What "sobering up" means to you depends on your situation. Sometimes it means decreasing the frequency or quantity of use. Called "harm reduction" in treatment terms, many people naturally do this when they notice a problem with drugs and alcohol but are unsure of its severity. For example, if you find that you binge drink (more than 4 drinks at a time for women and more than 5 for men) when you're out with friends at bars, you might decide to ask your friends to meet you at a movie instead of a bar. Shifting the environment in which problematic behaviors occur is a way to reduce harm. Likewise, you may try to limit the amount you are drinking or using, or you may make deals with yourself not to use at certain times of day or in certain places. All of these methods of control are common once a problematic pattern is recognized. Whether these methods of control work or not depends on your individual circumstances. Here's a guideline for the safe consumption of alcohol, by the way. Great graphic from the CDC.
Harm reduction is controversial, because many treatment professionals and many of those in recovery believe complete abstinence is the only way to sobriety. They might say that attempting to reduce harm only keeps you in the dangerous cycle of addiction, as you try to negotiate the problem away. There are reasonable arguments in favor of abstinence as the best strategy and it does indeed seem to work best for many. Taking a harm reduction versus abstinence approach is a very personal decision, one that I help clients make based on their own experiences.
Depending on the severity of the addiction and on the substances or substance combinations being used, withdrawal may with abstinence. Withdrawal symptoms range from mild to severe and vary depending on the drug. The process of withdrawal under medical supervision is called detoxification, and is the safest way to discontinue use of a drug when withdrawal is present, particularly with alcohol, opiates (heroin or prescription pain killers) and anti-anxiety drugs (like Xanax and Klonopin). After detox, many continue to residential treatment for 30 days or more, and some choose to move into sober living environments after residential care. These are each options along the way to sobriety, and most everyone's journey looks different depending on what they need.
Once a more sober life is established, you have entered "recovery." Below is the three part plan that I use with counseling clients to help sustain recovery.
What are the people, places, things, thoughts, feelings, or memories that make you want to use? Naming these is critical to understanding your addiction and thereby not returning to it. Sometimes there is a laundry list of triggers, and sometimes there are just a few. Watching yourself in your everyday life, noticing when cravings to use your drug of choice pop up, and noticing what's happening in the context around the craving, is a way to be mindfully present with your thought processes and behaviors. Our goal is not to get rid of triggers, but to manage them in a healthy way and to accept that they are present.
A critical part of therapy for anyone, whether addiction is present or not, is learning to identify and use coping skills that work. What do you do when you feel stressed out at the end of a busy day? What do you do when you fight with your spouse? What do you do when you come up short on your monthly bills? What do you do when your boss yells at you? These are just some examples of possible triggers (see above) that may lead to cravings to use if there are not more adaptive coping skills in place. Some examples of coping skills are exercise, art, reading, talking to trusted friends, 12 step groups like AA, support groups, meditation, spending time with pets, making music, listening to music, walking, drinking tea, taking a warm bath, having a massage, giving yourself a massage, learning a new skill, taking up a new hobby....the list is limitless really. The question to ask yourself is how can I soothe myself in a way that doesn't create harm?
Knowing your reasons not to use
Finally, it's very helpful to continually be aware of the reasons for you personally not to use drugs or alcohol. The reasons not to use are often very clear once addiction has progressed, but often are overlooked, on purpose, because the lure of the "quick fix" to triggering situations is so strong. For example, we know that if we keep drinking to relieve our work stress, we eventually will lose our job. We know that if we keep using Xanax to make social situations easier, it's going to be harder and harder to be social without it. These reasons are usually harder to identify in the early stages of substance abuse, but become quite clear when major negative consequences start occurring. In recovery, keeping reasons not to use and coping skills that work close at hand prevent triggers from leading to relapse.