If you or a loved one is considering entering treatment for drug or alcohol addiction, you may be faced with the obstacle of choosing between an inpatient or outpatient rehabilitation program. These two types of rehab programs, although both designed to treat substance abuse issues, vary a great deal in terms of cost, medical oversight, living arrangements, etc. If you or a loved one is grappling between inpatient and outpatient rehab, knowing the differences between the two can help you make an informed decision regarding which type of program my be best for you.
Differences between Inpatient and Outpatient Rehab
In inpatient rehab, individuals live at the facility where they are receiving treatment. Depending on the situation, this may be a hospital or a private rehabilitation center. Individuals eat, sleep, and undergo treatment at the facility, allowing them to focus completely on recovery in a controlled environment.
For outpatient rehab, individuals participate in treatment during the day and return home at night. Depending on the number of hours spent each day in treatment, most people will be responsible for their own meals while involved in an outpatient program.
As recovery from addiction can take time, many people begin treatment in an inpatient facility and transition to outpatient rehab. If an individual finds they need additional support and accountability during this time, sober housing can be an effective alternative to living at home during outpatient treatment. If you or a loved one is in need of sober housing, be sure to speak with staff at your treatment facility who can help secure living arrangements.
Medical Support and Supervision
One of the benefits of inpatient rehab is that individuals have access to 24-hour medical care, emotional support, and staff supervision. For people who are new to recovery or have a history of relapse, these services can make the difference between relapse and recovery. For individuals struggling with a serious or long-term addiction, detoxing from drugs or alcohol in an inpatient facility may also be the safest option. Some substances, such as alcohol or benzodiazepines, can cause life-threatening symptoms during the withdrawal process. Detoxing from such substances in an inpatient facility under medical supervision can be lifesaving under certain instances.
In outpatient rehab, individuals typically have access to medical staff and emotional support; however, these services may only be available during the hours spent at the facility. Reputable outpatient rehabs should have licensed mental health professionals on staff as well as a board certified medical doctor who, ideally, specializes in addiction medicine or addiction psychiatry. If you or a loved one is planning to receive treatment at an outpatient facility, be sure to ask staff what options are available if an emergency should arise after hours. Some outpatient rehabs have a member of staff on-call 24-hours a day to deal with potential crises. Others may refer you to your nearest hospital or emergency room. Either way, be sure to know your options beforehand so you can get help as quickly as possible if the need arises.
Inpatient vs Outpatient Detox
For individuals entering an inpatient rehab program, the first part of treatment involves detoxing from drugs or alcohol. Depending on the types of substances a person has in his or her system, the amounts used, and the length of time a person has been struggling with addiction, this process can last anywhere from three to seven days.
One of the benefits of detoxing from drugs or alcohol in an inpatient rehab program is that it will be done under medical supervision. As mentioned previously, certain substances like alcohol or benzodiazepines can cause life-threatening complications during the withdrawal process. Due to this risk, a person with a history of heavy alcohol or benzo use may be safest going through detox in an inpatient facility where they can be monitored by medical professionals.
For other substances that may have uncomfortable withdrawal symptoms but aren’t necessarily dangerous, the medical supervision that comes with inpatient rehab may still be beneficial. Doctors can provide medication to help ease withdrawal symptoms and other medical professionals can provide emotional support during the detox process. Since drug and alcohol withdrawal can be very uncomfortable, having proper support and supervision during detox can help prevent individuals from using again in order to relieve withdrawal symptoms.
Individuals in outpatient rehab typically detox from drugs and/or alcohol from home. If withdrawal symptoms are mild to moderate in severity and the individual has support from a loved one during detox, this can be a safe option. If you are planning to undergo withdrawal at home, speak to your health care provider first to get clearance that it will be safe. You can also ask if any medications can be prescribed to help ease symptoms.
Some individuals may also prefer to enter an inpatient detox facility during the withdrawal process and move into an outpatient rehab program after detox is complete. There is no best option—it’s all about what you feel will give you or your loved one the greatest chance of success in this early stage of recovery.
Number of Hours Spent Per Day in Treatment
Regardless of whether you choose inpatient or outpatient rehab, the number of hours spent in treatment will vary based on the program.
Many outpatient rehab programs, such as Nexus, operate on a tiered system, where individuals begin treatment with full, eight-hour days and transition to lower levels of care. This allows individuals to gain more independence and responsibility over time, ensuring a better chance at long-term sobriety. At Nexus, the three levels of care are as follows:
- Partial Hospitalization Program (PHP): The Partial Hospitalization Program (PHP) is designed for those who are new to the recovery process. At the PHP level of care, clients participate in treatment activities for a minimum of six hours a day, five days a week.
- Intensive Outpatient Program (IOP): The Intensive Outpatient Program (IOP) is ideal for those who are transitioning from a residential treatment facility or who need a part-time yet intensive schedule that can accommodate their work, school, and/or family life. At the IOP level of care, individuals participate in the rehab program for three to four hours a day, three to five days a week.
- Outpatient Program (OP): The Outpatient Program (OP) s designed for those who are transitioning from an intensive outpatient program or for people who need less intensive treatment and require a flexible schedule to accommodate work, school, or family obligations. At the OP level of care, clients participate in the program for two hours a day, one day a week. Individuals will eventually fully transition out of the outpatient program but continue to participate in regular recovery support activities such as weekly 12-step meetings.
Another factor that may affect your decision regarding inpatient or outpatient rehab is cost. While costs of programs vary between treatment centers, due to the intensive level of care provided in inpatient rehab, inpatient programs tend to come with a higher price tag. Some individuals may choose outpatient rehab because they are able to keep working during treatment, as well.
However, if you feel inpatient rehab will give you or your loved one the best chance at achieving long-term sobriety, don’t let the higher cost of inpatient rehab deter you from entering an inpatient program. Many inpatient and outpatient rehab centers have staff who are able to inform clients and their families of financing options for addiction treatment programs. Depending on the treatment program, some options for financing may include:
- Health insurance
- Payment plans
- Sliding scale fees
- Grants or scholarships
Contact with Friends and Family
When it comes to contact with friends and family, every treatment center has a different set of rules. However, because inpatient rehab tends to have a more structured schedule and clients spend 24 hours a day at the facility, individuals in inpatient programs may have less contact with friends and family during treatment. For some individuals, this break is necessary. Many people struggling with addiction find that certain relationships are “triggers” for substance abuse and that repairing relationships with friends and family is crucial during the recovery process. For these individuals, being able to visit with friends and family in a neutral environment outside of the home may be beneficial to some people in the early stages of recovery.
Since individuals in outpatient rehab programs do not live at the facility, they typically are able to maintain more contact with friends and family members during treatment. For some people, keeping this contact is preferred or even necessary. For instance, some individuals may not be able to leave children for the one to three months to attend an inpatient program. As individuals in outpatient programs may still be have “triggers” when it comes to friends and family, many outpatient rehab programs offer family therapy or family group sessions so that friends and family can learn how to support the individual in treatment.
Length of Program
The length of inpatient and outpatient rehab programs tends to vary by treatment center. Many inpatient programs run anywhere from 30 – 90 days; however, some can last six months to a year. Outpatient programs are similar, with programs spanning anywhere from a few weeks to several months. In reality, however, individuals should remain in inpatient or outpatient rehab until the treatment teams believes they are ready to return to their communities and be able to handle everyday situations and stressors without drugs or alcohol.
With any rehab program, there is never a guarantee of success. As addiction is a chronic disease, unfortunately, relapse can be common. Consequently, when making the choice between inpatient and outpatient rehab, consider the factors that you feel will give you or your loved one the best chance of success. If your loved one is suffering from an and/or long-term addiction, has a history of relapse, or has been unsuccessful in an outpatient program, inpatient rehab may be the best choice.
Studies have shown that what may be most effective for many individuals seeking treatment for drug or alcohol addiction is a mixture of inpatient and outpatient rehab with a gradual decline in intensity of care. If you or a family member is in need of treatment for substance abuse, you might consider starting treatment in an inpatient facility and eventually transitioning to outpatient care. This approach allows individuals to slowly transition back to their communities and helps reduce the amount of overwhelm that can occur when an individual completely leaves a structured, supportive treatment environment.
Making the Decision
Making the decision between inpatient or outpatient rehab can be challenging. Remember, however, that one type of rehab program is not better than the other—it’s all about what is best for you or your loved one.
To learn more about the recovery process and gain further insight as to whether inpatient or outpatient rehab is right for you, contact Nexus today to speak with one of our trusted recovery advisors. These intake specialists are here to answer questions and make the process of entering treatment as easy as possible.