4 Stages of Alcohol and Drug Rehab Recovery

Think about it. Thoughtful serious beardful man sitting in the empty room holding hands near mouth and thinking.

yacobchuk / iStock / Getty Images Plus

Table of Contents
View All
Table of Contents

Recovery from an alcohol use disorder requires effort, time, willpower, and support. When you decide to enter a professional alcohol and drug treatment program, you will begin a journey through four distinct stages of rehab recovery as you learn to develop a healthy and sober lifestyle.

The four stages of treatment are:

  1. Treatment initiation
  2. Early abstinence
  3. Maintaining abstinence
  4. Advanced recovery

These stages were developed by the National Institute on Drug Abuse as a resource on individual drug counseling for healthcare providers, but it is also a useful model for recovery from alcohol addiction. In this model, recovery is a lifelong process.

Press Play for Advice On Finding Help for Alcohol Addiction

Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring multi-platinum award-winning singer Bryan Abrams, shares his sobriety journey and how he found treatment that actually worked. Click below to listen now.

Follow Now: Apple Podcasts / Spotify / Google Podcasts

Stage 1: Treatment Initiation

When you reach out for help from a professional alcohol and drug rehab program, you begin the first stage of your recovery, treatment initiation.

Whether you seek help voluntarily or are forced by circumstances to enter rehab, your recovery process will begin with a professional treatment program.

In the early hours and days of your rehab, you probably will have some ambivalent feelings about giving up your drug of choice permanently, and you may think that your substance abuse problem is not as bad as others'. Be wary of this attitude. Ambivalence and denial can be your worst enemies in the first days of your recovery.

At this point in treatment, the goal is to help the individual decide to actively participate in treatment and accept that abstinence is the goal. To accomplish this, a substance abuse counselor may help the individual do the following:

  • Look at the damaging effects of addiction
  • Explore feelings of denial with regards to the problem
  • Help the person become motivated to recover

During this stage of treatment, an individual's alcohol and drug use history will be taken, the treatment program will be introduced, and the counselor will work with the individual to develop an individualized treatment plan.

Stage 2: Early Abstinence

Once you have made a commitment to continue treatment for your substance abuse problem, you will enter the second stage of rehab, known as early abstinence. Early abstinence from alcohol is significantly associated with positive treatment outcomes. This can be the toughest stage to cope with because of many factors, including:

  • Continued withdrawal symptoms
  • Physical cravings
  • Psychological dependence
  • Triggers that can tempt you into a relapse

Challenges at this stage of treatment include cravings, social pressure to drink, and high-risk situations that can trigger alcohol consumption. It is during this early abstinence stage that your trained addiction counselor will begin to teach you the coping skills that you need to lead a sober lifestyle. The tools that you learn to use now will help you throughout your recovery.

Early abstinence issues that are worked on at this point in treatment including learning about the physical and psychological aspects of withdrawal, learning to identify alcohol use triggers, and learning how to handle alcohol cravings without drinking.

Some strategies that can be helpful include:

  • Encouraging participation in healthy activities
  • Finding alternative behaviors to engage in rather than turning to alcohol
  • Participating in self-help groups that offer support and information
  • Recognizing environmental triggers that lead to cravings, including people, places, and things

Stage 3: Maintaining Abstinence

After approximately 90 days of continuous abstinence, you will move from the early abstinence stage of recovery to the third stage, maintaining abstinence. If you started in a residential treatment program, you will now move to the continuing or follow-up counseling phase of your rehab program on an outpatient basis.

One focus of this stage of rehab is obviously to maintain abstinence by avoiding a relapse. You will learn the warning signs and the steps that can lead up to a relapse.

Also during this stage of your rehabilitation, you will learn to put the tools that you learned in early abstinence to use in other areas of your life, so that you can continue to live a truly sober lifestyle. You will discover that your future quality of life depends on more than simply not using.

You will learn new coping skills and tools to help you:

The maintaining abstinence stage of rehab will begin at about three months into your rehabilitation program and last until you reach approximately five years clean and sober, at which time the follow-up counseling will usually terminate.

Stage 4: Advanced Recovery

After approximately five years of abstinence, you will reach the fourth and final stage of your rehab: advanced recovery. It is that this point that you take all the tools and skills that you have learned during your rehab counseling and put them to use living a satisfying, fulfilling life.

Strategies that can help at this point include:

  • Creating long-term goals
  • Establishing a consistent daily schedule
  • Forming social relationships with people who do not drink
  • Participating in recreational activities that do not involve alcohol
  • Finding ways to reach beyond oneself in order to seek happiness and fulfillment, whether it involves religion, spirituality, community work, or social activism

Learning to implement these strategies not only will help you remain sober, but you will also have the skills to become a healthier person, a better spouse and parent, a productive member of society, and a good neighbor and citizen. Recovery is much more than merely staying sober. It's learning to live a happier and healthier life.

A Word From Verywell

Alcohol treatment and recovery is a lifelong process that requires commitment and changes in many aspects of a person's life. These four stages of treatment can help people with alcohol use disorders learn about the benefits of recovery, find the motivation to change their behavior, and learn new skills that will help them succeed in the long term. 

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mercer DE, Woody GE. An individual drug counseling approach to treat cocaine addiction: The collaborative cocaine treatment study model. National Institute on Drug Abuse.

  2. Lima-Rodríguez JS, Guerra-Martín MD, Domínguez-Sánchez I, Lima-Serrano M. Alcoholic patients' response to their disease: Perspective of patients and familyRev Lat Am Enfermagem. 2015;23(6):1165-1172. doi:10.1590/0104-1169.0516.2662

  3. Dunn KE, Harrison JA, Leoutsakos JM, Han D, Strain EC. Continuous abstinence during early alcohol treatment is significantly associated with positive treatment outcomes, independent of duration of abstinenceAlcohol Alcohol. 2017;52(1):72-79. doi:10.1093/alcalc/agw059

  4. Pettersen H, Landheim A, Skeie I, et al. How social relationships influence substance use disorder recovery: A collaborative narrative studySubst Abuse. 2019;13:1178221819833379. doi:10.1177/1178221819833379

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.