Continuing Care: Life and Recovery After Treatment

Many parents expect their child to be “fixed” following treatment, but substance use disorder can be a lifelong, relapsing disease that requires ongoing management. The initial completion of treatment is just the beginning of what may be a longer road to recovery. Your child will need help to manage their recovery over time.

Treatment for substance use disorder is often not a “one-and-done” type of situation. Because of the nuanced and often emotional work involved, as well as the reduction or elimination of physical dependence on substances, treatment can often take multiple attempts. This is true whether it’s as outpatient or at an inpatient facility. Whatever treatment looks like, recovery is always continuous work.

First, if your child lives with you or visits, it’s time for a thorough housecleaning to prevent any temptations:

• Take all substances and paraphernalia you can find out of your home.
• Secure all alcohol or remove it completely from your home.
• Lock up your medicine cabinet and dispose of any old or unused prescriptions.
• Search your child’s room for drugs, alcohol and paraphernalia — and then search it again.

Next, get naloxone as a prevention measure, if your child’s substance use included opioids (heroin and prescription pain medications like Vicodin, OxyContin and Percocet). Naloxone (also known by the brand name Narcan) can reverse an overdose, potentially saving a loved one’s life. It’s never the wrong choice to be safe. In many states, chain drugstores, as well as some independent drugstores, are providing naloxone through pharmacies without requiring a prescription.

Be sure the naloxone kit is easily accessible in your home, and that you and your family members know how to use it.

If your child needs treatment for an injury or surgery, be sure to talk to the provider about their pain management plan. It’s important to use alternatives to opioids (e.g., prescription pain medications like Oxycontin and Vicodin) where possible so as not to trigger a relapse, especially for loved ones who have struggled with heroin, fentanyl or pills but also for alcohol and other substances.

The first step is to fully understand what the treatment facility is recommending for the next steps and clarify anything that is unclear or concerning to you. Hopefully, you and your family were part of developing this “aftercare,” “discharge,” “continuing care” or “stepdown” plan — the plan for those next steps after treatment.

Aftercare plans could include the following:

• Family counseling
• An outpatient program
• Recovery support groups
• Psychiatric appointments
• Ongoing psychiatric medications, and/or medication-assisted treatment

There are some logistical things to consider with an aftercare plan, too.

Is your child going to need a ride to and from an outpatient program or to counseling or support groups? Since this is vital to their recovery, if transportation is needed, make arrangements ahead of time with your employer or hire someone to drive them to appointments, programs or meetings.

You may need to plan to take time off from work to attend family meetings that are a part of your child’s aftercare program. Your continued involvement matters very much to your child — despite what they may say.

Your child may need help in finding healthy friends and activities, given that many of their friends may still be using substances.

If your child is living in sober housing or in an Intensive Outpatient Program (IOP) instead of coming home, you will want to become familiar with the requirements and rules for their stay in this type of living community.

Even though your child is the one receiving treatment, the rest of the family would greatly benefit from regular counseling and support groups of their own. This can be a difficult time of transition for your family and it’s critical everyone is supported, and has help coping and addressing any issues that come up.

You’ll want to establish some boundaries and rules with your child. Some families find it helpful to develop a contract. This will include both positive reinforcement or rewards for good behavior and consequences when they push boundaries or break the rules.

In addition to a contract that simply states what is expected, you should also create a Recovery Plan. A Recovery Plan is for both you and your child to put down in writing what you both agree to do (or not do) to help support and maintain continued recovery and personal growth.

Sit down during a calm time soon after they get home to develop a plan as a family. Here are some questions to ask your child as you develop your plan:

• How can I be helpful?
• What would be stressful or unhelpful for you?
• Can we agree on what will be discussed and what won’t?
• Can we talk about how we will communicate with each other in both easy and difficult situations?
• Would you prefer to keep your treatment and recovery private from others outside our family?
• If you are willing to talk about it, with whom and how much information will you provide?
• Are there upcoming family weddings, barbecues, parties or other gatherings where alcohol will be served that might be too difficult or a trigger for your child so new to recovery? Decide as a family if you will decline an invite or attend with a plan in mind to protect your child’s recovery first.
• Can you think of fun activities to do together as a family? After all, your child may need to stay away from the friends they were hanging around before they went to treatment.