Just because your system has been cleansed of substances of abuse during detox, and you have gone through productive therapy and equipped yourself with defence mechanisms against relapse, does not mean that you can let your guard down and consider yourself “cured”: that mindset is asking for trouble as it encourages you to become too casual and overconfident about your position in relation to substance abuse.
People who misuse alcohol are often addicted to the act of drinking, as much as the alcohol itself. For that reason, you may need to learn skills and coping mechanisms to help you avoid alcohol once you leave a treatment center or return to familiar environments where the urge to drink may be stronger. Your doctor may refer you to a counselor or other treatment program to help you learn those skills and coping strategies.
Lastly, group therapy prepares you for what lies ahead after your rehab. Upon your return home, you will be encouraged to participate in a local support group as part of your aftercare programme. The fact that you have undergone group therapy should mean you are already comfortable with a group setting once you start attending support group meetings.
Another factor to consider in choosing between inpatient and outpatient rehab options is whether you have a healthy and supportive home environment where your recovery will be a priority. If you do, outpatient treatment could be a good fit. Otherwise, a residential treatment program where you will have a built-in system of support will probably be the most effective option.
Intake lasts only a couple of hours, but alcohol detox can last anywhere from five to 14 days, depending upon the withdrawal symptoms you experience. Withdrawal symptoms will vary depending on your history with alcohol and side effects from withdrawal can include anxiety or depression, tremors, mood swings, irritability, insomnia, lack of appetite, sweating, confusion, fever, seizures and more.
While a relapse or slip-up is by no means inevitable, you might face some setbacks during recovery. This does not have to mean returning to alcohol use. A lapse should not signify the end of your recovery, provided you act appropriately, in order to avoid a full relapse. You might even find that this small slip is enough to remind you of why you wanted to quit in the first place.
In addition to CREB, it is hypothesized that stress mechanisms play a role in dependence. Koob and Kreek have hypothesized that during drug use, CRF activates the hypothalamic–pituitary–adrenal axis (HPA axis) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with psychological dependence. They found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid. In rat models, the separate use of CRF inhibitors and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed dysregulation of other neuropeptides that affect the HPA axis, including enkephalin which is an endogenous opioid peptide that regulates pain. It also appears that µ-opioid receptors, which enkephalin acts upon, is influential in the reward system and can regulate the expression of stress hormones.
The important thing to remember is that relapse doesn’t mean drug treatment failure. Don’t give up. Call your sponsor, talk to your therapist, go to a meeting, or schedule an appointment with your doctor. When you’re sober again and out of danger, look at what triggered the relapse, what went wrong, and what you could have done differently. You can choose to get back on the path to recovery and use the experience to strengthen your commitment.
Inpatient usually offers more services, but it tends to cost more. Outpatient is a less-expensive option that's generally safe and effective for people with mild or moderate alcohol withdrawal. It works best if your physical and mental health is good, your home is stable, you have support at home, and you don’t have a long history of problem drinking. Drug Addiction : How to Recover from Alcohol Addiction