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Substance use disorder treatment programs generally fall into 1 of 2 categories: inpatient or outpatient. While equally focused on rehabilitation, each type has unique attributes and benefits to offer. Inpatient treatment programs, also known as residential treatment programs, are intensive and are designed to treat serious substance use disorders and addictions. Outpatient treatment, on the other hand, are part-time programs that allow for some level of flexibility so a patient can attend treatment without missing work or school responsibilities.
It’s important that both the individual with a substance use disorder (SUD) and their loved ones understand the differences between these two types of treatment programs before making a decision. Exploring all options prior to making a decision can help put the individual or a loved one on the road to long-term sobriety.
When determining what type of care you need, it's important to understand the differences between inpatient and outpatient treatment. Dr. Ashish Bhatt, MD explains.View All Videos
Inpatient recovery programs require patients to admit themselves into a controlled environment to address substance use disorders, co-occurring mental health conditions, and other behaviors that may be causing them difficulty. During this time, patients stay in a residential treatment center where they receive 24-hour medical and emotional support.
There are different levels of residential treatment centers, with some being more hospital-like in nature, and others that are modeled more like a spa or luxury hotel. The core concept of 24-hour care and support is the same no matter the type of facility.
It’s important to properly prepare for treatment. There’s no set amount of time needed to prepare for treatment, but the sooner the better in most cases. It’s also important to set an entry date for admission and to have affairs settled before that date.
Some of the things to take care of before entering treatment include:
Successful inpatient programs know that 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 programs’ policy is different. Some offer limited or no visitation during treatment, while others may allow for unlimited visitation and even involve family and friends in the recovery process. Some programs also encourage and provide family counseling for the family of the individual in treatment.
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During inpatient treatment, residents can 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 30 days to 6 months.
The first step in inpatient treatment, for many, is medically assisted detox. During detox, physicians and addiction specialists monitor patients’ vital signs while the substances exit the system. Drug cravings are common during detox and can be difficult to overcome, often leading to relapse. The 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. Withdrawal symptoms aren’t pleasant for any substance, but some require medical supervision to reduce risk of serious medical complications from occurring. In some instances, withdrawals can be fatal. Lethal withdrawals are linked to substances like synthetic Opiates, Benzodiazepines, alcohol, and Heroin. During inpatient treatment, patients have access to 24-hour medical attention. This attention can mean the difference between relapse and recovery.
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Outpatient treatment is generally considered to be less restrictive than inpatient programs. Outpatient recovery programs fall into 2 different levels of care: partial hospitalization and intensive outpatient. Each level typically occurs after a residential treatment stay or if assessed as the appropriate level to start off at by a behavioral health professional.
Partial hospitalization programming (PHP) is the most intensive type of outpatient treatment, which focuses on stabilizing behaviors in early recovery. Most residential programs have a PHP that patients commonly transition to if they live locally. PHP programs are generally 5-6 hours of treatment per day, usually for 5-6 days a week. This level of care is often done while not working, as the treatment itself can be as time consuming as residential treatment.
Intensive outpatient programming (IOP) is a step down from PHP, in which patients begin to return to their daily lives by attending services for 3 hours of treatment per day for 3-5 days a week. This allows more flexibility for work and life needs, as well as an opportunity to readjust into the world with support.
These sessions focus on relapse prevention, psychoeducation, individual, and group counseling; teaching recovery skills to help reduce relapse and promote long term recovery. Outpatient treatment can be a helpful option for someone with a mild substance use disorder, or it can be part of a long-term treatment program. Outpatient drug rehab can last 3 to 6 months, similar to inpatient treatment, but can last for well over a year for more serious cases.
Patients with mild to moderate substance withdrawal symptoms might find outpatient detoxification a fitting alternative to residential detox. Outpatient detox is safe, effective, and can be more flexible for those that are deemed ready by a treatment specialist.
Unlike residential detox, patients must visit a hospital or other treatment facility for physical and mental check-ups during outpatient detox. Clinicians or doctors might administer medications on-site to soothe withdrawal symptoms like anxiety, depression, and increased heart rate.
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Outpatient treatment allows those in recovery to remain at home during treatment or at a sober living home that may be connected with the treatment program. Those undergoing outpatient treatment can continue working and remain close to family and friends. Outpatient treatment centers usually conduct IOP at night or in the early morning to help those in the program maintain their normal schedules outside of treatment.
Twelve-step groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) may be used as part of outpatient treatment. Studies show that participating in recovery groups like AA and NA helps recovering addicts stay sober. Many individuals with a substance use disorder (SUD) also turn to outpatient treatment after completing an inpatient program as part of their continued recovery.
Inpatient treatment programs typically cost more than outpatient treatment programs. The 24/7 on-hand medical care and psychotherapy available to residential rehab patients increases treatment costs. The price difference should not encourage or discourage someone from choosing the best treatment route for them.
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No matter which treatment option you choose for yourself or a loved one, treatment can change your life. Addiction is a chronic illness, and recovery is a lifelong process. Medical professionals, mental health counselors, and community groups like AA can teach the necessary skills to avoid relapse.
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Travis Pantiel, LMHC, MCAP
Travis Pantiel is a Licensed Mental Health Counselor and a National Board-Certified Counselor with specialized expertise in the co-occurring disorder treatment field.
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