Back to School after Rehab

As summer winds down, teenagers around the country head back to school. Some start in the beginning of August, while some start later, around Labor Day. In the Los Angeles area of Southern California, where Evolve offers substance abuse and addiction treatment for teens, high school tends to start in the middle weeks of August. That makes the beginning of the month transition time: families return from vacation, teenagers clock their last shifts at summer jobs, schools host open-house and orientation programs, and parents make school supply runs to local big-box stores. School uniforms, back-to-school wardrobes, and new shoes take the place of board shorts, flip-flops, and tank tops. Sports practices, extracurricular clubs, and the last-minute push to finish summer reading lists knock beach time and lazy afternoons at the pool off the calendar.

That’s how it goes for most families with teens returning to high school. But there’s a subset of teenagers and families with a different challenge to face as the first day of school approaches. To this group, new clothes, new backpacks, and which club to try or sports team to join are the least of their worries. These families and students have something more important to deal with: how to stay clean and sober after a summer rehab program.

Relapse Readiness: Top Triggers for Teens

If you’re a teenager who entered treatment for substance abuse or addiction problems this summer, it’s likely your counselors and therapists worked with you to formulate a solid re-entry plan, which included long-term strategies for sustaining your sobriety through both the easy times and the hard times. You learned that in order to stay drug and substance free for the long haul, you need to work your program – in your own way – every day. The best treatment programs, whether they’re residential, partial hospitalization, or outpatient, create individualized strategies and sustainable sobriety plans for each person. Your program might include exercise, meditation, 12-step support groups, journaling, regular visits to a therapist or counselor, or some combination of all of these.

Whatever your program includes, going back to school creates a set of new challenges for you to overcome. We’re sure your rehab program included ample discussion of triggers, how to deal with them, and what to do when you feel so triggered you’re on the verge of relapse. As a reminder, here’s a list of the most common triggers for teenagers early in their recovery journey from substance abuse or addiction problems:

Stress.

The first day of school brings a special brand of pressure. No one is immune – not even teachers. Once you clear that hurdle, though, you’ll encounter a variety of stressors during the year, some of which are acute (short-term) and some of which are chronic (long-term). Academic stress can be both: a hard test in a challenging subject qualifies as acute stress, while the desire to get a good overall GPA qualifies as chronic stress. Social stress, which includes romantic relationships, can also be both acute and chronic: an argument with a friend counts as acute, while a general feeling of not fitting in counts as chronic. You need to be ready for the different varieties of acute and chronic stress, and have solid coping strategies at hand to deal with them when they come up.

Peers.

 If you’re returning to your old school and a group of friends you used to drink, smoke, and party with, you need to be prepared to handle those tricky situations ahead of time. Unless the people in your peer group also went through rehab and are serious about recovery, they’re probably going to pressure you to pick up right where you left off last year. Your best bet is to avoid those people altogether, but if that’s simply not possible, you need to be ready when they ask you to skip class and get high, blow off soccer practice to drink, or offer you amphetamines to help you through late-night study sessions. If you didn’t role-play these situations during rehab, then now is the time to make a realistic plan, because these situations will come up. The more prepared you are, the better of you’ll be.

Social Anxiety.

If you developed your drug or alcohol use as a coping mechanism to deal with social discomfort or feelings of alienation, this may be your most powerful trigger. Use the skills you learned during treatment to identify the uncomfortable feelings of social anxiety, and come to school prepared with positive coping mechanisms: bring a journal, use mindful breathing, talk to a trusted friend, or call a family member during lunch or breaks between classes.

Availability.

It’s no secret teenagers bring drugs and alcohol to school. Kids motivated to drink and get high will find a way to do it, no matter how strict the school policies are. During the summer, you can avoid drugs and alcohol by staying away from them. School, however, can be a problem: you have to go, which means you’ll have to deal with them. Your first day of school might also be the first day after rehab when you actually have to test your resolve and your commitment to sobriety. It might be hard for you, and it might be easy: either way, the first time you say, “No thanks,” is incredibly empowering, and will set the tone for the rest of the year.

Places.

It’s not only people, but also places that can lead to relapse. And it’s not only places, but the sights, smells, and feelings associated with the places that act as powerful triggers. If the first place you got high was behind the gym, right outside the back door of the locker room, then be ready for a flood of memories when you return to that location. The smell of the locker room, the sound of the heavy door opening, the sight of the sports fields – all of these can cause you to go on autopilot and elicit intense cravings for your drug of choice.

Overconfidence.

 Self-belief and confidence in your ability to stay clean are essential elements of your long-term sobriety. Part of your treatment likely involved bolstering your self-esteem and learning (or re-learning) that you’re strong and capable of handling the stresses of life, family, and school without using drugs. In fact, if you’re in the early stages of recovery, you may feel super-strong, filled with energy, and close to invincible. Sobriety feels good. Sobriety is empowering – and that’s an amazing place to be. At the same time, it’s critical to remember what got you there.

Don’t let your confidence turn into complacency.

Work your program, do the little things every day that got you back to a drug-free life, and remember: consistency over time is what turns new behaviors into ingrained, life-long habits. Stick to your program, and before you drop elements of your sobriety plan because you feel great and everything is working, check in with your therapist, counselor, recovery partners, or people at your support group meetings. They’ll give you a reality check, and help you decide on the best course of action.

Time to Test Your New Skills

It’s ironic that the one place you have to go – school – is also the one place you’ll find the most powerful relapse triggers clustered together. Look at it both as a challenge and an opportunity. Reading the list of common triggers for teenagers above, you’ll quickly realize you’ll probably encounter every single one of them every single day of school.

For that matter, you might even have to deal with all of them before the first bell rings on day one. From peers in the parking lot to the chaos of the hallways, you may feel like you’re about to run the gauntlet, like a graduation ceremony or an initiation ritual in an old kung fu movie. In a way, you’re exactly right: your sobriety skills will be tested. Your resolve will be challenged. You may feel overwhelmed. But in the end – just like the heroes in those old movies – you’ll rely on your training. You’ll remember the coping strategies you learned, the tough conversations you had during individual and group therapy, the supports you have in place, and all the hard work you did to get sober.

You’ve got all that on your side. You got clean and sober this summer. You have that experience to draw from. You’re ready. When school comes around, you can walk through the door with confidence.

You got this.