Difference Between Inpatient vs Outpatient Rehab

Generally speaking, there are two main types of treatment options when it comes to dealing with addiction recovery programs: inpatient rehab and outpatient rehab. In many ways, the two are similar in that they offer recovery programs that focus on the causes of addiction while offering tools to help people get out of it.

The differences between inpatient and outpatient programs lie in the intensity of the recovery program and the approaches taken. As the name suggests, an inpatient program requires staying at a facility for a period of time and working intensely with addiction counselors for extended periods each day. Outpatient programs, by contrast, deal with people on a part-time basis to help them overcome their addiction while they remain in society.

The Disease of Drug and Alcohol Addiction

According to the National Institute on Drug Abuse, addiction can be defined as “a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and changes in the brain, which can be long-lasting.” People with severe drug addiction can actually change the chemical and physical structure of their brain, leading to lasting problems with cognition, emotional control, and motor function. The effects on the rest of the body can be just as damaging, and depending on the drug in question, severe damage can be inflicted on the heart, lungs, kidney, liver, and other internal organs.

In addition to all the physical and mental problems that can develop from addiction, there are also the interpersonal ones. Oftentimes, addiction will put a heavy strain on relationships. This can include both personal relationships, such as those with family and loved ones, and professional relationships at work or school. The disease of addiction can destroy a person’s life in pretty much every way imaginable, which makes the importance of treatment and addiction recovery paramount.

Preparing for Inpatient Rehab

Inpatient programs can last anywhere from three weeks to 12 months depending on what the particular circumstances of a person’s addiction necessitate. Regardless of how much time is going to be spent in one of these residential treatment programs, preparations will need to be made ahead of time to ensure the transition is as seamless as possible. Here are some important items to keep in mind if you are preparing for long-term treatment:

  • If you are employed, then talking to your employer about your situation is necessary. The Americans with Disabilities Act (ADA) offers certain protections for those who are entering a long-term inpatient program, so you don’t need to fear being fired outright for seeking help.
  • Obviously, if you are a single parent or have a special living situation where you care for a parent or loved one, finding alternative arrangements is a necessity. In many cases, this help will come from family or friends who also want to see a successful recovery.
  • For those who rent an apartment or own a home, finding a way to keep the bills paid will also be a necessity. Monetary support can come in the way of private loans through a bank, grants through organizations like SAMHSA, family and friends, or Medicaid/Medicare.
  • An important thing that can easily get overlooked in all the craziness of preparing for inpatient treatment is finding out what sorts of personal items are allowed. Different facilities have different guidelines for what is and is not permissible for long-term patients, but everyday things such as clothes, jewelry, personal items, an alarm clock, and a personal journal will be fine.
  • Finally, after all the other preparations have been made, make sure there is reliable transportation both to and from the rehab center. While some people may be able to get rides from family or friends, there are others who may need to use a taxi or some form of public transportation. If the facility is located in another state, then securing airfare or a bus ticket may be necessary.

Entering Inpatient Rehab

For people who are suffering the worst effects of alcohol or drug addiction, an inpatient program might be the best way to go. These programs are held at clinics, rehab centers, and, occasionally, hospitals that provide 24/7 care as well as intensive recovery programs.

In most cases, when someone enters an inpatient rehab, they will have to undergo a detoxification period and medically managed withdrawal before they can begin the recovery process. This is when all traces of alcohol or drugs are removed from one’s system. For those who are entering an inpatient facility, the amount of a substance in their system may be high enough that there will be a physician monitoring the detoxification process to keep the patient safe. This is especially true in the case of alcohol, which can lead to severe withdrawal symptoms such as delirium tremens, hallucinations, accelerated heart rate, and seizures. During detoxification, medical physicians may prescribe medications to help alleviate symptoms of withdrawal.

The Treatment Process

Once the detoxification process is complete, the process of recovery can begin. Treatment plans can vary to some degree depending on where you stay, but, generally they are all well-structured programs designed to promote a healthy lifestyle while abstaining from drugs and/or alcohol. The day will begin with a healthy breakfast and morning treatment sessions. Some facilities offer yoga classes, meditation, and exercise programs to help relieve any stress and get ready for the day. An important part of the addiction-recovery process is to learn new healthy routines that you can take with you when you leave.

After breakfast, there will be a morning counseling session that can last until lunch. This is usually a group session with a treatment professional leading the discussion. The session will typically focus on the direction of treatment, long-term recovery, 12-step programs, and other similar topics. There is a lot that is misunderstood about the process of recovery, so the main point of these group sessions is to have everyone work together to come to a clear understanding of how it works. Part of this process also includes group discussions of triggers and behavioral patterns to help elucidate what they are and help avoid them in the future.

In the afternoon, there is more counseling, but this time, the process is one-on-one and will delve much deeper into individual issues. Here are some of the types of programs you may encounter:

  • Cognitive Behavioral Therapy (CBT) is a goal-oriented approach that uses the tools of psychotherapy to address problematic areas of a person’s life with the purpose of changing negative attitudes, thoughts, and behaviors. CBT is an excellent way of dealing with triggers and repetitive behaviors associated with alcohol and drug addiction. It is also effective for dealing with depression, anxiety, and relationship issues.
  • For some people, there are specific triggers that lead to substance use. These can include anger management, overwhelming stress, and grief over some type of loss. Specialized therapy sessions can help teach coping mechanisms for dealing with these feelings and provide tools for avoiding them whenever possible.
  • Family therapy is an important component because addiction is a disease that doesn’t just affect the person who is suffering from it. Families experience just as much grief and pain from addiction. Having sessions with everybody present can help the family as a whole along the process of healing while also providing the person who is addicted with extra resolve.
  • Alternative methods of therapy are often implemented alongside the above-mentioned programs. Some of these alternative methods include art or music therapy, equine therapy, exercise, and dance therapy.

The Importance of Family in Addiction Recovery

Even if someone is not engaged in family therapy while in an inpatient recovery program, they are still encouraged to have regular contact with family members during their stay. Whether it comes from a parent, child, sibling, or partner, the bonds of family can be an integral part of any recovery process.

Outpatient Rehab

Outpatient programs serve two purposes that are very similar. They are for people who need help with their addiction or substance use disorder but have not gotten to the point where they need an inpatient program. Outpatient rehab also serves as the next step for those who are exiting inpatient care. Depending on the level of treatment and care a person may need, there are a number of different programs that fall under the rubric of outpatient rehab to choose from. Here are the most common options:

  • Intensive outpatient treatment (IOP) provides a great service for those just starting the recovery process and for those who are transitioning from an inpatient program. IOP consists of both group counseling as well as one-on-one therapy sessions, and the program generally lasts anywhere from one to six months. During this time, attendees will take part in both group and individual counseling sessions multiple times a week. Each session will typically last between two and four hours.
  • Partial-hospitalization programs (PHP) offer a higher level of care and management than what is found in standard outpatient programs. In addition to counseling or therapy, addiction sufferers will also receive medical monitoring throughout the day. Generally, people in PHP will attend therapy sessions three to five times a week for four to six hours at a time.
  • Therapy and counseling is also available in less intense forms for people who are in the beginning stages of addiction or have a substance use disorder. These treatment options focus on what caused a person’s drinking or drug abuse in the first place and how to avoid falling into traps that can lead them further down the road into addiction. Counseling and therapy at this level are tailored to individual needs based on what both the patient and therapist/counselor feel are appropriate. The main form of treatment applied at this stage is CBT, but other treatment options are also available.

Inpatient vs Outpatient Care

If you are currently dealing with an addiction or substance use issue, you might be wondering which of these options listed above would work best for your situation. There are some general guidelines that counselors, therapists, and healthcare professionals use to determine if an inpatient or outpatient program is appropriate. Here are some guidelines to go by:

Inpatient Care Considerations

  • Inpatient programs are specifically designed to help people who are heavily addicted to substances and need to detox and go through withdrawal.
  • Since these facilities provide 24/7 care, there is always staff on hand to help addiction sufferers to cope with the initial stages of their sobriety.
  • Every aspect of an inpatient treatment program is highly organized and structured to support the ultimate goal of continued sobriety. This is important for long-term addicts who have built up their lifestyle around addiction. These programs work at both the interpersonal and intrapersonal levels.
  • There are doctors on hand to provide any medical assistant a patient might need. They can offer medications to assist with the recovery process and are available to assist in the rare event that an emergency arises.

Outpatient Care Considerations

  • Living at home during your treatment is far less expensive than being at a facility 24/7. This is true not only in terms of the specific cost of the program but also in terms of other costs incurred from loss of work, bills, and childcare.
  • If there is a positive network of family and friends available who are supportive, remaining at home can sometimes be a much better option. A positive support network at home is an important aspect of addiction recovery.
  • Depending on one’s level of addiction, an outpatient program might not be intensive enough. Those who have been using for a long time and are likely to go through withdrawal symptoms may want to opt for inpatient treatment.
  • Going to treatment once to a few times a week leaves much more time open for work, childcare, and all the other activities of life.