Substance abuse, which includes alcohol, illegal substances, harmful chemicals, and abuse of prescription drugs, has the ability of blinding people to the problem. That little March Leprechaun and green beer of St. Patrick’s Day may seem cute, but substance abuse is no laughing matter. I’ve seen people who have lost jobs, friends, family, children, home, freedom, health, and finally their lives over substance abuse. Most people who enter therapy for the first time try to explain why they “don’t have a problem.” I listen to these excuses carefully, for these individuals are telling me the next step and the direction where they are headed. One person may say “I don’t drink daily” and most likely he’s saying that he drinks more days than not and soon will become a daily drinker. When someone tells me, “I’m not homeless. I have a friend living on the street and I’m not like him,” I have a serious concern that this person is heading in this destructive direction.
There are six stages of substance abuse and recovery. People move back and forth between stages, and mastering one doesn’t ensure that you won’t return to it at a later time.
Precontemplation: Not considering quitting. Denies having a problem.
Contemplation: Considering quitting but has made no commitment. Is beginning to become aware that there is a problem that he needs to work on.
Preparation: Planning to quit in the near future and has made attempts to quit. Is beginning to develop actions and a change in life-style that are preliminary to a new lifestyle. He admits to having a problem most of the time.
Early Recovery: Successfully discontinues addictive behavior. Still has addictive thinking, may still associate with other addicts or addictive life-styles. Often considers abstinence to be a temporary state and thinks about going back to using when the present crisis is resolved. May still minimize the extent of his problem and makes excuse for his use. Feels he is recovered because he has stopped using.
Middle Recovery: Has remained abstinent for three to six months and is no longer having cravings or physical withdrawal symptoms. Has looked at his addiction honestly. Has made a commitment to remain abstinent. Has made new friends and avoids people and situations that put him at risk for relapse.
Maintenance: Has maintained abstinence for one year. Has made changes in lifestyle and thinking that encourage ongoing abstinence from addiction.
Relapse: Relapse may occur at any time but does not have to be a permanent setback. I do not consider this to be a stage of recovery, as considering it a stage is allowing for a relapse. If one happens, it’s time to stop and return to abstinence. Being human, we often make bad choices in life, but they do not mean that we have failed, only that we need to get up and begin again.



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