Do you know the stages involved in recovery from substance use disorder?

Oct. 25, 2022
Women hug during a support group meeting. There are three stages of recovery.
If you’re struggling with substance use disorder, recognizing the three stages of recovery can be helpful. Photo: Getty Images.

If you’re struggling with substance abuse, don’t lose hope. Recovery is possible, though it can take time.

Amy Goodwin, a licensed professional counselor and behavioral health counselor at UCHealth Behavioral Health Clinic in Steamboat Springs, outlines when to seek help and what to expect from recovery.

When should I seek help?

The earlier the better. Clear signs that you should get support include difficulty functioning for a week or two without substances, and seeing impacts to your health, relationships and work. But Goodwin encourages everyone to explore their emotions and choices with substances.

“Sometimes we suspect that our choices are impacting our health,” Goodwin said. “It can help to have a little validation for our own instincts in order to motivate us to embrace change.”

The stages of recovery

“I have noticed the transition from substance use disorder to healthy recovery can happen in stages, and each stage has its own challenges,” Goodwin said.

In Stage 1, the body detoxes from the substance. “This can be extremely distressing as our body has to readjust in so many ways,” Goodwin said.

This is a photo of Amy Goodwin, a licensed professional counselor and behavioral counselor at UCHealth Pain Management Clinic.
Amy Goodwin is a licensed professional counselor and behavioral health counselor at UCHealth Pain Management Clinic in Steamboat Springs. Photo by UCHealth.

Connect with your health provider to determine a safe tapering plan, as withdrawal from certain drugs can involve dangerous physical effects.

The peak of withdrawal symptoms usually occurs around 72 hours once the drug has left the bloodstream. After that, someone is sober but left with what Goodwin calls a “bankrupt brain,” in which it can be very difficult to create sensations of pleasure or hopefulness.

During withdrawal, people usually feel the opposite of how they felt when intoxicated. For instance, alcohol and drugs such as Xanax can make people feel more relaxed but during withdrawal, people may experience increased anxiety, restlessness, agitation and insomnia. Opiate medications, on the other hand, suppress the pain response, so during opiate withdrawal, someone may experience a heightened sense of pain.

Goodwin refers to Stage 2 as “getting our brain and body back.” The chemical imbalance can take up to 90 days to build back its own natural chemistry.

“We can benefit ourselves in this stage by connecting with a support group, exercising, making sure we have plenty of nutrients through a healthy diet and developing healthy sleep rituals,” Goodwin said.

Repairing the damage to cells and organs done by substances requires time; extremely toxic substances like street methamphetamines can cause semi-permanent damage and take years for healing to occur. Medication-assisted treatment, in which a safer medication is used as the body slowly rebalances, can be beneficial through this stage.

As people enter Stage 3, they should feel proud of their accomplishment and recognize the effort it’s taken to get there. In this stage, which Goodwin calls “a new way of living,” there is the difficult work of recreating a sense of self.

“Often, we adopt monikers to our identity based around the substances we are regularly using, such as ‘I’m a smoker,’ ‘He’s a partier,’ or ‘It’s who I am.’ This can lead to identity confusion and the need to find ways to ground our identity in a new set of values or passions,” Goodwin said.

While this stage may include exciting exploration to discover new interests and skills, it can also be disorienting and Goodwin encourages people to lean on their support network through the journey.

“In this stage, getting support from loved ones and peers is incredibly important as we often gain the experience of self-esteem knowing we are valued even without our old patterns of drug use,” Goodwin said.

This story first appeared in the Steamboat Pilot.

About the author

Susan Cunningham lives in the Colorado Rocky Mountains with her husband and two daughters. She enjoys science nearly as much as writing: she’s traveled to the bottom of the ocean via submarine to observe life at hydrothermal vents, camped out on an island of birds to study tern behavior, and now spends time in an office writing and analyzing data. She blogs about writing and science at