With drug and alcohol abuse on the rise in the United States, the need for good treatment is more urgent than ever. According to the National Survey on Drug Use and Health, 19.4 percent of Americans age 12 and older used drugs in 2018. Also, the survey estimated 67.1 million binge drinkers over the age of 12.
Sadly, only a fraction of those who abuse drugs or alcohol seek treatment. Those who do, however, hold much better chances of getting sober. Outpatient programs, in particular, can play a big role in helping.
Drug And Alcohol Outpatient Rehab: The Basics
Per popular thinking, drug and alcohol programs fall into one of just two different categories: medical residential programs or 12-step programs such as Alcoholics Anonymous. In reality, however, there are many types of treatments.
Inpatient and 12-step programs can support people, but a middle ground exists: outpatient treatment. This approach is similar to inpatient programs, but it gives people a clinically-backed alternative to counseling groups.
Most outpatient programs focus on therapy and education, but some also offer medical support. Opioid treatment programs (OTPs), for example, often use methadone to reduce the risk of relapse.
The Outpatient Process: Steps to Recovery
Patients may be able to get enough support using outpatient options alone. These offer counseling and education, and they still allow people to live by themselves. Outpatient also helps patients who have gone through inpatient programs but who still need clinical services.
They have guidelines that spell out how people should go through the outpatient process. But no two treatments look exactly the same. Some people may not need inpatient or serious outpatient care. Some may get better quickly after doctors help them.
Many people move slowly through many levels of inpatient and outpatient care to deal with their drug abuse and problems related to their drug abuse. People may start their journey at the hospital and later move into outpatient programs. Over time, they can keep up their sober living with the help of weekly individual or group therapy visits.
Levels of Outpatient Care: How Much Time Should You Spend in Treatment?
Outpatient care can take many forms. Some programs treat care much like a full-time job, with up to seven hours per day spent on treatment. Other patients may only visit facilities once or twice per week.
Good outpatient treatment is judged by what happens to your symptoms. Are they getting better or worse. Many patients try different levels of care, such as:
- Partial hospitalization program (PHP). An intense type of care, PHP is best for those who have already done inpatient but who still need more support. This option can also be for patients who need a lot of help, but do not need so much help that they have to do inpatient treatment. To qualify, you have to be able to live by yourself. Types can include cognitive behavioral therapy (CBT) as well as dialectical behavior therapy (DBT).
- Intensive outpatient (IOP). A notable step down from PHP, this type does not have the same level of time commitment. However, you still need to spend many hours a day on it. IOP is considered to be Level II care. (Normal outpatient is just Level I care.) The Substance Abuse and Mental Health Services Administration (SAMHSA) says that people need to have structured programming; individual, family, or group therapy; and drug abuse education.
- Outpatient. There are many lower intensity options based on what you need and what you have the time and energy to do. Normally, you need to spend nine or fewer hours per week in treatment if you’re an adult. For teens, the time requirement is less—just six hours or less per week. Many people go to treatment just once or twice per week. As with IOP, they do a blend of therapy and drug abuse education.
- Early intervention. ASAM calls this type “Level 0.5 care”. Early intervention helps people who are most at risk of getting addicted to drugs. This may be good for people who have not yet been diagnosed with a problem, but who clearly need care. You get screened and go to individual or group counseling. You may need to be moved into more intensive treatment later.
When Outpatient Treatment Is Not the Right Strategy
Outpatient treatment is not an ideal solution for people who have serious symptoms or symptoms that are possibly life-threatening. These people often need to be watched round-the-clock, for instance, to protect them from the harmful effects of physical recovery. In this case, outpatient withdrawal from drugs would not be as safe.
The American Society of Addiction Medicine (ASAM) has spelled out alternatives to outpatient care. These include:
- Managed intensive. This involves 24-hour nursing and daily physician visits. Counseling is available, but physical symptoms receive the greatest attention.
- Monitored intensive. This level maintains 24-hour nursing care but moves from daily physician visits to a strictly as-needed basis. At this level, counseling becomes available 16 hours per day.
- High-intensity residential. Patients involved in this level of care do not need as much medical support. Instead, they get 24-hour access to counselors.
- Low-intensity residential. The lowest level of care before you need to go to the hospital or intensive outpatient, this option offers the support of a facility but largely shifts its focus to transition. It also offers at least five hours of clinical service per week.
When Is an Outpatient Program Better?
While abuse cases need round-the-clock care, many people do better with less structure, in which they get research-backed support to help them on the road to recovery.
Outpatient care’s strength is that it is slow and steady. It aims to get you back to living by yourself. After all, the real world looks a little like a facility, where support and accountability are all around you — and opportunities for drug use don’t really exist. Outpatient care gets participants to take on real-world challenges and deal with difficult emotions in a smart way.
During outpatient, participants get mental, emotional, and social support. This can ease the shock of going too quickly from 24-hour care to being by yourself. Patients are still watched. They can go back to the programs if they have a need for more help.
Many outpatient programs provide lots of mental health support. Mental health problems often cause addiction or make it worse. In 2018, the National Survey on Drug Use and Health found that 9.2 million United States adults have both drug use disorders and mental illness. Research says that fixing one problem can help with the other.Outpatient can help deal with many types of drug abuse problems.
While the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment says that no one treatment is good for everyone, better outpatient care can help many drug and alcohol abusers. More access to these programs could reduce relapse rates and improve long-term recovery chances.