Inpatient vs. Outpatient Rehab

Rehab is an essential part of the recovery process when dealing with a substance use disorder. However, rehab treatment programs vary, and your specific situation may benefit more from an inpatient rehab or an outpatient rehab. When looking at inpatient vs. outpatient rehab, you should consider several things while keeping in mind that any treatment plan is beneficial to your recovery.

Inpatient Rehab Programs

Inpatient rehab programs provide intensive care around the clock as you stay overnight at the facility. An inpatient rehab stay can vary from three weeks for a short-term residential program to a year or longer if you are in a long-term program.1 Your length of stay depends on your situation and needs as assessed by a team of professionals.

Inpatient rehab often starts a period of detox, where your body works to get rid of the substance you have been using. The detox process can be difficult and uncomfortable if you experience withdrawal symptoms. In some cases, medications are recommended to help you through the detox process, and these can be administered and monitored in an inpatient program. You can expect other interventions at an inpatient facility, including:2

  • Education about various substances and how they impact your health
  • Cognitive-behavioral therapy to help you identify unhealthy thinking and behaviors
  • Motivational therapy to help you change patterns and learn new coping skills
  • Support groups with others on a recovery journey
  • Medication-assisted treatment, if applicable

Deciding between inpatient and outpatient care will involve assessments from medical and mental health professionals. Some of the reasons why inpatient rehab may be recommended are:

  • If you have a dual diagnosis such as co-occurring substance use disorders or a mental health condition that coincides with your substance use disorder
  • If you need medical attention during your recovery
  • If your home environment is not conducive to recovery because of access to substances or lack of support
  • If you have a history of relapse or trying to quit a substance without success

Advantages of Inpatient Rehab Programs

Inpatient care has many benefits, including:

  • A highly structured care approach that provides comfort and consistency
  • Rigid routines that help you develop better habits and coping skills
  • Separation from an environment that may enable you to return to the substance you are recovering from
  • Little to no exposure to triggers or stressors that cause you to want to use
  • 24-hour access to medical professionals
  • A safe place to detox and receive medication for withdrawal symptoms
  • A supportive community of people on the same recovery journey

Disadvantages of Inpatient Rehab Programs

Inpatient rehab programs can have downsides:

  • Expensive
  • Lack of insurance coverage
  • Time away from family/work/school
  • Possible job loss

Outpatient Rehab Programs

Outpatient rehab programs will vary in what they offer and how they look. Outpatient refers to a program that allows you to attend appointments during the week and return home when the appointments are over. Some of the different types of places that offer outpatient services are:3

  • Various health clinics, such as a community mental health clinic or a hospital clinic
  • Professional counselor’s offices
  • Local health department offices
  • Residential rehab centers that offer outpatient services

A wide variety of outpatient programs have different schedules, formats, and styles, so you can decide which one will best fit your lifestyle and schedule preferences. Depending on what the treatment team recommends, you can opt for more or fewer sessions per week. Many centers offer evening and weekend appointment times that coordinate well with work and school schedules and family responsibilities.

All outpatient programs will offer some forms of behavioral therapy as part of your recovery treatment. Some of the more common therapies offered include:4

  • Cognitive behavioral therapy (CBT), which helps you to identify and change thinking patterns that lead to substance misuse behaviors
  • Family therapy, which is particularly helpful for adolescents or if your substance misuse has caused stress in your relationships
  • Motivational interviewing, which utilizes questioning to help you discover what it will take to make meaningful changes in your life
  • Contingency management, which uses incentives and positive reinforcement to encourage abstinence from substance use

Outpatient programs will also offer education on your substance use disorder and provide tools to help you in your recovery. Relapse prevention plans are usually included as a way to help you recognize

Outpatient treatment is generally more suitable for you if:

  • You have a supportive environment in your home and community.
  • You do not need around-the-clock medication maintenance or health monitoring.
  • You are motivated to make changes and remain in outpatient treatment.

Advantages of Outpatient Rehab Programs

Choosing outpatient rehab programs over inpatient care has some unique benefits, including:3,5

  • Outpatient programs usually cost less than inpatient since you are not paying for overnight stays, and you will be attending fewer appointments.
  • You have more flexibility in your schedule to attend appointments while also maintaining your work, school, and personal life.
  • There is easy access to outpatient programs.
  • Since you are leaving appointments to return to your day-to-day life, you have immediate opportunities to practice the skills you learned.

Disadvantages of Outpatient Rehab Programs

Choosing an outpatient program rather than a residential center can also have disadvantages, including:

  • You will not have 24-hour access to medical professionals in an outpatient program.
  • Medication-assisted detox is not an option for outpatients since you need to be monitored by medical staff.
  • If your home or work environment is triggering, you risk returning to your substance misuse without proper coping skills in place.
  • You may miss out on the chance to build a robust support system that develops during residential stays.

Inpatient vs. Outpatient Rehab Success Rates

Both inpatient and outpatient rehab treatments are effective in treating substance use disorders. Research shows that most people stop using substances and see improvements in all areas of functioning after they remain in treatment for the recommended amount of time.6

Some research shows benefits in the effectiveness of inpatient care over other types of treatment. One such study found that learning new behaviors and making lasting habit changes is more successful when you also change your environment.7 Being in an inpatient environment where triggers and drug accessibility are removed gives you a better chance of making long-term changes to your lifestyle.

Some other research that points to the importance of inpatient care is around relapses. Studies show that 40-60% of people with a substance use disorder experience relapse in their recovery process. One survey found that in a group of people with opioid addiction, 27% relapsed the day they left a brief detox program, and 65% relapsed within 30 days of leaving.These numbers can suggest that relapse rates increase when you leave treatment, therefore suggesting that longer stays in treatment could help lower your risk of relapse.

Other conflicting studies show there is not a major difference in success rates between intensive outpatient programs and inpatient programs.10

The real takeaway from all of the research available is that treatment is effective in recovery. If you or someone you love has a substance use disorder, please call 800-662-4357 to speak to a specialist about whether inpatient or outpatient rehab is the best course of treatment.

Resources

  1. National Institutes on Drug Abuse. (2018). Types of Treatment Programs. National Institutes of Health.
  2. Dydyk, A.M., Jain, N.K., Gupta, M. (2022). Opioid Use Disorder. StatPearls Publishing.
  3. Center for Substance Abuse Treatment. (2014). What is substance abuse treatment? A booklet for families. HHS Publication No. (SMA) 14-4126. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  4. National Institute on Drug Abuse. (2019, January 17). Treatment Approaches for Drug Addiction DrugFacts. National Institutes of Health.
  5. Texas Health and Human Services. (n.d.). Adult Substance Use Outpatient Program.
  6. National Institute on Drug Abuse. (2018). How effective is drug addiction treatment?
  7. Carden, L. & Wood, W. (2018). Habit formation and changeCurrent Opinion in Behavioral Sciences, 20, 117-122.
  8. National Institute on Drug Abuse. (2018). Treatment and Recovery.
  9. Bailey, G.L., Herman, D.S., & Stein, M.D. (2013). Perceived Relapse Risk and Desire for Medication Assisted Treatment among Persons Seeking Inpatient Opiate DetoxificationJournal of Substance Abuse Treatment, 45(3), 302-305.
  10. 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 Services65(6), 718-726.

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