Walking into a treatment center for the first time carries many emotions that most people do not expect. There’s relief that something is finally being done, anxiety about what happens next, and often, sheer exhaustion from whatever brought an individual to this moment.

The first week of treatment establishes what’s to come, but when you don’t know what’s really happening, the first few days can be overwhelming.

The Initial Assessment

The first day is essentially paperwork and questions. Questions from the medical team (and substance use staff) to get a comprehensive understanding of the situation, what was used, for how long, at what amounts, when was the last use? These are not investigative nor judgmental; these are for safety purposes since withdrawal can be dangerous based on what’s been used and how often/when it was last used.

Expect a physical exam, bloodwork, and perhaps some additional testing for someone who was treated with a substance use disorder. Many people enter treatment with co-occurring physical illnesses that they have neglected for months or years. Blood pressure could be high; there could be issues with the liver or nutritional deficits. Medical staff also check for psychiatric comorbidities, which are more common than most people realize.

A clinical assessment occurs at the same time as the medical assessment. This includes an assessment of psychosocial history, family connections, past treatment options if applicable, and aspirations of goals for treatment to date. This can feel intrusive but, like all things in treatment, it’s clinically relevant because two people could have alcohol use disorders but their unique paths to treatment differ and so treatment needs to be customized.

Detox and Physical Adjustment

For many people entering treatment, the body needs to get rid of toxins before therapeutic work commences. Detox is not always mandatory, for example, it depends on what’s been used and for how long, but when it is necessary, having a medical professional along with group support makes it more effective than trying to cold turkey things on one’s own outside of treatment.

Physical symptoms can range based on what’s used. Alcohol and benzodiazepines can be fatal if not medically supervised during detox. Opioids are rarely fatal during detox but feel like pure hell while doing so. Stimulants bring intense fatigue/depression. Drug treatment centers in Tampa offer medication-assisted treatment during this phase to combat symptoms and cravings, making this part better than expected.

Sleep becomes a tricky thing during the first week. Some people sleep excessively as their bodies heal and others suffer insomnia as night stretches on and on. Appetite does weird things, too, some people have none while others find their appetites returning after months of avoidance due to substance intake.

This peaks and then becomes more acceptable over the course of those first few days. This is where 24-hour coverage is crucial, staff can offer adjustments, comfort measures and reassurance that what’s happening is temporary and to be expected.

Meeting Your Team

Treatment facilities are team-based rather than provider-oriented. Expect to meet multiple people in care. For example, there will be a primary therapist/counselor to lead treatment; staff who medicate those who need help; case managers/people who address other smaller concerns (insurance questions, family check ins/intervention talk, planning for post-treatment).

Group therapy often starts in that first week even if someone doesn’t feel at their best yet. This is an orientation group focused on rules/expectations/basics for getting to know other patients and building rapport. This potentially feels awful at first, no one wants to share their vulnerable position with strangers, but many people find that one of the most incredible aspects of treatment is found within groups.

Individual therapy sessions also start, they’re not necessarily delving deeply into trauma but instead, maintaining rapport because therapists know that trust takes time. Early sessions establish goals, help identify triggers and patterns, and start introducing coping skills that will be necessary throughout treatment.

Establishing a Routine

Treatment centers run by schedules: meals at certain times, groups in between those times, free times later in the day (if applicable). Some centers have exercise programs/art therapy/recreational activities with scheduled free times woven throughout. For someone who’s operated by inconsistent schedules/out of control patterns to fuel substance use, this structure may feel overwhelming.

Expect to wake up early, most centers have 7 AM as a wake-up call; meals are served afterward and then morning groups are held. Midday meals are followed by afternoon therapy sessions or wellness workshops regarding addiction/recovery. Evenings offer meals and group time or free time before lights out.

Weekends may be slightly different but maintain the same basic structure.

This helps create stability where uncertainty otherwise reigns; it’s an easy way to keep patients busy rather than sitting around ruminating; and it fosters the kind of structured habits that will support long-term recovery. The brain likes patterns, treatment fosters positive patterns instead of the negative ones that addiction cemented.

Emotional Turbulence

The emotional rollercoaster during the first week is unexpected but common, in one hour, someone feels hopeful and determined to change; in the next hour they’re riddled with self-doubt, angry they had to come there in the first place or resentful for everything addiction took from them; one minute they’re at peace; the next they’re panicking over having to live life without substances numbing such difficult feelings.

Crying happens; laughter occurs at odd times in which people didn’t expect their bodies to respond positively or humorously. The emotional numbness that many enter with starts subsiding, which means feeling everything once again, and feeling it more intensely. This can feel uncomfortable but it’s necessary, learning how to cope without reaching for substances is integral to successful recovery.

Other patients quickly become significant, there’s something powerful about being surrounded by others who understand addiction from the inside out. People drop their façades. Others share their struggles for the first time in open environments they’ve never thought about being vulnerable within. Intense friendships blossom quickly as they realize they’re all there fighting similar battles.

Family Connections

Most facilities put up walls between contact with the outside world during the first week, calls are limited to certain times (if they’re allowed); visitors aren’t permitted until a few days in. This bubble protects individuals by allowing them to focus solely on themselves without outside distraction.

When family connection does happen, it’s usually supervised or structured better than just an open dialogue, at least in the beginning. Family therapy sessions occur to determine dynamics that complicated either addiction or recovery. These conversations become difficult but necessary, addiction doesn’t happen in a vacuum, it impacts everyone in someone’s periphery.

Life Moving Forward

By week’s end, fog starts to clear. A new normal emerges as physical symptoms ease up from their intensity; routine becomes familiar; relationships with staff and other patients form organically and more importantly, work begins to understand substance use disorder along with coping mechanisms.

This first week might feel like the hardest, it’s also where hope ignites for something better; where the body learns how to heal and the mind processes what’s next; where someone finally learns they’re not alone and have advocates supporting them through every step right alongside a family of like-minded others all working toward similar goals. Treatment may not solve everything in seven days but it lays the groundwork for everything yet to come.

Jane