Inpatient and Outpatient Treatment
Drug and alcohol treatment programs generally fall into one of two categories — inpatient or outpatient rehab. While equally focused on rehabilitation, each type has unique attributes and benefits to offer.
Inpatient rehabs are intensive, residential treatment programs designed to treat serious addictions. Outpatient rehabs are part-time programs, allowing the recovering user to keep going to work or school during the day.
It’s important that both the addicted person and their loved ones understand the differences before selecting a treatment program. Finding the right treatment program can put you or a loved one on the road to sobriety.
Inpatient Rehab and Treatment
Inpatient recovery programs, also known as residential treatment, require patients to check themselves into a controlled environment to overcome their addictions. Patients stay at a clinic with 24-hour medical and emotional support.
Preparing for Inpatient Rehab
It’s important to properly prepare for rehab. There’s no set amount of time needed to prepare for treatment. It is important to set an entry date for rehab and to have affairs settled before that date.
Some of the things to take care of before entering rehab include:
- Talking to your employer
- Finding living arrangements for children or other family members
- Planning how to get to and from the rehab center
- Finding out what personal items are allowed
Family Support and Contact in Inpatient Rehab
Successful inpatient clinics know family involvement is crucial to recovery. Family members can contact loved ones in residential treatment to provide emotional support and encouragement.
When it comes to how and how often residents can communicate with their loved ones, each inpatient center’s policy is different. Some rehab centers also provide counseling for the addicted person’s family.
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Daily Life During Inpatient Rehab
During inpatient treatment, residents are able to completely focus on getting well and sober without the distractions of everyday life. A typical day in residential treatment is carefully scheduled and accounted for. Psychologists, counselors and psychiatrists meet with patients individually and in group settings to guide inpatient recovery.
A typical inpatient program runs anywhere from 28 days to six months.
The first step in inpatient treatment is medically assisted detox. Physicians and addiction specialists monitor patients’ vital signs while the drugs exit the system. Drug cravings are common during detox and can be difficult to overcome, often leading to relapse.
Constant medical care provided during inpatient treatment helps guard against relapse. Clinicians can provide necessary medicine and medical expertise to lessen cravings and withdrawals.
The brain reacts differently to different addictive substances over time and frequent use. Withdrawal symptoms aren’t pleasant for any drug, but some drugs should never be quit without medical supervision. Some withdrawals can be fatal. Lethal withdrawals are linked to drugs like synthetic opiates, benzodiazepines, alcohol and heroin.
During inpatient rehab patients have access to 24-hour medical attention. This attention can mean the difference between relapse and recovery.
How to Choose an Outpatient Program
Outpatient rehab is a form of substance abuse treatment that does not include living at the facility. Outpatient treatment can vary widely, from partial hospitalization to 12-step meetings.
What Is an Outpatient Program?Outpatient rehab programs allow you to continue to live at home during drug or alcohol rehabilitation. Outpatient rehab tends to cost less than residential or inpatient treatment, and it may be more suitable for those unable to take extended absences from work or personal obligations.
Before you choose a program, consider which type of outpatient treatment program will work best for you and ask some questions about the program - such as how much it costs, what kind of treatment it offers, and where it's located.
Types of Outpatient Treatment
There are many outpatient rehab treatment options to choose from depending on your level of addiction and personal needs.
- Intensive outpatient: These programs are similar to inpatient residential programs with respect to service and effectiveness. The major focus is relapse prevention. Intensive outpatient programs usually meet at least 3 days a week for 2-4 hours a day or more. These programs are often scheduled around work or school to accommodate daily schedules. 1
- Partial hospitalization: This treatment is specifically meant for people who require ongoing medical monitoring but have a stable living situation. Partial hospitalization treatment programs usually meet at the hospital for 3-5 days a week for at least 4-6 hours per day.
- Therapy and counseling : These treatments are usually combined with other treatment methods or as follow-up support after inpatient rehabilitation. Therapy and counseling can help you identify the root cause of your drug use, repair relationships and learn healthier coping skills. Treatments include behavioral therapy, group or individual therapy, and family counseling.
Reasons to Choose an Outpatient Facility
Outpatient is good for less severe addictions and for people transitioning out of inpatient.
Deciding What's Right for You
Many factors go into determining what's right for your specific needs. It's important to consider all of them before choosing a program.
How Serious Is Your Addiction?
You need to understand the severity of your addiction to figure out what type of treatment is right for you.
- Do you think your addiction requires strict detox treatment (detox is the process of removing any remaining drugs or alcohol from the body)?
- Has a recommendation been given to you to undergo a supervised withdrawal period (some substances, when abruptly stopped, can result in an extremely uncomfortable and dangerous withdrawal syndrome when abruptly stopped)?
- Have you tried outpatient treatment before and then relapsed soon after?
- Do you feel you might need to remove yourself from your current environment to focus on recovery?
If so, then inpatient or intensive outpatient rehab may be more effective.
What Is the Program's Treatment Schedule?
Outpatient treatment program schedules and timelines vary. Everyone progresses through drug addiction treatment at different rates, so there's no set length of treatment. Programs can run between 1-3 months or longer. Participation is usually recommended for at least 90 days to maintain positive outcomes 2. Based on your recovery progress, the length of a course of outpatient treatment can be extended, following ongoing evaluation and further recommendation from your addiction treatment professional.
When finding an outpatient program, check their schedule to see which days and times they offer treatment to see if it fits with your schedule.
Where Is the Program Located?
If you plan to continue working or taking care of personal commitments during rehab, you'll probably want to find a program that's close to your home or work.
What Kind of Treatments Does It Offer?
Before beginning outpatient rehab, ask the facility about the therapies offered and make sure you feel comfortable with them. Outpatient treatment can include behavioral therapy, medications or their combination.3 Behavioral therapy is an effective and common treatment method in outpatient rehab, since it empowers you to take control of your addiction.4 A few of the key behavioral therapy tactics include:
Contingency management therapy: This technique uses positive reinforcement by providing rewards and privileges for compliant behavior such as remaining drug free, participating in counseling sessions or taking medications as prescribed consistently.5 It is normally a voucher-based system, where the voucher value adds up over time with compliant behavior. Eventually, these vouchers can be exchanged for retail items or services.
Cognitive behavioral therapy (CBT): This therapy aims to prevent relapse by helping you understand triggers and consequences of drug use.5 It provides you with training to recognize situations or states of mind where you're most vulnerable to drug use. It also teaches you coping skills when presented with the opportunity to use.
Motivational interviewing: This therapy style helps you explore and resolve your uncertainty about treatment.5 It's intended to enhance your self-motivation for change and recovery from addiction.
Individual or group counseling: Individual counseling focuses on reducing drug use and addressing hard to manage areas of your life like employment status, illegal activity and family relations.3,4 Group counseling is extremely effective due to the social reinforcement offered by peer discussion and support. Many group counseling services follow the 12-step model such as Alcoholics Anonymous or Narcotics Anonymous.3,4
How Much Does It Cost?The cost of outpatient drug rehabilitation can vary depending on the type of facility, quality of care and length of treatment. Generally, outpatient programs are less expensive than inpatient programs; however, intensive outpatient programs can often be as expensive as standard inpatient facilities.
There are many options to reduce the cost of outpatient rehab programs.
Several facilities accept private insurance. Certain procedures such as drug detoxification, withdrawal monitoring and psychological counseling are covered under insurance plans.2 If you have health insurance, call our helpline at the number above to ask about mental health and substance abuse coverage. We will provide you with information on the coverage your insurance company will provide and your expected out-of-pocket expenses.
- Additionally, many programs offer payment plans to accommodate those with strict budgets.
- If you do not have insurance, there are still opportunities to access low-cost or free treatment. Local health and social services departments often run drug treatment programs. Some facilities offer certain services for free, while others subsidize services based on your income.
- If you are on Medicaid or Medicare, detoxification and withdrawal treatment may be free.
- Church groups, charities and non-profits may offer free drug and alcohol addiction treatment.2
- Contact SAMHSA (Substance Abuse and Mental Health Services Administration) to learn different ways to finance your treatment, as well as rehab centers that cater to those without insurance.
Can the Program Treat Dual Diagnosis?
Drug addiction is often a brain disease and can occur with other mental disorders (including eating disorders and process addictions). Approximately 6 in 10 people with a drug addiction suffer from another mental illness. 3 This is known as "dual diagnosis" or "co-occurring disorders."
If you're struggling with a mental health issue and a substance abuse problem, it's important to enter programs that treat co-occurring disorders by integrating both mental health and substance abuse treatment methods.2
Look for programs that can treat dual diagnosis if you have a mental illness and a substance abuse disorder.
What Are the Credentials of the Staff?
Make sure the treatment program is accredited by the state it is in and by national organizations such as the Commission on Accreditation of Rehabilitation Facilities .6 These accrediting bodies require programs to meet rigorous standards of patient care and quality treatment.
Additionally, the facility should be run by well-trained, licensed mental health professionals and addiction specialists. This should include a core clinical medical staff (i.e., psychiatrists, internists and nurses), licensed addiction counselors, master's-level therapists and social workers.6
Does It Offer Individual Treatment Plans?
Everybody's treatment needs are different based on their history of abuse, substance being abused, duration of abuse and much more. Depending on these factors, you may require varying combinations of services and treatment such as a combination of counseling or psychotherapy, medication, medical services and family therapy. Additionally, these needs may change as treatment and recovery progresses.
Therefore, make sure that the outpatient rehab program offers individual treatment plans and a continuing care approach where the treatment intensity varies over time according to your changing needs.3
Does Outpatient Treatment Work?
How to Find a Facility
If you are looking for an outpatient facility, call our helpline at 1-888-319-2606Who Answers? , and a treatment support team member will help you find an outpatient facility that meets your needs.
Frequently Asked Questions About Outpatient Rehab Centers
What Does Outpatient Rehab Mean?
In an outpatient rehab program, you participate in regularly scheduled treatment sessions, but remain living at home or in a pre-arranged sober living setting. The time commitment will vary, but typically you'll attend recovery sessions at a designated clinic or other rehab program location for, at minimum, a few hours a week. The precise number of days and hours that you attend treatment depends on individual requirements, as well as how the program is structured.
Outpatient rehab allows you to get the help needed while also having time to attend work or school. These programs are also used for people who are transitioning out of more intensive treatment in an inpatient recovery program .
How Does Outpatient Rehab Work?
Each outpatient rehab is somewhat unique. But common characteristics are found in most programs.
Typically, outpatient rehab programs are less intensive than inpatient programs. You are able to sleep at home or in a sober living house, and attend treatment during a scheduled portion of the day or evening.
Outpatient rehabs can fall into different categories:
Partial hospitalization plans (PHP) are the most intensive and structured type of outpatient. PHP programs are typically attended 4 to 5 days per week for up to 6 hours per day. They offer group, individual and family therapy in addition to facilitating access to certain hospital-based care and services that may be needed by those enrolled in the program.
Intensive outpatient plans (IOP) are less intensive than PHP. But they still offer a very structured outpatient program. These programs are usually held 3 to 4 days a week. Like PHP, they offer group and individual therapy.
Individual therapy is a relatively less structured outlet for outpatient treatment. The intensity of this type of treatment is highly dependent on the needs and motivation of the individual seeking care. It is best for someone who has maintained sobriety for a period of time. Individual therapy begins with finding a therapist or psychologist who specializes in addiction treatment. Therapists meet with clients 1 to 2 times a week for one hour. But the duration and frequency of such appointments can be adjusted, as needed.
How Long Does Outpatient Rehab Last?
The length of outpatient rehab depends on the program and your own individual needs. For instance, many programs might last for 30 or 60 days, but they can be shortened or extended based on your rate of progress and ongoing needs. When looking for a program, it is best to ask about its average length and how flexible the treatment duration is.
Attend the whole program, because outpatient programs are designed around a curriculum that includes certain topics. Insurance companies will often only cover a certain amount of time in treatment, so confirm how much coverage you have before entering a program. If you know that you will not be able to attend the whole program due to insurance, ask the outpatient program how they handle these situations.
Since different types of outpatient rehab programs exist (PHP, IOP, individual therapy), it is possible to transition to a less intensive program after completing another program. For example, many people go from IOP to individual therapy because they benefit from the continued support of a therapist.
How Do I Find an Outpatient Rehab Center Near Me?
Contact a treatment support advisor at 1-888-319-2606Who Answers? . These trained representatives can answer any questions you have and help you find an outpatient program in your area.
What Are the Benefits of Outpatient Rehab?
Outpatient rehab offers many advantages:
Outpatient rehabilitation allows you to remain in the comfort of your own home while attending a program.
Outpatient recovery approaches derive from evidence-based practices that have been shown to be effective by research studies.
Outpatient programs offer support, education and resources that are helpful in early recovery, and even after maintaining sobriety.
Should I Do Inpatient or Outpatient Rehab?
The decision of whether to do inpatient or outpatient rehab depends on your individual circumstances. You have several considerations to weigh:
Severity of addiction. Inpatient programs are frequently recommended for more severe addictions, while outpatient programs might be better for less severe addictions or if it is your first time in treatment.
Need for detox. Some detoxification periods—including those for alcohol and sedatives such as the benzodiazepines—can result in dangerous acute withdrawal symptoms and should be closely supervised by a medical professional. 7 Other types of drug detox—such as detox for cocaine and/or opiates—can result in an uncomfortable withdrawal period, but are usually not dangerous. However, it is best to consult with a medical professional prior to enrolling in any treatment program to make sure that will meet your needs.
Cost. Inpatient treatment is often more expensive, and insurance companies may be more willing to pay for outpatient.
. McCarty D, Braude L, Lyman DR, Dougherty RH, Daniels AS, Ghose SS, Delphin-Rittmon ME. Substance abuse intensive outpatient programs: assessing the evidence. Psychiatr Serv. 2014 Jun 1;65(6):718-26.
. Budney AJ, Roffman R, Stephens RS, Walker D. Marijuana dependence and its treatment. Addict Sci Clin Pract. 2007;4(1):4-16.
. Principles of Drug Addiction Treatment: A Research Based Guide. Third Edition. National Institute on Drug Abuse. http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/acknowledgments. Last updated December 2012. Accessed July 30, 2015.
. Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 4. Services in Intensive Outpatient Treatment Programs.
. Carroll KM, Onken LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005 Aug;162(8):1452-60.
. Broome KM, Flynn PM, Knight DK, Simpson DD. Program structure, staff perceptions, and client engagement in treatment. J Subst Abuse Treat. 2007 Sep;33(2):149-58. Epub 2007 Apr 16.
. 1. Kosten, T. R., & O'Connor, P. G. (2003). Management of drug and alcohol withdrawal. New England Journal of Medicine, 348(18), 1786-1795.
- Your addiction isn't as severe: If you're in the early stages of an addiction or your addiction isn't severe, outpatient rehab may provide the necessary support required for your recovery (see "How Serious Is Your Addiction?" section below).
- You're using it as continuing care: Outpatient rehabilitation is normally recommended after you've been treated at an inpatient facility. It's an effective way to maintain the long-term effects of recovery and prevent relapse.
- You need support of family and friends: Many recovering from drug or alcohol addiction are more effective with regular support from family and friends.
- You can't commit to inpatient care: If your professional or personal situation doesn't allow you to take an extended leave of absence, outpatient rehabilitation may be a better fit for your lifestyle. Programs are scheduled around work and school to accommodate daily commitments.
- You can't afford inpatient: Outpatient rehab programs are generally less expensive than inpatient programs, since you're not paying for room or board. They can be a great option to get help without the financial stress.
Outpatient treatment can be extremely effective. Many who begin and continue treatment stop using drugs and improve their occupational, social and psychological functioning.
Intensive outpatient programs can be as effective as inpatient and residential treatments with reduction in problem severity and increased days of abstinence.1,4
Learn more about rehab programs: