: checking my mooring ropes | taking a new path

  4. It would be really helpful for me if I had any study that support it. Since you wrote it, Have you found any references that support it?

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