Addiction is a chronic disease that affects the lives of millions of Americans.1 Drug, alcohol, and behavioral addictions can destroy personal relationships, cause chaos at work, and leave families in turmoil.
According to the 2015 National Survey on Drug Abuse and Health, more than 21 million people over the age of 12 had a substance abuse disorder during the previous year.1 Only 10.8% of those people received treatment in a professional addiction treatment program, which is unfortunate, since comprehensive addiction treatment is the key to many successful recoveries.1
Many people do not have the time or resources to attend an inpatient treatment center and may think that is their only option. But many viable treatment alternatives exist, namely outpatient programs.
Consider Outpatient Treatment for Behavioral Health TooBehavioral health disorders are illnesses that are precipitated or perpetuated by your conscious decisions, despite negative consequences. And treatment for them is just as important as that for substance use disorders. Read More
What’s the Difference Between Outpatient and Inpatient Treatment?
Inpatient and outpatient treatment programs have the same goal: helping you get sober and stay that way. They offer many of the same therapies and treatment approaches, but vary in terms of intensity, length, and cost. What follows is a quick overview of some of the main differences between inpatient and outpatient rehab programs.
Patients in an inpatient treatment program live at the facility for the duration of their treatment. But in outpatient treatment, you live at home and come to the treatment center for a certain amount of time each day or each week.
People in inpatient treatment programs engage in different forms of therapeutic work throughout the entire day. While inpatient programs allow for some free time, they are highly structured to ensure that patients are occupied from morning to night.
By contrast, outpatient programs vary widely in therapeutic intensity. Intensive outpatient programs (IOPs) can involve full or partial days of therapy, with patients returning home at night. Other outpatient programs require participation for only a few hours per week.
Inpatient rehab programs typically last 30, 60, or 90 days (and in some cases, longer).
Outpatient rehab programs are less expensive than their inpatient counterparts, which allows people to stay in treatment longer. Though some people begin outpatient with a similar time frame to inpatient (30, 60, or 90 days), they may then transition to a less-intensive aftercare program, which can last indefinitely.
Inpatient treatment programs are well-suited for people with more severe addictions. Severity, in this instance, accounts for various factors such as the duration of addiction; type(s) of substances used; history of unsuccessful rehab attempts; history of withdrawal complications; and history of mental instability.
Outpatient programs are also an option for people with relatively severe addictions, although some people in this category benefit from first spending time at an inpatient detox facility before transferring into outpatient care. Someone who is medically or mentally unstable can be difficult to treat on an outpatient basis, so doctors might recommend hospitalization before addiction treatment begins. Generally speaking, outpatient programs are most appropriate for those with less-acute addictions.
Inpatient addiction treatment programs can be quite expensive. Costs vary between programs and will depend on factors such as location, amenities, and duration of treatment. Programs that involve residential facilities, meals, and full-time medical staff will, naturally, be considerably more expensive than an outpatient rehab center.
The cost of outpatient rehab also varies between programs depending on location, treatment intensity, and duration. For example, a 5-hour-per-day IOP is more expensive than 2 hours of individual counseling a week.
Insurance policies vary, but outpatient treatment is generally covered more than inpatient treatment. You may find that your insurance covers some, but not all, of your treatment, and there may be a cap on the duration of treatment. Call and find out what your insurance plan covers before making your final decision.
What Services Do They Offer?
Outpatient drug and alcohol rehab programs come in many forms. Some specialize in particular issues, such as behavioral addictions or alcoholism, while others primarily serve opioid abusers in need of daily methadone maintenance. There are standard outpatient rehab programs that involve 1-on-1 addiction counseling on a weekly or twice-weekly basis. Then there are intensive outpatient programs (IOPs), which, according to the American Society of Addiction Medicine, represent Level II treatment (inpatient and residential programs are considered Level III).2
IOPs are best suited for people who do not require medical detoxification or 24-hour supervision. This is sometimes the case when a person has already completed a detox program or an inpatient program.
People with mental health problems are far more likely than the general population to have substance abuse issues.
IOPs often treat people with co-occurring mental health and substance use disorders, such as anxiety and a benzodiazepine addiction. People with mental health problems are far more likely than the general population to have substance abuse issues. Conversely, people with substance abuse issues are far more likely to have mental health problems. Treating both conditions at the same time is essential for a successful recovery, which is known as dual-diagnosis treatment.
Common outpatient treatments include:
- Detox. Some people are much better off detoxing at an inpatient detox facility, but others can benefit from outpatient observation. However, you are less likely to receive medically assisted detox treatment on an outpatient basis.
- Individual therapy. This involves meeting 1-on-1 with a therapist to discuss the underlying causes of your addiction and to plan strategies to reduce your risk of relapse.
- Group therapy. This involves therapist-led discussion among a group of people struggling with addiction. People might share stories and discuss their commonalities and differences.
- Mental health therapy and treatment. This involves meeting with a counselor or a psychiatrist to discuss emotional or behavioral problems. If needed, medications such as antidepressants may also be prescribed at this time.
- Aftercare planning. You work with your treatment team to develop a long-term sobriety plan. This may include slowly decreasing the number of hours spent in professional outpatient treatment, transitioning to meeting weekly with a therapist, or attending 12-step meetings.
- 12-step meetings. Peer-to-peer support groups are a part of many treatment plans. As you decrease the number of hours you spend in professional treatment, you might increase the amount of time you spend at these free support meetings.
Several different types of therapy are offered in outpatient treatment settings, including:
- Family therapy. Addiction often causes chaos in families, so family therapy brings in parents, children, partners, and other family members to open communication around the damage that addiction has caused and discuss how to restore those relationships.
- Cognitive Behavioral Therapy (CBT). Cognitive behavioral therapy focuses on understanding the thoughts and behaviors that led you toward drugs, alcohol, and behavioral addictions. The goal of CBT is to help you identify negative thought patterns and replace them with healthier ones and choose better behavioral responses.
- Dialectical Behavior Therapy (DBT). DBT is most often used as a treatment for borderline personality disorder, but it also works well in addiction treatment. DBT encourages mindfulness and helps people recognize problem emotions and behaviors.
- Motivational Interviewing (MI). MI is a therapeutic tactic that helps you discover and strengthen personal motivators to get clean.
Outpatient treatment programs are sometimes targeted toward special populations. While most programs are designed to be inclusive, some meet people’s unique needs better than others, including:
- Teen-specific. These programs are designed to meet the unique needs of adolescents, who are often more comfortable with other teens. Program curriculum and activities are tailored to be age-appropriate.
- Single-gender. Some programs are exclusive to either men or women.
- Faith-based. Faith-based treatment programs take a more spiritual approach to addiction treatment and include something for people of all faiths, including Christianity, Judaism, and Islam.
- LGBTQ+. Some programs are exclusively tailored toward members of a diverse sexuality and gender identity–based community who face their own set of unique issues every day.
- Veterans: Focused on the specific needs of those returning from combat or other military assignment, veterans programs provide a supportive community of people who have been through similar experiences.
How to Choose One
There are many factors to consider before choosing a drug and alcohol rehab program, so it might help to make a list of your top priorities and concerns. Ask yourself a few questions, such as:
- How much will it cost? Insurance might cover some, but not all, of the cost. Can you afford a particular program?
- Do you want a mixed-gender program? Many people prefer single-gender programs to reduce unwanted distractions.
- Do you want to be with your peers? Such as with LGBTQ+, veterans, adolescents.
- What treatment level do you want? Would you prefer standard outpatient or intensive outpatient.
- Do you need mental health treatment? For depression, anxiety, or some other mental health condition.
- Which treatment approach do you prefer? Such as CBT, DBT, family therapy, or trauma therapy.
- What kind of aftercare are you looking for? Examples include an alumni program, continued counseling, and the like.
- Are online reviews important to you? What are people saying about the program, the staff, and the follow-up care?
Cost and Payment
Addiction treatment costs vary depending on the treatment intensity, location, and supplemental therapies offered. The cost of drug and alcohol rehab can be intimidating, but there are ways to finance your addiction treatment. Insurance may partially or fully cover several weeks of treatment. Call your insurance company first to learn about your options.
If you don’t have insurance, there are other ways to finance outpatient treatment.
- Find a sliding-scale program. Some programs provide free or low-cost treatment to people who cannot afford to pay.
- Ask for a loan. Talk to your friends and family about your recovery plan; many are happy to contribute.
- Ask for donations. Appeal to members of your community or faith-based group.
- Start a crowdfunding campaign. Try sites like gofundme.com or kickstarter.com.
- Use a credit card. You may decide your sobriety is worth leveraging your credit; just be sure you can make the regular payments if you do.
- Use savings. Weigh the risks of dipping into your savings against the risks of continued drug use.
- Substance Abuse and Mental Health Services Administration. (2016). Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.
- McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance Abuse Intensive Outpatient Programs: Assessing the Evidence. Psychiatric Services, 65(6), 718–726.