Inpatient Versus Outpatient Treatment

Choosing to change your relationship with drugs or alcohol is an essential first step toward recovery. But recovery is a process — a process that drug and alcohol rehab programs can (and will) help you through. There are many types of substance use treatments, including detox, therapy, and counseling. These fit into two categories: outpatient and inpatient rehab.

Your needs and the severity of your substance use problem will help to determine which type of rehab will be best for you. Both outpatient and inpatient rehab will help you desist from using drugs or alcohol and reduce the risk of using them again after your recovery.

So, is there one that is typically more effective than the other? The truth is that no type of rehab is better or more effective than the other. What's different about them is the setting and what works best for you and your personal situation. You could have two people with similar addiction issues, and have one of them favor inpatient treatment while the other fits better in an outpatient program. It all boils down to what your specific circumstances and needs are.

Differences Between Inpatient and Outpatient Treatment

Technically, an inpatient treatment program is performed in a hospital or professional clinic. Individuals in inpatient treatment programs have some type of condition or situation that requires that they be monitored by a professional medical team (e.g., nurses, doctors, etc.) around the clock.

There are numerous conditions that require this level of medical monitoring, including going through alcohol and drug withdrawal, having a co-occurring mental health disorder that needs to be addressed, being suicidal, having a physical condition that needs medical treatment, having numerous relapses and unsuccessful attempts at recovery, and so on.

Residential treatment programs and partial hospitalization treatment programs differ from classical inpatient treatment programs as individuals in these programs do not require 24-hour medical monitoring and medical care.

This article will consider inpatient, residential, and partial hospitalization treatment programs as belonging to the same category described as inpatient treatment. In these programs, the treatment is generally provided in or very near the same facility where the individual lives.

Outpatient treatment programs are any type of treatment programs where individuals attend treatment in some office, clinic, hospital, etc., and then after the treatment is completed for the day, they go back to their home or to some other arrangement that is separate from the treatment center.

Individuals in outpatient treatment programs are allowed to visit family members at their convenience, go to work, engage in recreational activities, etc. Outpatient treatment as defined here also includes intensive outpatient treatment programs (IOPs) which often provide a similar level of treatment as inpatient treatment programs.

Introducing Inpatient Addiction Treatment

Inpatient rehab is also called residential rehab because you live at the rehab facility. Inpatient rehab can be effective for persons who have severe problems with drugs or alcohol, and especially those who are dealing with other mental health conditions. Living at the rehab program facility will help you to avoid the temptations and influences in your daily life that trigger your substance use. Living in a healthy environment ultimately supports your recovery.

Licensed inpatient facilities will offer 24-hour support and intensive care. They will incorporate 3 phases of recovery into their treatment plans: detox, reflection, and growth. The programs are focused on helping patients adapt to drug- or alcohol-free lifestyles after treatment.

Many of these programs involve a steadily-paced step-down approach to aid the patients in transitioning from inpatient care to individual or group counseling outside of the facility. The importance of this is to bypass severe withdrawal symptoms, some of which could be life-threatening.

There are both short-term and long-term residential rehab programs. Patients will typically stay at long-term residential facilities from 6 months to a year, while short-term facilities require stays of about 3 to 6 weeks.

Inpatient rehab centers offer several benefits that make them the best option for some people:

a) Both short-term and long-term inpatient rehab programs are designed to help you with detoxification and prepare you for life after treatment.

b) Residential facilities provide care 24 hours a day, usually in nonhospital settings. You are never alone while working to overcome your addiction.

c) Treatment is highly structured and focuses on all aspects of addiction. This might include social factors — such as relationships and lifestyle — and psychological factors related to your personal history and situation.

d) Safe housing and medical attention are available 24 hours a day. This is especially important for patients with severe problems that may be complicated by other mental health conditions or disorders.

Benefits of Inpatient Rehab

According to the American Society of Addiction Medicine (ASAM), and the National Institute on Drug Abuse (NIDA), the advantages of using an inpatient withdrawal management program for an alcohol use disorder are outlined below.

1. Close 24-hour medical supervision allows for immediate treatment of any complications during the withdrawal process, including emotional issues, physical symptoms, and/or cravings.

2. The inpatient environment makes it extremely hard for individuals to get alcohol if they wish to do so.

3. Individuals in an inpatient treatment program for withdrawal management are in the company of others who are experiencing the same issues. This provides much needed support.

4. The structured nature and intensive treatment in an inpatient environment can help to distract the person from withdrawal symptoms and cravings or other issues that could spur a relapse.

5. Beginning treatment in an inpatient unit can lead to a greater commitment to successful long-term recovery.

Drawbacks of Inpatient Rehab

There are, however, some disadvantages associated with inpatient treatment:

1. In order for inpatient treatment to be covered by insurance companies, it must satisfy the notion of medical necessity. This means that a less expensive and less restrictive form of treatment that can provide the same results or benefits, such as outpatient treatment, would be chosen over inpatient treatment. Medical necessity can be difficult to substantiate.

2. Inpatient treatment is far more expensive than outpatient treatment. Most insurance plans do not cover the entire cost.

3. Inpatient treatment programs are very restrictive. Individuals cannot engage in aspects of their normal daily lives while they are in inpatient care.

4. Inpatient treatment programs are time-limited. Eventually, individuals will have to transition to some form of outpatient treatment.

Introducing Outpatient Addiction Treatment

Outpatient rehab involves daily treatment, such as therapy, counseling, or group sessions, at a clinic or facility. People that choose outpatient treatment may continue to live at home as they recover, which will allow them to take care of children or family members, keep up with their jobs, and stay on track in school. Outpatient care typically costs less than inpatient rehab, but the level of support may also be less intensive.

Most programs will usually involve individual or group counseling and use a step-down approach, which will mean that the sessions become less and less intensive and frequent as you grow during treatment. These programs aid the patients to overcome their drug or alcohol dependence and then maintain their recovery over the long-term.

Benefits of Outpatient Rehab

1. Outpatient treatment programs allow individuals to continue with their lives and maintain important life commitments to family, work, school, etc.

2. Outpatient treatment programs can be ongoing. They are not time-limited.

3. Outpatient treatment programs allow individuals to immediately practice what they learn in the real world.

4. Being in an outpatient treatment program protects confidentiality. When an individual goes into an inpatient treatment program, they must explain to coworkers, peers, etc., where they are going and why.

5. Outpatient treatment programs provide the same services and the same quality of treatment as inpatient treatment programs.

6. Outpatient treatment programs can be very intensive. For example, intensive outpatient treatment provides nine or more hours of intensive treatment per week.

7. Outpatient treatment programs help individuals to develop a strong and diverse social support network of other individuals in recovery.

8. Outpatient treatment is less expensive than inpatient treatment.

Drawbacks of Outpatient Rehab

There are also some general disadvantages to outpatient treatment programs:

1. Outpatient treatment programs do not provide 24-hour medical care for individuals who need it.

2. Emergency situations cannot be immediately addressed for individuals in outpatient treatment.

3. It is much harder to monitor an individual's abstinence from alcohol when they are in outpatient care.

4. Outpatient treatment results in too much freedom for individuals who have had multiple relapses and unsuccessful attempts at recovery. There may be too many temptations initially, and this makes relapse more likely.

To this end, outpatient care may not be the best choice for you if:

• You experience constant urges to use.
• You have a hard time showing up to group sessions on your own. The success of outpatient rehab depends on your ability to regularly attend and participate in sessions. If you feel that you need more structured and monitored treatment, you may want to consider an inpatient facility.
• You need treatment for multiple disorders, and you need medical attention. Some outpatient programs may not be able to administer medications or offer intensive, multifaceted recovery programs for complicated addictions.

Getting Help

Depending on what your unique set of needs looks like, you may respond favorably to either. If you are a busy person that needs to be active to keep affairs in order, outpatient rehab may be better. If you have a constant urge to use and require all-round attention, then inpatient rehab may be better.