Addiction Treatment Phases Across Gauteng Facilities

Detox happens first because nothing else matters until the body stops reacting to withdrawal. This phase restores sleep, eating patterns, hydration, and medical stability so the patient is capable of engaging in therapy without being overwhelmed by physical distress. Detox is short, usually three to seven days, longer for complex substances, but essential. It is the baseline from which the clinical team can assess what the patient actually needs. Rehab doesn’t begin until the body stops fighting for chemical survival. Detox is the doorway, not the destination.

Primary care is where patients finally see the truth of their addiction. The brain clears, denial cracks, and the clinical team narrows the gap between the patient’s perception of their addiction and the reality that brought them into treatment. This phase is intensive: therapy, routine, exposure to honest feedback, accountability, and deep emotional work. Patients examine their behaviour, relationships, thinking patterns, trauma, and the emotional survival strategies that shaped their addiction. It is the first time many people understand why they couldn’t stop using, even when everything was falling apart.

Primary care lasts 21–42 days, depending on clinical need and medical aid authorisations. But sobriety after 21 days isn’t stability. It’s vulnerability. Primary care prepares the person for change, it doesn’t complete the change.

If primary care reveals the truth, secondary care teaches the person how to live differently. This phase exists because early sobriety is emotionally unpredictable and full of triggers that don’t appear inside a rehab environment. In secondary care, patients gain more independence while still receiving structured therapeutic support. They practice emotional regulation, build routines, confront stressors, work on relationships, and apply skills they learned in primary care to real-world pressures in a controlled environment.

This phase is crucial because relapse rates drop significantly once patients pass the ninety-day mark. The brain stabilises further, denial decreases, and sustained behavioural change becomes possible. Secondary care is where sobriety begins to feel real rather than fragile.

Tertiary care bridges the gap between treatment and everyday life. Patients live in sober homes with structure, accountability, peer support and therapeutic oversight while working, studying, repairing relationships or rebuilding independence. This phase addresses the part of recovery that treatment alone cannot fix, how to function in real life without collapsing.

In tertiary living, the patient’s world expands again, slowly and safely. They make mistakes, correct them, seek support, learn responsibility and rediscover autonomy. This isn’t “extended rehab.” It’s sober life with scaffolding. People who skip this phase often return to environments that emotionally outpace their readiness, which is why halfway care dramatically improves long-term outcomes.

Not everyone needs full-time residential treatment. Some people, especially those with strong support systems, can stabilise in an outpatient model. Outpatient treatment at Changes allows patients to live at home, work full-time, and attend evening therapy and structured clinical groups. This phase still includes accountability, relapse-prevention work, counselling, and group therapy, but without the intensity of residential care.

Outpatient treatment is not a “lighter” option; it is the right option for the right patient. Its purpose is to prevent deterioration and intervene early before an addiction escalates to the point where residential care becomes necessary.

Leaving treatment is not the end of the process. It’s the part where people most often relapse if they’re not connected to ongoing support. Aftercare offers structured therapy, group sessions, family guidance, and relapse-prevention work for people with six to nine months of sobriety. Life Orientation groups extend this support to a year of structured maintenance, because emotional stability, behavioural consistency and support networks take time to solidify.

The reason this works is simple: addiction changed the brain long before the person entered treatment, and it takes sustained work, usually close to a year, for new neural pathways, routines and coping strategies to become automatic. Aftercare gives people the runway they need to move from sobriety as effort to sobriety as a lifestyle.