As an addict in recovery, the most important thing to remember about recovery is this one mantra: What you do after you leave drug rehab is just as important as what you accomplish during rehab.

Data from the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Survey on Drug Use and Health revealed that, in 2009, 23.5 million people in the United States older than 12 years old needed treatment for a drug or alcohol abuse problem¬ — or 9.3% of this population. Sadly, just 2.6 million of these people, or 11.2% of those who needed treatment, actually went on to receive it at a specialized rehab facility.

Meanwhile, SAMHSA’s Treatment Episode Data Set from 2008 showed that alcohol abuse treatment accounted for 41.4% of treatment admissions. With respect to drug-related admissions, heroin and other opiates comprised the largest percentage of admissions (20%), while marijuana accounted for 17%.

A study published in Evaluation Review found that just 33% of people who are clean for less than a year will remain sober. Meanwhile, among those who reach a year of sobriety, less than 50% will experience a relapse. Then, if you’ve made it to five years of sobriety, the likelihood that you will relapse is less than 15%. They also found that, each year, recovering addicts were more likely to be sober the following year if:

They are female

They have legal involvement in their recovery

The majority of their friends are clean and sober

They had weeks of treatment in aftercare

Addiction is a disease, and like any other disease¬¬ — like diabetes or asthma¬ — successful management must include lifestyle changes, medical appointments and treatment plan modifications. You should always keep in mind that recovery is a process and not an event. Walking out of rehab is just the beginning, and it’s important that you know what to expect after drug rehab.

Early Recovery: Physical Withdrawal Symptoms

Wondering what to expect one month after drug rehab? The first thing you’ll probably feel are the lingering physical symptoms of drug withdrawal. The duration of these symptoms will largely depend on how much drug abuse you endured and the type of drug abused. Some of the more common physical symptoms can include:

Heightened heart rate and/or blood pressure

Sweating, chills, runny nose and fever

Body aches, pains and cramps

Hallucinations, seizures, confusion

Nausea and vomiting, decreased appetite

Insomnia, restlessness

Anxiety, nervousness, increased stress

Volatile and unpredictable mood swings, suicidal ideation and prolonged periods of depression

Post-acute withdrawal symptoms usually occur in episodes that last for a few days. As time moves on, you should find that episodes begin to taper off. There is no real trigger for these episodes, but there are a few things can do to try and mitigate the amount of discomfort you experience during them. These management techniques include:

Being patient. Try to get through the episodes just one day at a time without feeling overly resentful. The negative energy will leave you feeling more exhausted than you need to be and can potentially exacerbate certain withdrawal symptoms.

Giving yourself some TLC. You’re going to need a lot of breaks and time to rest during these episodes. Be good to yourself during them, and remember that even amid all the moving parts of life, you have permission to focus on yourself.

Going with the flow. These symptoms are undeniably uncomfortable, but focusing your energy on thinking about them will only make them worse. Do whatever it is you need to do to distract yourself from them without overexerting yourself.

It is likely that you’ll experience a few nights with bad sleep, low amounts of energy and irritability. Don’t let these episodes become a trigger for relapse.

Early Recovery: The “Emotional Rollercoaster”

After completing your first month post-rehab, it’s unlikely that you’re completely transitioned back into your home. During the first few months, you’re likely to face major challenges as you try and reorient your life while maintaining sobriety. Perhaps the most formidable challenge of all is the fact that avoiding addictive substances is now your personal responsibility. In rehab, a drug-free environment and supportive staff make avoiding drugs relatively easy when compared with outside.

This time period is often characterized as an “emotional rollercoaster,” because your ups and downs can be very extreme at times. A large part of these ups and downs can be attributed to certain withdrawal symptoms, which can vary in intensity based on the drug that was being abused.

For instance, methamphetamine addicts often have trouble staying away during their first few weeks of sobriety. During addiction, their bodies had been starved of rest and they need time to re-establish balance in all of their physical systems. Meanwhile, people who had been addicted to marijuana report having trouble sleeping because their bodies no longer know how to relax without the drug.

Other reasons behind these swings may include:

With sobriety comes the presence of mind to know who you’ve wronged in the past. Having to directly face the wreckage of your past is hard and can feel devastating.

Raw emotions. Prior to sobriety, the chemicals in drugs or alcohol numbed you to emotions, meaning highs and lows may feel pronounced now.

Major life changes. Inevitably, you will have to make major life decisions in the first weeks and months of your recovery, which can incite a very high amount of stress. Life unfortunately does not take a break, even when you most need it.

Nutritional deficiencies. During your addiction, you may not have been getting proper nutrition which, after a while, could cause physical ailments and pains. No longer taking drugs will make you acutely feel those aches and pains.

Early Recovery: Salvaging or Writing Off Relationships

Beyond the physical symptoms of early recovery, you should know what to expect six months after drug rehab in terms of your interpersonal relationships. Much of what you’ll need to focus on during this time is beginning to decide whether or not your old relationships can be repaired or not. In particular, you should know that, while completion of rehab is definitely a positive thing in your life, your friends and family may express varying reactions to your return. Some people may express a lack of optimism about your chances of actually remaining clean and sober, while others may harbor anger about previous wrongdoings.

Once you’re sober, you can’t just wait for the good things in life to come your way, and this is especially true when considering your relationships. You have to take concerted steps and actions to right the wrongs you’ve done unto others. When the opportunity arises to make an apology and genuinely offer an “I’m sorry,” it’s natural to feel like you don’t want to, or can’t. Although apologies leave people feeling vulnerable, you should put your best foot forward and make the apology if you can. You’ll find that the experience can be freeing.

Importantly, the most precarious relationships you’ll have to deal with may be the relationships you had with people who were involved in substance abuse alongside you. They could try and sabotage your efforts to stay on the path to recovery with peer pressure. In your still-weakened state, maintaining awareness of this possibility is critical. Staying sober must be your top priority, especially during early recovery.

Early Recovery: Dangers and Threats to Sobriety

Being aware of what to expect six months after drug rehab will help you to successfully manage your recovery going forward. At this stage, it is of paramount importance that you know what the major triggers for relapse are. Some of the most common triggers for relapse include:

Loss of commitment to the recovery program. Just because you’ve successfully completed drug rehab does not mean you are ready to stand on your own two feet without support. When the inevitable compulsions and cravings come along, you’re going to need tools to cope with them and someone to lean on.

Having too much confidence. Since addicts normally have low self-esteem during addiction and the earliest of all recovery stages, it may seem counterintuitive to say confidence is a bad thing. Sometimes, too much confidence can mean that you don’t think you need to continue with recovery efforts — that your problem is solved. This is commonly referred to as “Pink Cloud Syndrome.”

Trying to resume normalcy too quickly. You need to take the time to completely recharge after a rehab experience. Taking on too much too quickly can generate large amounts of stress, which is the hallmark risk factor for relapse.

Frustration. This often manifests itself in having unrealistic expectations about your recovery. Some people allow this disappointment and impatience to be used as an excuse to relapse.

Abusing different substances. Just because you entered rehab for drugs doesn’t mean that your experience with alcohol would end any differently. Don’t switch one vice for another.

Hunger, Anger, Loneliness, Tiredness (HALT). When your most basic needs aren’t met, you may be susceptible to relapse, among other self-destructive behaviors. The good news is that the HALT triggers are easy to address and to recognize before you reach a breaking point.

Late Recovery: What to Expect Two Years After Drug Rehab

Making it to two years after drug rehab is an important milestone. Thankfully, you can expect that most lingering effects of post-acute withdrawal syndrome will have totally vanished by this point. Also, many people at this stage of recovery claim that they think about alcohol or drugs only rarely. Physical cravings can occur, but this is also rare.

There is a wide range of positive things you can expect once you reach the more advanced stages of your recovery. You should feel a sense of accomplishment and a greater confidence in the idea that you really do have the ability to maintain sobriety. Substance abuse is not causing you to miss out on the finer moments in life. Also, it is likely that you have acquired and fine-tuned the coping skills needed to deal with the major life changes that you were likely advised to avoid during your early recovery.

While much of the early recovery stage is spent addressing some of the major character flaws that defined you as a person while you were an addict, the advanced stages of recovery are more about stripping yourself completely of those flaws. These flaws often stand in the way of your happiness. The work involved in this pursuit is never truly finished. You are in a good position to set goals and work toward dreams. Even better is the fact that you are now better positioned to help people around you who may still be struggling with addiction.

Late Recovery: Common Mistakes Can Undermine Accomplishments

Although you can expect many positive things to happen in your life as you move forward in your recovery, it’s important to remember that entering the advanced recovery stage does not mean you’ve been cured from your addiction and your problems are gone forever. You should dedicate your energy to making sure you don’t make the following common mistakes as you move through this stage:

Just because you’ve been clean for a few years does not mean you have the ability to begin responsible drug use. This is dangerous logic that essentially serves as a one-way ticket to relapse and an exacerbation of the life problems you worked hard to alleviate during recovery.

In a similar vein of logic, there is never an appropriate time to closely reconnect with the people you surrounded yourself with during your time of abuse. If they still use, you will be putting yourself at risk for relapse each and every time you hang out with them.

Reaching advanced recovery is also not an invitation to slack off in your daily efforts to remain sober.Many characteristics associated with an addictive personality, including impulsive behavior and sensation seeking, are lifelong conditions that must constantly be managed. It is estimated that as many as 10-15% of the population exhibits some characteristics of an addictive personality.

Some people who reach advanced recovery turn to other maladaptive behaviors, such as over-exercising or workaholism, to fill the void of feeling stagnant in their recovery. Focusing on a new vice may lead certain people to forget about how bad life was during addiction. Those who forget their mistakes are doomed to repeat them.

Advanced Recovery: Reaching Emotional Sobriety

A year or so after you’ve established yourself as physically clean and sober, you’ll need to begin addressing your emotional sobriety. Addressing your emotional sobriety entails confronting the feelings and emotions that may have led you toward the path of addiction in the first place. The pursuit of emotional sobriety includes:

Enhancing your ability to be comfortable with yourself and your life in the present moment. Spending your time longing for the future or regretting your past can be self-destructive and unproductive.

Using the coping skills you’ve picked up along the way and honoring them no matter what is going on in your life. You should be able to maintain a positive view on both your life and future.

Making a concerted effort to exude the highest level of control over your own behavior. Being able to avoid dealing with emotions that are too strong will help you maintain low levels of stress in your life. As discussed, stress is one of the biggest triggers for relapse¬ — even when you’re years into your recovery.

Practicing mindfulness meditation or another spiritual exercise to try and better understand your emotions and keep a grasp on them.

Above all things, make sure you set realistic expectations for how you feel during this stage of your recovery. Achieving emotional sobriety does not mean you will feel unending bliss at all times, no matter what’s going on. The main goal of emotional sobriety is to gain the ability to maintain control of your emotions even during the most trying times. Dangerous emotions for people in recovery include:

Fear

Disappointment

Loneliness

Feelings of excessive joy that are not sustainable and could be followed by an extreme low

The boredom of not partaking in the social activities that you used to, due to the presence of drugs

Guilt about the wrongdoings of the past

Anger and resentment toward yourself or those around you

Advanced Recovery: Sometimes the Struggle Is More Than Just Addiction

It’s possible that, despite reaching advanced recovery, you may continue to feel poorly and down on yourself. One of the main reasons why this occurs is because of an overlooked dual-diagnosis. A dual-diagnosis is when a person simultaneously suffers from addiction and another mental health disorder. Keep an eye out for any of the following warning signs associated with mental health disorders:

Extreme mood changes

Confused thinking or difficulty concentrating

Withdrawal from friends, family and social activities

Suicidal ideation

SAMHSA publishes studies every few years investigating the different causes, effects and treatment options among people with dual-diagnosis. The agency estimates that 8% of the adult population in the US (17.5 million people) suffered from a serious mental health disorder during the past year. Of those people, 4 million also suffered from a co-occurring substance abuse issue. Also, SAMHSA observed that over the course of the past six years, the percentage of people in drug rehab seeking help for addiction who were also diagnosed with a mental health issue increased by 12% to 16%, suggesting a greater awareness of this serious issue.

The 12 Keys Rehab Approach

Many people who end up going to a rehab facility will have done so because they’ve reached rock bottom in their life due to addiction. Unfortunately, even when you leave rehab, you’ll likely still have to face some of the bad consequences of your previous behavior. The good news is that navigating these uncertain waters is not something you have to do alone.

12 Keys Rehab’s Aftercare Planning Program lets recovering alcoholics and addicts build supportive relationships with others who have traveled similar life paths. These relationships can help you and your loved ones build up the newfound foundation of sobriety in a safe, compassionate and empathetic manner. Individuals with more experience living soberly can offer sound advice on maintaining the clean lifestyle, while those in a position of expertise benefit from acting as a mentor to those needing guidance.

The counselors and specialists at 12 Keys are uniquely positioned to provide empathetic, competent care because our staff is comprised of many recovering alcoholics and addicts. We know what it’s like to struggle with addiction, and we live our daily lives as role models of what a successful ongoing recovery can be.

Unlike other rehab programs, the 12 Keys real recovery experience will enable you to secure the tools and resources you need to learn to love life again. We believe in the importance of teaching people to live a sober lifestyle in the “real” world, as opposed to living sober only in rehab. How well you manage your early stages of recovery is the biggest determining factor in what to expect five years after drug rehab.

Call 12 Keys Rehab today to make sure your life gets back on track emotionally, physically and spiritually after leaving rehab.