Addiction Treatment: What's The Difference Between Inpatient And Outpatient Rehab?

Over 20 million US adults are suffering from a substance use disorder — an alcohol or drug problem — at any given time. Far too few get the help they need, with only about 7.5 percent entering treatment each year.

Rehab can be conducted on an inpatient basis — where someone spends all their time in a specialized treatment facility until they complete the program — or an outpatient basis, in which addicts benefit from professional care while being able to go home every night. What is the difference between these two, and how do clinicians determine which one is right for an individual struggling with substance addiction?

Addiction: Who needs inpatient rehab?

Inpatient care may also be essential for addicts who are experiencing suicidal feelings or have comorbid mental or physical conditions that lead them to need more intense medical care. It should include a full physical medical evaluation to ensure that patients get the help they need for underlying medical conditions they may not have tended to while addicted, and to manage potential physical complications of the addiction. A full psychological eval should also take place early on in the process. 

People addicted to drugs it's medically safe to stop using on their own may still choose inpatient rehab because these full-time addiction recovery programs allow them to:

• Focus solely on getting clean and well, without other distractions in their lives. 
• Get away from the familiar environment in which they are used to abusing substances, and thus remove themselves from triggers like people they used with or circumstances that prompted substance abuse. 
• Benefit from intense full-time treatment, including individual, group, and family therapy sessions. 
• Spend time with and receive support from other recovering addicts. 

Access to inpatient rehab facilities for the treatment of substance abuse is difficult to come by in many places, however, and will, depending on where you live, often be expensive — and not covered by insurance. Not every person suffering from a substance use disorder will voluntarily choose to start an inpatient program, either. 

Who may be a candidate for outpatient rehab?

Even outpatient detoxification may be a possibility in some cases, however — in Australia, for instance, alcoholics who usually drank up to 25 standard drinks a day may have the opportunity to detox at home, under medical supervision from family doctors, including prescription medications and dietary support to aid the process. This process may be suitable for addicts who are weary of clinicians, would refuse inpatient treatment, and feel more comfortable going through withdrawal at home with a supportive family. 

The best outpatient treatment programs for addiction feature the same components inpatient programs do, and may be intense (taking up most of the day, on most days) or less intense. Addicts in recovery can expect:

• One-on-one therapy with a qualified psychologist or psychiatrist. 
• Group therapy with other recovering addicts who are attending the same program. 
• Where possible, family therapy sessions in which addicts and their close relatives work towards healing and building a better relationship. 
• Education about substance use disorders. 

The ultimate goal matches that of inpatient treatment — getting clean and sober, learning coping techniques to manage potential triggers for relapse, and working on building the life recovering addicts envision. Where there are comorbid mental health disorders like depression or post traumatic stress disorder, participating in treatment for these often offers the best chances of abstinence. 

Some recovering addicts who start off in inpatient care will later continue with outpatient programs, while others begin here. The advantages are that it's usually cheaper and more accessible, allowing people working on achieving remission from a substance addiction to receive the care they need while also continuing their lives. Being out in the world some of the time, however, some people will find that outpatient care increases their risk of relapsing. 

The bottom line

Each person suffering from a substance abuse disorder will have individual needs — and the most effective treatment is tailored to the addict. If you are not sure what kind of program would benefit you most, or how to access treatment programs, family doctors are often a good starting point. They can discuss the options and refer addicts to available programs.