Are there rules for people in recovery?

No, there is no universal rulebook for people in recovery. Treatment programs set their own agreements, clinicians tailor care to the individual, and SAMHSA describes recovery as highly personal and occurring through many pathways. Sources do, however, describe some common practical commitments, such as staying engaged in treatment and being open with a clinician about setbacks.

Why there is no single rulebook

SAMHSA says the process of recovery is highly personal and can include clinical treatment, medications, faith-based approaches, peer support, family support, and self-care. NIDA says treatment should be tailored to each person's drug use patterns and drug-related medical, mental, and social problems. Because paths differ, expectations differ too.

The expectations a person meets usually come from a specific setting, such as a treatment clinic, a residential program, or a peer group. These vary, and they are agreements about taking part in that service, not laws of recovery. Anyone can ask a program to explain its expectations before joining, including what happens after a lapse.

Practical commitments that sources describe

Staying in treatment and following the plan

NIDA states that if people stop following their medical treatment plan, they are likely to relapse, and that detoxification alone, without subsequent treatment, generally leads to resumption of drug use. It also says some medications help people stay in treatment. Medicines, where prescribed, are part of the plan; any change to them belongs in a conversation with the prescriber, not a solo decision. See medications used in treatment. For alcohol and some other substances, stopping can be dangerous and should be medically supervised (see withdrawal and detox in outline).

Understanding and avoiding high-risk situations

NIDA says stress cues tied to past use, such as people, places, things, and moods, and contact with drugs, are the most common triggers for relapse. CBT therefore includes identifying high-risk situations and avoiding them, particularly early in recovery, according to a review of CBT for substance use disorders. See relapse prevention strategies.

Telling a clinician about lapses

NIDA says relapse is not a sign that treatment has failed; it is a sign the person should speak with their doctor to resume, modify, or change treatment. It also warns that after time away from a drug, using the same amount as before can cause an overdose. The Project MATCH coping skills manual describes a program in which people were allowed to continue after a drinking episode if they committed to working toward renewed abstinence, were encouraged to talk openly about any use, and were urged to examine a slip with someone rather than sweep it aside.

Example of one program's ground rules

That same manual, written for a research study, also asked participants not to come to sessions under the influence, because they could not concentrate on or recall what was covered. Anyone who did was asked to leave in a way not meant as punishment and encouraged to return sober. This is one research protocol, not a general standard.

Rules, support, and respectful language

Rules work best alongside support. Peer and family involvement, described in mutual-help groups and supporting a family member, are part of what SAMHSA lists as recovery supports. Approaches that start from a person's own reasons for change are described in motivational interviewing.

NIDA's language guidance also bears on how people are described. It recommends person-first wording, such as "person with a substance use disorder," and says labels that define a person by their condition elicit negative associations, punitive attitudes, and individual blame. NIDA reports that feeling stigmatized can make people less willing to seek treatment. For that reason, this site avoids those labels.

What to ask a program

A person can ask a program to put its expectations in plain language: attendance, testing if any, medication adherence, what happens after a lapse, and who can see their information. Questions about what fits a particular person are for a qualified clinician. For first steps, see what happens when you ask for help.