Treatment for substance abuse in individuals with co-occurring disorders requires a careful consideration of relapse prevention strategies. Those with co-occurring disorders often face difficulties that last well beyond initial stabilization and recovery. Substance abuse and mental health disorders are often long-term conditions. Therefore, they can be optimally treated when care and interventions are considered over an extended period.
In general, research has shown that relapse rates are significantly higher during the first year of sobriety. The highest success rates have been observed in those who adhere to thoughtfully planned treatment recommendations that consider long term continuity of care.
Current guidelines from the Substance Abuse and Mental Health Services Administration (SAMHSA) suggest that successful continuing care plans should address three key features. These include consistency between primary treatment and ancillary services, seamless transitions from residential or partial hospitalization programs to outpatient treatment, and the coordination of present and past treatment episodes.
Those who adhere to aftercare recommendations without gaps between services stand the best chance for a lasting recovery and shorter relapses should they occur. Aftercare recommendations should be individualized to meet the treatment needs of each person.
They often include a focus on employment, housing, health care and medication management, financial concerns, recreational services, social networks, twelve-step and other self-help groups, and individual and group therapeutic services.
For those with a chronic history of relapse or a prior failed attempt at quitting, a plan that is designed to take into account high levels of structure and support for up to a year has proven most effective. It is not unusual for half-way-houses or other sober living environments to be discussed as part of a step-down plan of care. The rate or relapse tends to drop significantly after one year of abstinence and stability.
Therefore, any means that can offer structure and place obstacles in the way of high risk situations and potential substance use can prove invaluable in promoting a course of recovery.