When Recovery Stops Too Soon: A Silent Challenge in Addiction Care

Dr SATISH RASAILY, Consultant Addiction Psychiatrist, Convener (IPS Community Psychiatry)

A 27-year-old man, Mr. XY, was brought by his father with troubling behavioural changes that had been worsening over six months. He had become increasingly irritable, restless, and aggressive, often talking irrelevantly and exhibiting unusual beliefs, including a grandiose sense of self and heightened religiosity. His sleep was severely disturbed, and he frequently wandered aimlessly.

His father reported that Mr. XY had been using cannabis for over a year, after which these symptoms began to appear and gradually intensified. Despite spending four months in a rehabilitation center, his condition did not improve. Instead, after returning home, he became more aggressive, resumed heavy cannabis use, and resisted all attempts at counseling.

Matters took a serious turn when Mr. XY began expressing suicidal thoughts. On assessment, he revealed that he was hearing voices commenting on him and sometimes instructing him to harm himself—features suggestive of a severe mental illness such as Schizophrenia, along with substance dependence.

He was started on appropriate treatment, including medications and psychological therapy. With regular follow-up and strong family support, his condition improved significantly over six months. He regained stability, reduced substance use, and began functioning better in daily life.

However, just as recovery seemed within reach, Mr. XY stopped coming for follow-up and discontinued treatment.

This story reflects a harsh reality in addiction and mental health care. A large number of patients discontinue treatment prematurely, even after significant improvement. Reasons range from lack of insight and stigma to medication fatigue and recurring substance cravings.

Experts emphasize that conditions like addiction and severe mental illness require long-term treatment and follow-up, often for several years. Stopping treatment early greatly increases the risk of relapse, undoing the progress made.

Mr. XY’s journey is not uncommon—but it is preventable. Recovery does not end when symptoms improve; it continues with consistent care, family support, and sustained motivation.

Seeking help is the first step. Staying in treatment is what makes recovery last.