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What’s the Difference Between Inpatient and Outpatient Addiction Treatment?

Finding the best support for dealing with drug or alcohol addiction can be tough.

There are hundreds of different addiction recovery programs to choose from, countless forms of various therapies, and a medical community that still isn’t 100% sure on the absolute best way of treating substance abuse problems.

It’s understandable, then, that picking the right treatment center can seem a bit overwhelming.

The best place to start, though, is understanding the main categories of treatment – namely the difference between inpatient vs. outpatient treatment.

What makes these two levels of care so different? Where do they overlap? What kinds of therapies are used in each? And how can you find out which is right for you or your loved one?

This guide takes a closer look at these questions. That way, you can get a better understanding of which is right for you and, most importantly, finally get the treatment you need to kick addiction to the curb for good.

Inpatient vs. Outpatient: Where Do They Overlap?

Inpatient and outpatient addiction programs both offer treatment for substance use disorders that have turned into serious problems.

There are three goals in particular that both programs focus on. These goals are to help addicts:

  • Stop using addictive substances immediately.
  • Help and motivate substance abusers to stop using for the long-term by giving them coping strategies and specialized therapies for preventing relapse.
  • To re-integrate addicts into normal society and help them become a productive member of the community, their family, and their workplace.

What separates these two types of treatments is the intensiveness of the recovery, the various therapies used, and how long the programs are.

Principles of Effective Treatment

Though addiction treatment doesn’t guarantee a life of sobriety, researchers in the field have identified a number of core qualities of programs that offer the highest levels of success. Both inpatient and outpatient programs can offer these characteristics.

According to the National Institute on Drug Abuse (NIDA), these core qualities, known as the Principles of Effective Treatment, are as follows:

  • Addiction is a complex but treatable disease that affects brain function and behavior.
  • No single treatment is right for everyone.
  • People need to have quick access to treatment.
  • Effective treatment addresses all of the patient’s needs, not just his or her drug use.
  • Staying in treatment long enough is critical.
  • Counseling and other behavioral therapies are the most commonly used forms of treatment.
  • Medications are often an important part of treatment, especially when combined with behavioral therapies.
  • Treatment plans must be reviewed often and modified to fit the patient’s changing needs.
  • Treatment should address other possible mental disorders.
  • Medically assisted detoxification is only the first stage of treatment.
  • Treatment doesn't need to be voluntary to be effective.
  • Drug use during treatment must be monitored continuously.
  • Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.

What Is An Inpatient Addiction Treatment (Residential Treatment)?

Inpatient addiction treatment is the more intensive form of substance abuse rehabilitation.

That’s because inpatient programs require recovering addicts to eat, sleep, and receive treatment on the campus grounds. And in most cases, patients aren’t allowed to leave without permission or a supervising chaperone.

The more controlled environment allows for less access to the substances of abuse as well as a calmer environment to reduce the stress of the patients, a common cause of relapse.

On top of that, patients will be able to focus entirely on their recovery throughout the course of the program.

There are a host of benefits of choosing an inpatient program.

More Extensive Treatment – Since patients stay at a facility for the duration of an inpatient program, this type of rehabilitation is able to offer a much more extensive treatment than outpatient programs.

Patients can focus entirely on their recovery and undergo a wide range of therapies, counseling, and education sessions simply because they have more time to devote to it.

Availability of Nursing Staff & Medications – Another enormous benefit of inpatient treatment is that patients have 24/7 access to nursing staff and counselors in most cases. Not only does that allow for a safer experience, but it also opens up the door to the use of powerful prescription medications.

These medications can reduce the intensity of withdrawals and help eliminate cravings too.

Little or No Access to Substances – Obviously, one of the biggest benefits of inpatient treatment is the fact that access to addictive substances is nearly impossible during these programs. And while many recovering addicts think they can withstand the cravings, most are surprised at just how overwhelming they can be.

Think of it as a final safeguard to preventing relapse.

Cut Off From Stresses of Outside Life – Last but not least, an inpatient program can also be especially helpful because it removes patients from the stresses, obligations, and triggers of the outside world. Without these extra burdens (which can increase the risk of relapsing), patients are freer to focus on their recovery and maintain positive thinking throughout.

Despite the numerous benefits of inpatient treatment, it isn’t right for everyone. Here are the biggest downfalls of this kind of program.

  • Higher Cost – One downside of inpatient treatment is the fact that it tends to cost more than outpatient. With the nutrition-rich meal plans, the rooming, and the around-the-clock care, the price of maintaining inpatient facilities is higher than outpatient ones. And that means a heftier price tag for the patients.
  • More Disruptive to Daily Life – Inpatient care requires a serious commitment to recovery. And in most cases, these programs do not allow their patients to attend school, go to work, or even fulfill some family obligations throughout the course of treatment. For some people, that can be a serious deal breaker.
  • Less Personal Freedom – Finally, inpatient programs are highly structured recovery programs. Many adhere to a strict daily schedule filled with various therapies and exercises, and patients are expected to follow that schedule. On top of that, most do not let patients leave the campus grounds without a chaperone. Even though that structure is there for a reason, some people may still find it quite off-putting.

The length of inpatient programs tends to vary.

In general, short-term inpatient addiction treatment programs will last around one month. Other inpatient programs like long-term residential treatment can last anywhere from several months to a year or more.

Inpatient treatment isn’t right for everyone. And for some, the intensive care may actually end up being more than some people need or can handle.

Below are a few qualities of someone for whom inpatient rehab is the right choice for recovery.

  • Has an addiction that is severe and/or long-lasting.
  • Has tried a rehabilitation program several times before but continues to relapse.
  • Requires medications in order to cope with cravings and prolonged withdrawal syndromes.
  • Needs around-the-clock care.
  • Has the time to dedicate to the full treatment program.
  • Is willing to pay more for a significantly lower chance of relapse.
  • Is serious about their recovery and is ready to put in the work to achieve long-term sobriety.

Family is one of the most essential sources of support during recovery.

They can help addicts see that there’s so much more to life than using and can help keep them honest as they continue to get clean.

As such, most inpatient treatment programs allow visitations with family members during treatment. Often they will only be allowed during designated times (weekends, evenings, etc.).

However, some treatment centers will also incorporate family therapy into their treatment protocols as well. These treatment sessions are usually led by a certified counselor and can help heal the rifts between family members that have been caused by addiction.

In general, try to find a treatment facility that brings the family into the recovery process. This is one of the best ways to safeguard against future relapses and be held accountable for your substance use.

What Is Outpatient Treatment?

In contrast to an inpatient program, an outpatient addiction treatment program allows you to recover while keeping up with your responsibilities at home and at work.

As the name implies, outpatient care is an addiction treatment program that does not require residential treatment. In other words, outpatient addiction treatment lets you go through rehab while living at home.

Treatment sessions typically take place in the evening or on weekends, giving recovering addicts in this program the opportunity to keep up with work, school, or the family.

This added flexibility can make attending treatment both more realistic and less impactful on daily life as a whole.

Depending on the situation, outpatient treatment might be the best solution for some people. Some of the major benefits of this type of program include: 

Lower Cost – Given that patients in this program won’t be eating and sleeping on campus grounds, outpatient programs tend to be far more affordable than inpatient ones. It’s worth remembering, of course, that thanks to changes in new healthcare laws, both types of treatment are more affordable than ever. 

Even still, outpatient can end up costing only a fraction of inpatient treatment. And for some, that can be reason enough to attend. 

Can Carry on More of a Normal Routine – Since most sessions take place in the evening or over the weekend, most patients can stick to a semi-regular routine. Whether it’s going to work from 8 to 5 every day, attending school lectures and classes, or just being able to pick up the kids from school, outpatient gives most people time to keep on doing what they do every single day.

More Freedom – One thing that some patients in an inpatient setting don’t care for is the lack of freedom – the freedom to come and go as they please, the freedom to not stick to a recovery schedule every single day. 

With outpatient care, no one is stopping you from leaving. And on top of that, some programs even let you make up treatment sessions at other times in case you miss one or two. 

Immediate Applications to Real World – Outpatient treatment also allows recovering addicts to apply what they’ve learned in the classroom to the outside world immediately. Patients can test out new coping strategies in the face of real-life temptation, assess its effectiveness, and report back to instructors on whether it works for them or not. 

Not only will it provide a better form of practice, but it will also help them identify what’s working and where there may still be problem areas as well.  

Though this form of treatment is much more flexible than inpatient, it isn’t without its detriments. Some of the most notable problems with an outpatient program include:

  • Easier to Access to Addictive Substances – Of course, the main problem with outpatient programs is the fact that it allows for much easier access to addictive substances. And if patients aren’t educated enough in effective coping strategies, this could spell disaster for a struggling addict.
  • More Exposure to Triggers – The threats of being in the real world aren’t just limited to being exposed to drugs. It’s also about being exposed to triggers – people, places, things, or events that cause intense and sometimes overwhelming cravings. Rehabilitation will help recovering users identify these triggers but even so, facing them head-on can be quite difficult in the early stages of recovery.  
  • Less Focus on Recovery – Daily life is filled with the hustle and bustle of obligations to family members, friends, work, and plenty of other sources of responsibility. And sometimes, recovery can take a backseat to them. When that happens, the risk of relapsing grows. Unlike inpatient, outpatient treatment doesn’t protect patients from these other obligations. And that can be trouble for some.
  • No 24/7 Access to Staff – Finally, outpatient treatment doesn’t provide around-the-clock access to staff – whether it be counselors and support members or physicians and nurses. And that means no immediate access to medical care, medications for preventing overdose, or even late-night motivation to stay clean (unless they have a sponsor).

Outpatient programs usually last longer than the standard inpatient program. Most run for around 3 months.

This is partially because the treatment sessions are far less intensive than inpatient programs. They’re also set up this way so as to ensure long-term sobriety with consistent check-ins rather than a highly focused treatment program that happens all at once.

Outpatient can be tough for some people. Here are a few qualities of someone that probably needs outpatient treatment rather than inpatient.

  • Has a very mild addiction.
  • Has maybe just gotten out of inpatient and needs aftercare that’s a bit more intensive than regular support groups.
  • Doesn’t need any additional medications or 24/7 care.
  • Can’t afford the time or money required for an inpatient program.

Inpatient vs. Outpatient: A Side-by-Side Look

Inpatient Treatment Pros & Cons 

Pros

  • More Extensive Treatment
  • Availability of Nursing Staff & Medications
  • Little or No Access to Substances
  • Cut Off From Stresses of Outside Life 

Cons

  • Higher Cost
  • More Disruptive to Daily Life
  • Less Personal Freedom

Outpatient Treatment Pros & Cons 

Pros

  • Lower Cost
  • Can Carry on More of a Normal Routine
  • More Flexibility
  • Immediate Applications to Real World 

Cons

  • Easier to Access to Addictive Substances
  • More Exposure to Triggers
  • Less Focus on Recovery
  • No 24/7 Access to Staff
Inpatient vs. Outpatient Treatment: What’s the Difference?

Inpatient & Outpatient Subgroups

There are three main subgroups to inpatient and outpatient treatment: Intensive Outpatient Programs (IOPs), Partial Hospitalization Programs (PHPs), and Long-Term Residential Programs.

Intensive Outpatient Program (IOP)

A step down from inpatient but a step up from outpatient, IOPs offer a more focused level of care with added flexibility. It follows the typical outpatient model (evening classes, patients can still live at home, etc.) but the treatment sessions are longer and may happen more frequently throughout the week.

This type of program is a great choice for anyone who can’t afford the time commitment of inpatient treatment but still may need a bit more help in kicking their addiction than typical outpatient recovering addicts.

Partial Hospitalization Program (PHP)

PHPs are technically outpatient programs but are much more involved even than IOPs. A typical PHP program will require patients to attend treatment for anywhere from 4 to 8 hours a day, after which patients are free to return home.

PHPs can more safely be combined with certain medications to help treat addiction due to the increased hours of oversight. Even still, it doesn’t offer the same level of intensiveness as inpatient care.

Long-Term Residential Program

A long-term residential program will usually combine treatment sessions and a sober living environment for several months (or even years) at a time. These types of programs offer the most intensive form of recovery help out of all the programs.

Patients will typically live in sober communities throughout these programs given that a person’s surrounding environment and culture is a huge indicator of addiction risk.

The First Step to Any Addiction Treatment Program: Detox

No matter what kind of rehabilitation you choose, professional detoxification is typically necessary.

Whether it’s followed by inpatient care or an outpatient program, drug or alcohol detoxification is always the very first step to recovery. This stage is when the body first re-adjusts to functioning normally without the presence of the drug.

Over the course of an addiction, the body has physically changed in many ways. Certain chemicals may be stronger or weaker, cell receptors may have grown or died off, and many other processes have changed in a very real way.

Detox is the body's way of not only expelling the drug from the system entirely but also reversing these physical changes. And unfortunately, this process can end up being quite uncomfortable.

Depending on the substance of abuse, some symptoms of withdrawal may include:

  • Headaches
  • Muscle aches
  • Fatigue
  • Heavy sweating
  • Vomiting
  • Diarrhea
  • Tremors
  • Anxiety
  • Depression
  • Mood swings
  • Irritability
  • Hallucinations
  • Suicidal thoughts

In some cases, detoxification can even be deadly without proper medical care.

Alcohol and benzodiazepines, for instance, can be incredibly dangerous drugs to detox from at-home without professional help. They can cause grand mal seizures that can end up causing permanent damage, coma, and even death.

On top of that, detoxification from opioids like heroin, OxyContin, Vicodin, or Percocet has especially high rates of relapse. And given that tolerance fluctuates so quickly with these drugs, accidental overdoses are incredibly common.

Medically supervised detox is incredibly important for each of these drugs as well as plenty of others.

In the end, it’s absolutely necessary to partner with a professional detoxification provider before heading to rehabilitation – no matter what kind of program it is, and no matter what kind of drug it is.

In most cases, detoxification is only a part of inpatient programs, not outpatient ones.

Detox from drugs or alcohol can be both difficult and even dangerous in certain cases. As such, many people going through it will need 24/7 medical attention to prevent and treat any complications that may arise.

Given that addicts attending outpatient treatment are only supervised for up to several hours a day, they simply cannot provide the level of care and attention necessary during detoxification.

Most outpatient programs will work closely with other facilities that offer such services and provide referrals to these facilities.

However, either inpatient or outpatient treatment must follow detoxification. As stated by NIDA:

detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery.

It is highly dangerous to detoxify on your own before checking into a rehabilitation program.

Not only are withdrawals from some drugs deadly on their own, but there are also a wide variety of complications that can occur without proper professional help.

Some of the most common complications include:

  • Malnutrition
  • Dehydration
  • Arrhythmia & Cardiac Events
  • Choking
  • Pulmonary Aspiration
  • Aspiration Pneumonia
  • Psychosis
  • Self-harm

If you do decide to kick your habit on your own (even though it may be putting your life in danger), there are a few general tips you should follow to help make your at-home detox as safe as possible.

The Importance of Aftercare

Just as detox is an essential stage of recovery before rehabilitation, aftercare is also a critical component of any recovery plan.

Despite what many people believe, addiction isn’t cured once a former user graduates from a rehabilitation program. In reality, it often takes months and even years of hard work after leaving rehab to start feeling completely normal again without using.

Now, that doesn’t mean that addiction is a death sentence – once an addict, always an addict does not apply.

But without proper follow-up services, therapies, and meetings, the chance of relapsing rises dramatically.

That’s why aftercare is so important. It provides the continuing maintenance of healthy habits and helps recovering users keep their focus on staying clean. 

Types of Therapies Used In Inpatient & Outpatient Treatment

The core treatment in both inpatient and outpatient models comes from a number of different therapy types.

In many cases, these treatments can be used in either setting. However, recovering addicts in an inpatient setting will likely be exposed to more kinds of therapies simply because they’ll have a more intensive recovery experience.

Just what kinds of therapies will be included varies from program to program. That’s why it’s so important to understand what kinds of treatments are used before deciding to partner with any specific facility.

The main therapy methods that you will find are:

  • Cognitive Behavioral Therapy (CBT): This method helps patients to understand their addiction triggers. They’ll find out how to avoid them entirely as well as how to cope with them in a healthier, less drug-dependent way.
  • Family Behavior Therapy (FBT): This is used with both adults and adolescents with drug addictions. This type of therapy will guide the family to understand these drug using patterns and how to move forward drug-free. It can also heal any relationship damage that likely occurred due to the substance abuse.
  • Motivational Interviews: This helps individuals change behavior and enter treatment with a ready mind. It focuses on encouraging internal motivation to change so as to help patients really want to get clean.
  • Motivational Incentives: This therapy encourages you with positive reinforcement to help you abstain from drugs. These positive reinforcements may include everything from financial incentives to activity vouchers.
  • Individual Therapy: Many substance abusers have a history of trauma or emotional problems that they’re using drugs to self-medicate with. Individual counseling will help you get to the root of your substance abuse and treat the cause of the problem rather than just the symptoms.
  • Group Therapy: Steeped in the traditions of 12-step programs, group therapy allows patients to open up about their substance abuse to others. This not only helps foster a supportive relationship that can move well outside of treatment but can also keep people's lives in perspective.  

Cost of Outpatient vs. Inpatient Treatment

One of the biggest concerns of people seeking out addiction treatment help is the cost of these programs.

In fact, in the 2016 National Survey on Drug Use and Health (NSDUH), almost one-third of respondents who saw the need for treatment but didn’t receive it cited cost as the main reason for not receiving help.

What’s surprising is that addiction treatment is actually more affordable than it’s ever been.

One of the main reasons for this change in costs has to do with new legislation brought on by the Affordable Care Act. As a result, healthcare insurance providers are actually now required by law to help cover addiction treatment costs.

It’s always smart to verify your insurance coverage before siding with a particular provider. But in the vast majority of cases, if you have insurance, your costs are likely going to be more affordable than you think.

It’s also worth remembering that there are plenty of factors that go into determining costs of treatment including:

  • Facility type
  • Location
  • Program size
  • Types of treatments available
  • Duration of the program
  • Types of amenities

That being said, the typical costs of treatment for outpatient vs. inpatient treatment are as follows:

Inpatient Treatment: average daily cost of $400-$900

Outpatient Treatment: average weekly cost of $140-$500

There are free detox and rehabilitation services available in some locations. And for some people, this might be the preferable option.

However, it’s worth remembering that these programs are often free for a reason – they typically don’t stack up in quality or comfort of a paid program.

There are a couple of other reasons for recovering addicts to avoid free treatment. These include:

  • A complicated admission process that includes lots of red tape.
  • A long waiting list (that can end up taking months to get through).
  • A more uncomfortable experience (e.g., crowded living space, fewer amenities).
  • Unreliable program length that can be cut off unexpectedly.
  • Only cover basic treatment techniques.
  • No medically supervised detoxification.
  • Not everyone qualifies.

Questions to Ask When Looking for an Addiction Program

Finding the right rehabilitation center for you is critical to ensuring the best chances of future sobriety and success. And knowing the difference between outpatient vs. inpatient treatment is only one step in helping you decide.

That’s why you should be sure you know which questions to ask when trying to find an addiction facility to partner with.

Below are just some of the most important ones to help you decide.

Do you offer individualized care?
What about dual diagnosis services?
What is your staff-to-patient ratio?
Are you nationally accredited?
Do are your programs based on empirical evidence?
Do you provide detox services?
What kind of aftercare do you provide?
Is your rehab medication-based or more of a holistic approach?
Do you offer 24/7 nursing care?

Crack Cocaine Addiction and Treatment

The Bottom Line: Your Personal Recovery is What Matters

Whether you decide that outpatient is perfect, or inpatient might be more your speed, the key to a long-lasting recovery is picking a facility that’s right for you.

And knowing the difference between inpatient vs. outpatient treatment is one of the core steps of deciding on a treatment facility that fits the needs of you or your loved one.

At Northpoint Washington, we understand that there’s no one treatment approach or program that works for everyone. And that’s why we’d love to help find the right one for you.

Our Edmonds, WA facility offers both detox services and one of the best 30-day inpatient programs in the state. We’re nationally accredited, have among the highest staff-to-patient ratios in the area, and build each and every one of our individualized programs around the specific needs of the individual.

We also have a number of facilities that offer outpatient and intensive outpatient programs as well.

No matter where you’ve landed in deciding on outpatient vs. inpatient, we can provide the treatment that you need to recover.

Give us a call today to get started or to speak to one of our knowledgeable addiction professionals for more information.

So, get in touch today.

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Northpoint Washington: Opening April 2019

Our facilities currently open for services:

Ashwood Recovery at Northpoint

Outpatient drug and alcohol rehab and addiction counseling located in Boise, Idaho.

Northpoint Recovery

Our National Medical Detox and Inpatient Addiction Facility.

The Evergreen at Northpoint

Outpatient drug and alcohol rehab and addiction counseling located in Washington State.