The middle phase of recovery lasts from about the third year to the tenth year or beyond. At this point, you are fairly secure with abstinence and with your recovery program.

You may begin working on longer-term problems that have stayed on the back burner during the first couple of years.

Many people return to school, or find a better job. Now that life is less chaotic, there is time for other pursuits and new relationships. Some people experience a revived interest in religion or in civic activities.

You might find, though, that you are still struggling with feelings of depression or anxiety and that you are not experiencing the joy and contentment you expected. Longer-term issues might need to be addressed. Many people who develop addiction come from dysfunctional families and may have experienced abuse and neglect as children. It’s also very common for other psychiatric problems such as clinical depression or anxiety disorders to be present.

A common misconception in the recovering community is that working on your program alone should make you happy. This just isn’t so for a lot of people. You may be doing everything right and still be struggling. If you’re not yet feeling good at this stage you should seek evaluation from a psychiatrist or psychologist who understands addiction.

Relapse is still possible - it’s always possible - and there is effective treatment available if you ask for it.

Late Recovery
In the later stages of recovery, some people begin to loosen their attachment to 12-step programs and become emotionally invested in other relationships and pursuits. But many people remain quite active in their meetings, serving as sponsors for newcomers and keeping the meetings going. Without these “old-timers” the 12-step programs would cease to exist.

The risk of relapse continues. Many of those who remain active in 12-step groups maintain that they would relapse if they stopped going. I certainly can’t argue with that. Problems with depression, loss, and the stresses of aging are common. The ongoing support of the 12-step meetings is very helpful. Without it, some people feel that their thinking and attitudes begin to regress to the “stinking thinking” that characterized the addiction.

Outcome studies have shown that people who continue to be active in recovery programs show remarkable growth over the long term. Gradual development of the personality occurs, along with resolution of old conflicts. Relationships improve, and the damage caused by the addiction can be repaired.

There are those, however, who seem to stall out in recovery. They may continue to attend meetings, and they may remain abstinent, but personal growth stops. These people are at increased risk for later relapse, and may benefit from long-term psychotherapy to address personality issues.

Elizabeth Connell Henderson, M.D.

Glossary

Appendix A: Regulation of Addictive Substances

Appendix B: Sources of Additional Information