Stages of Addiction Recovery
Last Updated Dec 2, 2021
The transtheoretical model (TTM) of behavior change is a model commonly applied to addiction recovery. It focuses on the stages people often go through when trying to change their behavior.
While not the only way to look at recovery, it is a broadly helpful way of thinking about recovery.
The Stages of Addiction Recovery
There is no single “perfect” model of the stages of addiction recovery because recovery can look so different for different people. However, one useful and commonly used model is the transtheoretical model, also called the Stages of Change model.
TTM focuses on the decision-making of an individual and the stages they tend to flow through when changing their behavior.
Stage 1: Precontemplation
In this first stage of recovery, a person does not yet tend to think of themselves as trying to recover, though they may be aware that they are engaging in problematic or otherwise destructive patterns of behavior. They don’t intend to take action any time soon.
In short, they have not yet meaningfully contemplated trying to enact change.
Stage 2: Contemplation
This stage of the recovery process is one of the most important. In this stage, a person has identified that they have a problem and intends to try and address that problem in the foreseeable future.
While a person may not yet be fully committed to change or fully recognize the scale of their problems, they can at least see there is an issue and want to make a change.
Stage 3: Determination
Also called the Preparation stage, this is the stage where a person has now fully decided to make a change and plans to take action within about a month or less. They begin actively taking steps to combat their addiction, such as scheduling appointments with addiction professionals.
Stage 4: Action
In the Action stage, a person has now started taking actions to change their behavior. In the case of addiction recovery, this would mean detoxing, abstaining from drug misuse, talking with counselors, and engaging in other treatments as suits the individual’s needs.
Stage 5: Maintenance
This stage is similar to the Action stage, with an individual taking actions to change their behavior and resist drug use, but they have now sustained those positive changes for six months or more. The primary goal of this stage is to prevent relapse and continue to resist drug use.
This stage is the goal of most addiction recovery programs, as it means a person has enough control over their problems with drugs that they can usually function normally in society and aren’t at major risk of falling back to drug use, even if they still have to commit themselves to resisting drugs and continuing with certain types of addiction treatment.
Stage 6: Termination
This stage of change is difficult to achieve, and it doesn’t represent any moral failing if a person in recovery never reaches it. A person who has reached the Termination stage of recovery is no longer at risk of using drugs or at least no more than someone who doesn’t have a history of drug misuse.
Treatment programs generally can’t guarantee a person reaches this stage of recovery and don’t usually try to. Instead, the goal is to help a person gain enough control over their problems with drugs that they can resist drug use and live a normal, full life.
Relapse & Other Caveats
The TTM model has limitations, even if it is useful for understanding the basic flow of many people’s recovery journey.
First, these stages can cycle back into each other, and many people who we would say have had a successful recovery stay in the Maintenance stage of the recovery process rather than fully exiting the cycle. While these people may still experience drug cravings and need to work not to use drugs, this still represents success if they can resist drug use indefinitely.
As another example, “Relapse” is often put as the next step after the Action stage, but this makes the Stages of Change model a bit strange in that, at least as shown in many graphics, it implies relapsing is inevitable and necessary for recovery, but that isn’t true. While relapsing doesn’t mean a person has failed recovery, it also isn’t necessary to relapse.
Getting Help for Addiction
Getting help for addiction often begins with talking to an addiction treatment specialist. These are licensed medical professionals who understand addiction and how to help you tailor a plan to best suit your needs. These professionals are knowledgeable about other addiction resources in your area, and they can help you get access to the treatments that are most convenient and affordable to you.
To help control the costs of your addiction treatment, make sure you have a health insurance plan that can cover at least some of the costs of treatment. While it’s worth it in the long term, especially considering how expensive and dangerous addiction can be, addiction treatment can be a moderately expensive medical expense, especially if you need inpatient treatment. Luckily, most insurance plans will cover the majority of addiction treatment care options.
You can also talk to individual addiction treatment facilities about financing plans they offer. Many treatment centers offer payment plans where you don’t begin paying off the cost of treatment until you have finished care and have a strong footing in recovery.
What Program Is Right for Me?
When choosing a treatment program for yourself, there are a number of important considerations to make. The first is to establish what treatment options are available to you, both in terms of distance and cost. Then, talk to a treatment professional about which of the available options are evidence-based and the pros and cons of each.
If a program doesn’t seem to be working, you can try other options. Just make sure you’re following the recommendations of medical professionals and only engaging in evidence-based practices. Some addiction resources, even if they’re well-intentioned, may make claims and provide treatments that don’t have strong supporting evidence that they aid in overcoming addiction.
I Know I Need Help — Now What?
SAMHSA’s national helpline, available at 1-800-662-HELP, can be an excellent place to start getting help for problems with addiction. This number, which is free and confidential, is meant to connect callers to other addiction resources relevant to their needs. Professionals can help you get referrals to local treatment facilities, support groups, and community-based organizations.
With the right help, you can move through the stages of addiction recovery and find a new, healthier life in recovery.
Substance Abuse Treatment: Group Therapy. (2005). Substance Abuse and Mental Health Services Administration.
The Transtheoretical Model (Stages of Change). (September 2019). Boston University School of Public Health.
SAMHSA’s National Helpline. Substance Abuse and Mental Health Services Administration.
Neurobiology of Addiction: A Neurocircuitry Analysis. (August 2016). Lancet Psychiatry.
Neurobiologic Advances From the Brain Disease Model of Addiction. (January 2016). The New England Journal of Medicine.