Early and Middle Recovery Defined

By Greg Struve, MA, LAC

Clinical Director

The Road to Recovery from Drug Addiction and Alcoholism Early and Middle Recovery Defined By Greg Struve, MA, LAC Clinical Director A Sober Way Home Prescott, Arizona Based on the work of such imminent psychologists as Terrance Gorski (1986) and the authors of the Matrix Model (NREPP, 2006), we now understand that the course of recovery usually involves predictable stages. These stages tend to be similar regardless of the substance involved in addiction. The time frames which will be discussed here will more closely follow the Matrix model. Gorski’s work tends to be a bit less rigid in terms of the timing of the stages.

Recovery is accompanied by withdrawal symptoms, both acute and post-acute. An acronym commonly used for the latter is PAWS, post-acute withdrawal syndrome. This painful syndrome is one of the major reasons that early recovery can be such a challenge, especially in the case of methamphetamine addiction for which recovery tends to be uncomfortable for a more extended period of time.

The first six months of abstinence from the drug of choice is usually referred to as Early Recovery. The second six months is referred to as Middle Recovery. Today’s blog entry will present a quick overview of these periods. Subsequent entries will present a more in-depth look at each of the stages involved. Social anxiety is symptomatic of recovery during the entire first year. PAWS usually spans much of the Early Recovery period. Middle Recovery is usually characterized by a reorienting of the self to the social demands of the world. It is during the second six months that the underlying causes of social anxiety can be addressed. This is facilitated by attendance at 12-step meetings where the individual is given unconditional acceptance regardless of their behavior.

Most individuals who become addicted to drugs or alcohol start at a relatively early age, usually beginning with alcohol or marijuana and sometimes with behavioral addictions such as an obsession with pornography or eating disorders, all of which act on the brain in a similar fashion to drug use. This frequently occurs by the time the individual is in high school. Individuals, who anesthetize emotional pain with addiction at this early age, also anesthetize their emotional growth and development, becoming “frozen emotionally”. Consequently, individuals in early recovery display the emotional maturity of an early teenager or one even younger.

Our next Blog will take a more in-depth look at PAWS. Please join us then. References Gorski, T. T. (1986). Relapse prevention planning: A new recovery tool. Alcohol Health and Research World, 11, 6-11, 63. NREPP, (2006). Matrix Model, retrieved from: http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=87

At A Sober Way Home we are finding the more we track clients recovery the more it is so apparent they all need long-term treatment. 30 day treatment centers came about because that’s what insurance would pay for back in the 80′s. Treatment has changed drastically over the last 20 years. In my 23 years of experience I always tell families the least amount of time a client should spend in treatment is 6 months.