Summary: In the early stages of recovery – about a month in, give or take – your mood and outlook may improve dramatically, but there’s a good reason to stay in addiction treatment after you start feeling great: this phase typically doesn’t last long, and leaving treatment may have negative long-term consequences.
Key Points:
- There’s a phase in early recovery akin to a sugar high: it feels great, but when it passes, you don’t feel great at all.
- Leaving treatment during this phase, often labeled The Pink Cloud or Pink Cloud Syndrome, can increase risk of relapse.
- You may feel better than ever, which is a positive outcome in early recovery.
- Decades of first-hand reports from both treatment professionals and people in recovery warn that leaving treatment at this point – or thinking you’re cured or recovered or done with this part – can derail your process and delay your goal: long-term, sustainable sobriety.
Is Pink Cloud Just a Made Up Thing People in AA Say?
No, it’s not just a made up thing AA people say to keep you coming back or people at the treatment center say to keep you in their program.
It’s something you need to know about to achieve a successful, sustainable recovery.
The phenomenon called pink cloud or pink cloud syndrome is real, and it’s the main reason you should stay in addiction treatment after you start feeling great. It’s the reason almost everyone who’s been through recovery will advise you to stick to your residential treatment program – or double down on whatever program you’re in – rather than leaving treatment or abandoning the things you did that got you to the place where you feel great.
It was first described by an AA-adjacent physician, but that’s because AA was the first organized approach to addiction recovery that worked and had the attention of professionals in the medical establishment.
Although the phrase is not an official medical term, it was coined by a doctor named Harry Thiebot, M.D. in an article published in 1955 called “The Pink Cloud and After.” Dr. Thiebot was a psychiatrist and early advocate of the Alcoholics Anonymous (AA) 12-Step approach to recovery from alcohol addiction.
He defined the syndrome as follows:
“This blissful state is a logical aftermath of surrender. The ego which has been full of striving, just quits and the individual senses peace and quiet within. The result is an enormous feeling of release and the person flies right up to the pink cloud, and think they have found Heaven on earth.”
That’s an excellent narrative description of what happens in early recovery and explains why you might not want to stay in addiction treatment after you start feeling great.
However.
Additional information from the Substance Abuse and Mental Health Services Administration (SAMHSA) in the publication “Treatment Improvement Protocol (TIP) Series: Treatment for Stimulant Use Disorders” carries a warning about the dangers of pink cloud syndrome. Here’s what the experts from SAMHSA say about what happens after this period of feeling great:
“During the stage sometimes termed “the pink cloud,” patients enter a euphoric state. This often occurs around the 1-month mark following withdrawal and completion of detoxification, when the brain is overproducing dopamine. Patients may express a sense of positivity and self-confidence (“I am never going to use drugs again!”). However, this period quickly subsides as the brain begins to underproduce dopamine, and patients typically fall into a depression at the 3- to 6-month mark, when they have a high likelihood of return to use.”
That definition explains exactly why you may want to stay in addiction treatment after you start feeling great:
It doesn’t last, you might get depressed after it fades, and it increases your risk of relapse.
While we retrieved that definition above from a publication about stimulant use disorder, experts in addiction treatment – and seasoned AA members with decades of recovery experience – confirm through personal experience that pink cloud syndrome applies to almost every addition recovery process, particularly recovery from alcohol addiction, or alcohol use disorder (AUD).
What’s It Like to Be in the Pink Cloud Phase?
Signs of being in this phase include:
- Vastly improved mood
- Feeling joyful/euphoric
- Feeling positive and hopeful about the future
- Not taking support systems seriously
- Thinking you don’t need to do any more work
- Quitting your step work
- Skipping recovery homework
- Thinking you’ll feel this way forever because you’re now recovered.
People in this phase consistently report feeling all the positive things about recovery – hope, optimism, euphoria, excitement – and none of the hard things, like fear, anxiety, worry, sadness, pessimism, and loneliness.
Treatment providers love seeing people find hope, feel great, and connect to a positive vision of their future in recovery. They don’t enjoy being a downer and throwing a wet blanket over all that, but they have to be honest about what they see: a temporary phase that’s a typical part of the recovery journey but rarely lasts long.
According to treatment experts, most people who leave formal treatment or don’t develop a robust relapse prevention plan return to treatment sooner rather than later.
Benefits and Drawbacks of the Pink Cloud Phase
We’re not saying pink cloud is bad. We’re saying it’s a typical part of the treatment process that probably won’t last. With that in mind, there are positive things about this phase that can give you hope you’re on the right track, as long as you stick to your program:
- You feel good for the first time during treatment.
- This may be the first time you’ve really felt good in years.
- You’re thrilled you made it past withdrawal and start to realize the work of recovery might be worth the effort.
- You become confident, possibly for the first time, that you got this.
We also need to point out that the negative aspects of pink cloud are significant:
- You might leave treatment before you’re ready.
This is, by far, the most dangerous part of pink cloud syndrome.
- Overconfidence may cause you to stop working on and fully developing the daily skills that promote long-term recovery.
This may be the second most dangerous aspect of pink cloud syndrome.
- Overconfidence may cause you to be cavalier about risky situations (see previous bullet point). You might:
- Return to old friends who still drink/use drugs,
- Return to old places where you used to drink/do drugs.
- Reprise old patterns of thought and behavior that increase risk of relapse
- You may develop unrealistic expectations about what recovery is like.
In real life, every single day isn’t like being in your own personal Walking on Sunshine video.
Some days? Yes. All days? No.
Everyone has good days and bad days. People who’ve never had an addiction problem, ever, might have several bad days in a row. But they have the coping skills to manage them, and for many people in addiction treatment – maybe you, maybe not you – the primary coping skill was alcohol or drug use.
Developing Durable Coping Skills Increases Your Chance of Staying Sober
If leave addiction treatment once you start feeling great, your risk of relapsing increases, because you may not have taken the time to develop real-world coping skills. These include:
- Stress management
- Distress tolerance
- Emotion regulation
- Effective communication
- Robust sober/recovery friendly social support system
- Crisis management skills
When you want to leave you program but receive advice to stay in treatment, you may reply with something like this:
“But I’m eating healthy, doing yoga every day, going on hikes, and going to meetings. I’m totally ready to end treatment and get back to the real world.”
To which an experienced addiction counselor might respond:
“Yes, you’re doing a great job with all that, but what you really need is to find out how all these habits work when this phase ends, and you don’t feel like a million bucks. If you stay, we can help you develop the skills you need to navigate recovery when you’re tired, stressed, feel awful, and want to drink/use drugs more than ever.”
We’ll now share the results of the only known clinical study on pink cloud syndrome.
What the Research on Pink Cloud Says
We have one more definition of Pink Cloud Syndrome from the only peer-reviewed study published about it. The authors of “Pink Cloud Syndrome (PCS) Among Ruled Drug Users in Iligan City Drug Treatment and Rehabilitation Center (ICDTRC)” define the syndrome as follows:
“The term ‘Pink Cloud’ is used to describe a state in which a person undergoing treatment manifests euphoria, overconfidence, and a false sense of well-being, therefore making them vulnerable to relapse.”
Yes, we repeat ourselves with no shame, because this topic is that important. Also, that’s not us: that’s a direct quote from a group of clinicians and researchers. They developed and administered a questionnaire called “The Advanced Warning Signs of Pink Cloud Syndrome (PCS) Questionnaire” to a group of people in addiction treatment.
Here’s what they found.
PCS Symptoms and Relapse Risk: Outcomes
- People with more symptoms showed increased risk of relapse.
- People with fewer symptoms showed decreased risk of relapse.
- Younger people reported more symptoms, and showed increased risk of relapse.
- People with higher levels of educational attainment reported more symptoms, and showed increased risk of relapse.
Those outcomes confirm what we know about PCS and relapse risk. Believe us: we understand why you want to leave early. You feel good. You want to get back to your life. And you truly believe you’ve turned the corner and there’s no way you’ll ever go back.
Getting to that place is amazing. Experience teaches us that – full disclosure – being in the pink cloud is not an indication that you’re ready for full independence, but rather, you’ve done great work, and you have more to learn before you’re ready to go it alone.
What We Know About Pink Cloud Through Our Work in Treatment and Recovery
At Honu House, we’ve seen clients leave treatment soon after they start feeling great, and observed:
- False confidence mixed with a lack of robust relapse prevention skills.
- A return to enabling friends and family
- A return to dysfunctional patterns of behavior
- Relapse to alcohol and/or drug use
- Shame, depression, loss of hope due to relapse
- Self-isolation – because of shame – following relapse
- Delayed return to treatment due to fear of judgment
We hope we’ve made it clear that if you start feeling great early in recovery – for some people, that’s as early as 2-3 weeks, but for most, it’s about a month – the reasons you should stay in addiction treatment after you start feeling great include:
- It is unlikely to last long.
- When it fades, you might feel worse, i.e. depressed.
- If you don’t stay in treatment, your risk of relapse is very high.
With all of that said, we’ve observed three more things you should know about:
- Clients staying in treatment despite being sure they’re ready to leave – and soon realizing staying was a good choice.
- Clients returning to treatment after leaving early and relapsing.
- Returning clients making it through the pink cloud, developing the skills they need for long-term recovery, and achieving it.
In the end, whether you stay or go is your choice. If you have a strong support group, keep going to meetings, keep seeing a counselor, and keep working at recovery, it’s possible you can manage alone: we won’t put limits on anyone. But if you wonder why you should stay in addiction treatment after you start feeling great, we’ll say this:
