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Inpatient vs. Outpatient Rehab: Which is Better?

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Is Inpatient Treatment Better Than Outpatient?

Inpatient and outpatient rehab both have their strengths and weaknesses. Inpatient rehab provides a highly structured environment, in which patients receive around-the-clock support and care, whereas outpatient is a more flexible and affordable option. Whether you require inpatient or outpatient rehab largely depends on your individual needs, situation, and addiction severity.

How Common are Drug & Alcohol Addictions?

Addictions to drugs and alcohol.Substance use disorders, or addictions, are complex and devastating conditions that can severely impact one’s brain function, behavior, and quality of life.1 Problems with drugs and alcohol impact people of all ages and demographics, with the Substance Abuse and Mental Health Services Administration (SAMHSA) estimating that 20.2 million American adults (8.4% of the population) had an addiction to drugs or alcohol in 2014.2

As substance use disorders develop, people may begin to use drugs or alcohol despite clinical impairment, health problems, or inability to engage in responsibilities at home, work, or school. Because substance use disorders affect your physical, psychological, and emotional health, quitting on your own can be extremely difficult or even impossible in some cases.2,3 For this reason, formal addiction treatment is frequently sought by people looking to stop drinking or using drugs and to maintain their sobriety.

What to Consider when Comparing Options

Addiction treatment varies depending on the type of substance abused and the individual characteristics of each patient. With that said, effective treatment addresses each patient’s substance abuse and associated medical, physiological, social, and legal problems. It is also vital that the rehab takes gender, age, culture, ethnicity, and religion into consideration as well.1

Difference between inpatient and outpatient rehab.Addiction treatment programs will often utilize comprehensive treatment plan that includes a combination of therapy types, such as individual, family, marital, or group counseling. Counseling can help improve a patient’s motivation for change, build coping skills to resist drug cravings and drug use, and improve self-esteem and interpersonal relationships.1

Patients may also benefit from medication while in treatment. Options may include medications that alleviate drug cravings and block opioid effects, such as methadone, buprenorphine, and naltrexone. Psychiatric medications, like antipsychotics or antidepressants, may also be administered to those who are struggling with co-occurring disorders, such as depression and anxiety.1

Each program varies in duration, location, philosophy, and setting. However, the two major settings include inpatient and outpatient rehabs, both of which can help you on the road to recovery.

Inpatient

Inpatient rehab provides intensive services for people struggling with substance use disorders. People live at the facility and receive 24/7 monitoring and supervision throughout their duration of care. Treatment lengths vary (with averages from 28-90 days), though research supports longer durations of treatment (at least 3 months).1 Due to the costs of room and board and around-the-clock patient monitoring, inpatient treatment will be more expensive than outpatient. Inpatient treatment may range from about $14,000 to $58,000, depending on the location, duration, and your insurance policy.4 Insurance will most likely provide partial coverage for addiction treatment services, but you’ll be responsible for the remaining costs, which can get pricey. That being said, there are rehabs that offer payment plans, sliding scale services, grants, and scholarships for people of lower income levels.

Inpatient rehab separates patients from their current environments, which is likely to consist of people, places, or situations that trigger drug use. This means that patients can focus on recovering from addiction without external distractions.

Patients receive comprehensive treatment services from a variety of trained staff members, including:5

  • Psychiatrists and other medical doctors.
  • Therapists.
  • Addiction counselors.
  • Social workers.
  • Case managers.

Various forms of treatment for substance abuse.Inpatient programs vary according to amenities and services; however, they typically offer a combination of therapy (individual, group, marital, and family), peer support group meetings (such as Alcoholics Anonymous or Narcotics Anonymous), medical treatment, and discharge/aftercare planning.6

There are different types of inpatient rehab programs, such as:

  • Traditional inpatient, which is typically the cheapest and most accessible inpatient option.
  • Holistic inpatient, which emphasizes healing the whole body—mind, body, and spirit— without using medications. Services such as yoga, mindfulness, and acupuncture are often used.
  • Executive inpatient, which is intended for high-powered executives who want to keep working while in recovery. These facilities are often upscale and luxurious and they provide patients with high-speed internet access, private phones, and private work rooms.
  • Luxury inpatient, which may offer special amenities like, acupuncture, spas, swimming pools, golf, massage therapy, and equine therapy, all within an upscale environment that has a resort-like feel.
  • Faith-based inpatient, which aims to strengthen your spiritual foundation and relationship with your higher power.

It is important for you to do your research when choosing a rehab to find a program that best aligns with your values and priorities.

Outpatient 

Unlike inpatient rehab, outpatient treatment allows people to live at home and still tend to responsibilities at work or school while recovering from a drug or alcohol addiction. Outpatient rehabs vary in intensity, depending on a person’s needs, but they tend to be far cheaper than inpatient treatment since patients may have access to a relatively less intensive range of services and return home after each treatment session.

Most outpatient rehab programs include several hours of therapy and other clinical programming each week. Typically, treatment consists of individual and group counseling, drug education, and support groups. Counseling focuses on providing incentives for abstinence, addressing motivation and willingness to change adverse behaviors, and building skills to resist drug use. Like inpatient treatment, many patients in outpatient rehab benefit from medications for treating substance use disorders and/or co-occurring mental health issues.5

Outpatient treatment is a suitable option for patients with mild to moderate substance use disorders. It is helpful for those who want little to no disruption of their daily routines while receiving treatment for an addiction. Most people attending outpatient treatment are able to continue working, attending school, and fulfilling responsibilities at home.

There are different levels of outpatient rehab, including:7

  • Partial hospitalization (PHP): This is the highest level of care besides inpatient treatment. Patient receives a combination of medical and nonmedical interventions. Also referred to as “day treatment,” PHP involves several hours of treatment per day, for 5-7 days per week.
  • Intensive outpatient (IOP). This is a level of care just below PHP that involves several hours of addiction treatment services per week. Unlike PHP, IOP typically only offers nonmedical services.
  • Outpatient/Standard (OP). This is the least time intensive level of care and may require a few hours a week of clinical services.

What intensive outpatient programs are like.Furthermore, some people transition from inpatient care to either partial hospitalization (PHP), intensive outpatient (IOP), or standard outpatient care after completing their initial rehabilitation program. In this way, outpatient programs are used as step-down treatment for those who want to continue receiving support and monitoring without 24/7 supervision.5

If you’re unsure as to which level of care would be best for you, you can receive a professional assessment from your doctor. During the initial assessment, your physician will evaluate your addiction, as well as your physical, mental, social, and emotional health, to determine the appropriate level of care for you. They can refer you to a treatment setting that they believe will best suit your needs.

With that said, outpatient rehab is not suitable for everyone. Outpatient addiction treatment may not be recommended for those with:2.5

  • Co-occurring mental health conditions, such as depression, bipolar disorder, schizophrenia, or panic disorder.
  • Severe addictions.
  • Addictions to alcohol, sedatives, or opioids.
  • A poor support system.
  • Complicated medical issues.
  • Psychiatric emergencies, such as suicidal ideation.

These patients may better benefit from 24/7 monitoring and care due to the risk of medical or psychiatric complications.

Both outpatient and inpatient rehab programs help people get sober each and every day. You don’t have to struggle alone. Reach out for support and get the help you need to make a positive change in your life.

Sources

  1. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Model.
  2. Substance Abuse and Mental Health Services Administration. (2017). Mental and Substance Use Disorders.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. American Addiction Centers. (2017).
  5. Substance Abuse and Mental Health Services Administration. Substance Abuse Treatment for Persons With Co-Occurring Disorders.
  6. Substance Abuse and Mental Health Services Administration. (2016). Treatments for Substance Use Disorders.
  7. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment.

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