Consistent sleep. Regular exercise. Ample opportunities for social interaction. These basic-sounding elements of a productive life become essentials at the early stages of recovery. A physician who runs an outpatient addiction treatment practice on Long Island believes clinicians should do more to emphasize their importance—while not forgetting how difficult it might be for patients to implement them into a healthy routine.
“Rather than giving a rote reciting of every step in a routine, clinicians need to show real empathy toward their patients,” says Russell Surasky, MD, a neurologist who owns the Surasky Neurological Center for Addiction. “Patients want to know the why [of a routine]. They want to know, 'What's in it for me?'”
Adopting a healthy routine in early recovery can make the journey significantly less grueling for the patient, says Surasky, who treats a significant number of opioid-dependent patients with Vivitrol (injectable naltrexone) and supportive counseling.
“If you wake up every day and you don't have a plan for the day, it's easy to stray from the path you intended,” says Surasky.
Three key components
In citing the elements of a healthy routine that he considers most critical for individuals in early recovery, Surasky emphasizes these components first and foremost:
The sleep/wake cycle. Surasky recommends a consistent sleep schedule for patients. They shouldn't sleep in on the weekends if they get up early during the week, he says. He adds that patients, who already are susceptible to bouts of insomnia, should avoid using computers or cellphones near bedtime and should opt for reading or television instead. “Their habit is to stay up and text their friends, or look things up,” Surasky says. “Then they shut things down, but because of the blue light from their cellphones or laptops, their brain is still awake.”
Exercise. Surasky says regular exercise, at least 30 minutes a day, helps with sleep and in relieving symptoms of depression and anxiety. He believes it also shortens post-acute withdrawal. Any exercise that increases the heart rate, from aerobics to weight training, will pay off. “Slow walking doesn't do it,” he says. “Shopping at the mall doesn't count.”
Socializing. Clinicians should encourage social interaction as much as possible, to offset the feelings of boredom and loneliness that many individuals in early recovery consistently express.
Surasky says it is also important for clinicians to remind patients that the pendulum can swing too far toward becoming overly dependent on a routine. “These routines are meant to be flexible,” he says. “You don't want to become a slave to the schedule.”
Moreover, the first couple of months should prioritize support meeting attendance over other activities, Surasky says, as he recommends that patients attend at least one meeting daily during that period.