When the Glee star died at 31 of a toxic mix of heroin and alcohol, he was just two months out of treatment for substance abuse. Post-rehab, the actor looked healthy and happy, attending a hockey game with his girlfriend, Lea Michele, dining out with friends and attending a photo call for the next season of his FOX hit.
But addiction experts say that the immediate period after rehab is one of tremendous vulnerability.
"Newly sober people are more fragile than before they became addicts," says Bob Forrest, a California-based certified drug and alcohol counselor.
"They are raw, reactionary, insecure, resentful and need to be loved and supported," says Forrest, who has appeared as an expert on Celebrity Rehab and is the author of an upcoming memoir on addiction, Running with Monsters.
But often that isn't enough. Many other Hollywood stars, including Robert Downey Jr., David Arquette and Ozzy Osbourne, have been open about their past experiences trapped in the cycle of rehab-relapse-repeat.
"Addiction is a disease," says actress Kristen Johnston, who shared her battle with drugs and alcohol in a 2012 memoir, Guts.
"And like cancer, some die, some don’t," she says. "I have no idea why I'm alive and Cory Monteith and hundreds of thousands of others die. I do think many addicts blame themselves and have such profound shame that they 'lack the willpower' to stop. But quitting has nothing to do with willpower or fortitude. If it did, I wouldn't have been an addict in the first place."
Transitions DifficultSources confirm that Monteith spent time at both California’s Betty Ford Center and Crossroads Centre on the Caribbean Island of Antigua. But experts emphasize that rehab is merely the beginning of recovery, followed by the critical transition from in-patient treatment to sober living.
"When you consult no one and you are a couple months sober trying to figure out how to live life without heroin or alcohol or pills, it can get almost impossible some days," says Forrest.
At Betty Ford Center, counselors now recommend 90 days of rehab versus the previous 30-day standard to ensure that patients have enough time to prepare "a sober life plan," says spokesman Russ Patrick.
"A crucial episode in the alcoholic's life is transitioning from full-blown alcoholism to treatment and then transitioning to long-term living sober," says Patrick. "You literally leave with your architecture for a new life."
Support Groups VitalFor those just beginning a new life, addiction counselors say ongoing support groups and sober living facilities – in which recovering addicts live together in a drug-and-alcohol-free environment – are both key.
"Most people have a problem and they go, '[I'll do] 30 days at a treatment center, and then they leave and get back to their life,'" says actor Matthew Perry, who shared his own addiction battle in a recent PEOPLE cover story. "And they start to get uncomfortable, and then they get so uncomfortable they say the only thing that will fix this is the drug I was taking before: 'I gotta do that again because it's the only thing that will fix it.' That's why support groups are so important."
Likewise, sober living houses can aid a patient's recovery by providing a supportive environment that encourages healthy practices.
"It's very wise to then transition to a sober living house," says Perry, who transformed his Malibu beach house into a men's sober living facility. With daily curfews and meditation sessions, along with regular check-ins and drug tests, "it's a really good buffer" between rehab and the real world, says Perry.
Ultimately, the key to lasting sobriety "is having a sobriety life plan in place – short term and long term," says Patrick. "Those first 90 days away from the facility are key."
Adds Joe Schrank, who runs several sober-living facilities in New York City: "Rehab is theory, but the rubber hits the road in the world. Coming back into the world and the life that was very recently spinning out of control requires a comprehensive plan."
Reporting by CHARLOTTE TRIGGS, HOWARD BREUER and EMILY STROHM
Fans of Monteith's may make donations in his name to three charities that were especially important to him: Project Limelight Society, which exposes youth living in Vancouver's Downtown Eastside to the arts; Virgin Unite, founded to support entrepreneurial efforts to better the world; and Chrysalis, which helps homeless and low-income individuals find employment.