Drug addiction is considered a complex brain disease with far-reaching nuances and consequences that impact many facets of a person’s life. There are many different options for managing addiction The National Institute on Drug Abuse (NIDA) publishes that there are over 14,500 facilities in the United States providing specialized care for drug abuse and addiction.
The two main modalities of care are inpatient and outpatient programs. Both of these forms of addiction treatment are likely to include the following components:
- Group and individual counseling
- Behavioral therapies
- Life skills training
- Support groups and 12-step programs
- Relapse prevention
- Educational programs
- Medication management
- Treatment for dual diagnoses
- Ongoing recovery support
Both outpatient and inpatient drug treatment programs can be beneficial, depending on a person’s particular circumstances. Drug addiction affects every person differently, and there are many factors to consider when choosing an addiction treatment program. There is no one program that works for everyone.
Since each person is unique, what works for one person may be less than optimal for the next. It is imperative to find a drug treatment program that will be the right fit both for the person seeking care and for the family as a whole.
The Main Differences Between Outpatient and Inpatient Programs
The biggest differences between outpatient and inpatient drug abuse treatment programs are the structure, time commitment, and accommodations. With an inpatient or residential treatment program, the individual will stay in a specialized facility 24 hours a day for a set amount of time. An inpatient program is highly structured, and most of the hours of the day are typically planned and supervised.
Inpatient Treatment Programs
There are variations in types of residential programs.
The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that residential treatment programs can be offered within hospitals with specialty substance abuse treatment units, at facilities that focus on behavioral health and broader mental health concerns, at specialized substance abuse treatment facilities that provide intensive inpatient care, or within long-term residential treatment facilities or therapeutic communities (TCs).
An intensive addiction treatment program can last anywhere from three to six weeks on average, and long-term residential programs are set up to run between six months and a year, per NIDA. With an inpatient program, a person will be monitored around the clock and receive a high level of attention the entire duration of the program.
Inpatient programs often include additional components of care, such as holistic treatment methods like yoga, massage therapy, mindfulness meditation, nutritional planning, creative expression therapies, and fitness programs.
These programs typically begin with a medical detox protocol that allows drugs to process safely out of the body, often with the aid of medications, while providing medical monitoring and emotional support.
Inpatient programs provide a high level of care, structure, and supervision, and this can promote healing for the brain and body. They offer the time and space for new healthy habits to be created and solidified.
Generally speaking, the longer a person stays in a treatment program, the better.
The American Journal of Drug and Alcohol Abuse reports higher rates of abstinence among individuals who remain in a residential treatment program for longer periods of time.
Outpatient Treatment Programs
Outpatient programs differ from inpatient treatment programs in that a person will return home each night and not stay overnight in a treatment facility. These programs are offered in a range of settings, and there are several variations of outpatient drug abuse treatment, such as intensive outpatient programs (IOPs), partial hospitalization programs (PHPs), and traditional outpatient services.
IOPs and PHPs are highly structured and similar in modality to inpatient programs, with the overriding variable being that the person doesn’t stay on site. These programs provide services for several hours a day for a certain number of days per week. The journal Psychiatric Services publishes that IOPs can be just as comprehensive and effective as residential drug abuse treatment programs. They can offer the same highly structured programming and the types of services that inpatient programs do but without the overnight stay.
Traditional outpatient programs can be even more variable, and individuals are able to schedule sessions, meetings, and services at times that are convenient for them. This allows for a higher level of flexibility. Individuals can also pick and choose which treatment options are desired.
Outpatient services can be used as a step-down program from an inpatient program within a full continuum of addiction treatment. After completing a residential treatment program, outpatient services are often used for ongoing support and recovery management.
Choosing a Treatment Type
Drug addiction is a chronic disease that has a high rate of relapse. For addiction, relapse rates range from 40 to 60 percent. Relapse does not indicate failure; it merely means that changes may need to be made in the treatment approach.
NIDA explains that addiction treatment should be at least 90 days in duration, regardless of the form of treatment a person chooses. Longer times in treatment correlate to fewer instances of relapse.
When deciding on an outpatient or inpatient drug treatment program, the first step is to get a detailed and complete assessment by a medical, substance abuse treatment, and/or mental health professional. This initial assessment can help determine what level of care will be optimal.
Generally speaking, an inpatient program is highly beneficial for:
- Significant drug dependence and high levels of long-term drug use
- Intravenous (IV) drug use
- Presence of a co-occurring medical and/or mental health disorder
- Insufficient support at home
- Relapse after or during outpatient services
In the event that outpatient treatment services are not nearby, and transportation is an issue, inpatient programs may be preferable.
An inpatient program can provide an individual with the opportunity to focus solely on healing and building tools for relapse prevention, stress management, and essential life skills to sustain recovery. There is limited pressure from the outside world, and there is no access to substances of abuse while in an inpatient drug treatment program.
Outpatient treatment programs may be best suited to individuals who have:
- Stable home environments with cohesive family support
- Less significant drug dependence or who have been using lower dosages of drugs for a shorter period of time
- Reliable transportation and easy access to local care
- Already completed a residential treatment program
- Requirements for flexible scheduling to be able to fulfill family, school, and/or work obligations
Cost and insurance coverage are important factors when choosing an addiction treatment program. Insurance providers may cover different things, so it is necessary to find out what is covered and how to use coverage to offset costs.
In the long run, addiction treatment can save money. NIDA publishes that addiction treatment can actually save families and society upward of $12 to every $1 spent when you take into consideration healthcare costs, legal fees, and money associated with lost workplace production.
Both outpatient and inpatient drug treatment programs have benefits. Both types of treatment can be helpful in promoting recovery. It’s up to each person and their family to look closely at specific programs to determine what is best for them.
Questions to Ask When Looking At A Treatment Program
As previously stated, there is no single answer when it comes to drug abuse and addiction treatment. Each person will need to find a program that feels right for their situation. It is important to find a program that is in tune with your values and not to simply choose a program because it is highly recommended. That being said, referrals from medical providers and others in recovery can provide wonderful firsthand knowledge about local programs.
Once you have made the decision between inpatient and outpatient treatment services, there are several questions you can ask a treatment facility to ensure that the program will be optimal.
What types of services are offered? What does the daily or weekly schedule look like
Getting an idea of the structure of a program can identify if it feels right for your family
Are the programs based on current scientific models of proof?
Research into addiction is ongoing, and treatment programs must keep up with current studies and methods of care.
Are underlying and co-occurring disorders treated simultaneously and in an integrated fashion?
Co-occurring disorders can be complexly intertwined. Treating them both at the same time can help recovery for both.
What are the credentials of staff members and the licensure and accreditations of the facility?
Treatment providers should be board-certified to practice in their specialty, and high levels of education can indicate significant proficiency for care. Treatment facilities should be licensed within the state, and they can often obtain high levels of accreditation to indicate a commitment to excellence.
What is the ratio of staff to clients?
A lower ratio of clients to staff provides for more personalized treatment.
Is there a full continuum of care, and are regular assessments administered?
Checking up on how a client is doing in treatment is essential as needs can change. Find out if it is possible to move between levels of care as needed.
What types of aftercare support and recovery services are offered?
Treatment does not end after a set amount of time. Ongoing support is vital to enhance and maintain sobriety. Peer support groups, alumni programs, transitional services, ongoing counseling, and follow-up care are all beneficial.
Are there specialized programs for different demographics?
It can be helpful for adolescents to enter into a teen-based program, and women may find that a gender-specific program is ideal. Many treatment programs cater to gender, race, religious beliefs, sexual orientation, and age.
How are counseling sessions structured? How much one-on-one time is given?
Both group and individual counseling sessions are important during addiction treatment. It is essential to ensure that a person is getting adequate personal attention for optimal healing.
Is insurance accepted? Are there other options for financing?
Be sure to set up payment information ahead of time. Most facilities accept insurance or will work with families to set up payment plans.
How soon can treatment start?
Optimally, the person can start the admission process right away. The sooner treatment begins, the faster the path to recovery.
Addiction treatment programs are highly individual, and the decision regarding the type of program will depend on a wide range of circumstances. In general, the treatment program should feel good to the family and the individual. The goal is to provide a comfortable setting for healing as this will foster recovery.
If you have a particular treatment facility in mind, give them a call. They will have trained professionals on hand to answer any questions you have, and they can help you make an informed decision on the best type of treatment for you.