Inpatient drug rehab vs. outpatient

An outline of the main difference in inpatient and outpatiend drug rehab.

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All rehabs want you to quit drugs

The goal of every drug rehabilitation program is to help you achieve a substance free state, relieve the immediate symptoms of withdrawal, and treat any comorbid medical or psychiatric conditions.

But, what can you expect during a stay in a inpatient drug rehab? What is the differences and similarities between inpatient and outpatient rehab programs? We review here. Then, we invite your questions at the end. In fact, we try to respond to all questions personally.

Main differences between inpatient drug rehab vs outpatient

1.  Cost

1.1. Inpatient drug rehab – In general, a 28 day inpatient rehab costs, on average, around $20K. Low-cost rehab options may charge as little as $7,500 per month, whereas high-end luxury programs can cost as much as $120,000 per month. A good amount of evidence-based, high-quality options exist in the $18,000 to $35,000 per month range. However, insurance plans often assist in covering the costs. Ask your insurance company to check what’s included in the insurance you’ve chosen.

1.2. Outpatient drug rehab – Outpatient treatment varies in the types and intensity of services offered, but average around $2K per treatment episode of 8-10 weeks. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports.

2.  Residence

2.1. Inpatient drug rehab – Inpatient rehabs offer full residence, including thecost of meals and housing.

2.2. Outpatient drug rehab – Outpatient rehabs require that you live and commute from a home environment.

3.  Duration

3.1. Inpatient drug rehab – Patients receiving inpatient detox care are first admitted to a hospital or other medical facility, where they reside for the duration of treatment, which may range from 3 to 14 days.

Inpatient drug rehab lasts from 28-30 days, or is recommended in monthly treatment segments of 3 months (3,6,9 month stays) and can be recommended for a year, or longer.

3.2. Outpatient drug rehab – People who attend outpatient clinics are expected to travel to a hospital or other treatment facility daily (excluding weekends) for treatment sessions. The sessions may be scheduled for daytime or evening hours, depending on the program. Outpatient rehab usually lasts in cycles from 8-16 weeks and can require a weekly committment of 6-20 hours.

Inpatient versus outpatient drug rehab

A number of factors should be considered in determining the appropriate rehab setting for a particular patient. For example, some people benefit from a change in environment in order to focus on recovery. For these people who should not stay at home, inpatient drug rehab may be best.

People who attend outpatient rehabs can continue to function relatively normally and maintain employment as well as family and social relationships. Compared with inpatient settings, those patients in outpatient treatment retain greater freedom, continue to work and maintain day-to-day activities with fewer disruptions, and incur fewer treatment costs.

However, outpatient detoxification is not appropriate for suicidal or homicidal patients, those with severe or medically complicated alcohol withdrawal, patients in adverse or disruptive family or job situations, or patients who would not be able to travel daily to the treatment facility.

Similarities between inpatient and outpatient drug rehab

No matter what kind of rehab setting you choose, the stages of treatment and even the treatment modalities remain generally the same. Here are some key similarities:

  1. The process of detoxification will be a must if you have serious physical dependency on drugs.  Detox and withdrawal are often a requirement before entering either type of rehab.
  2. Most rehabs include specific education and individual/group counseling that will help you prepare for long-term treatment. Psychotherapy and behavioral therapy are at the core of both inpatient and outpatient rehab.
  3. If necessary, doctors can prescribe you medication-assisted treatment. Pharmacotherapies have been shown to increase retention in treatment and reduce risky behaviors.

Effectiveness of inpatient vs. outpatient drug rehab

NOTE HERE: Few studies show better outcomes in addiction recovery from inpatient treatment vs. outpatient rehab treatment. In fact, the majority find no significance once patient characteristics are controlled.

Still, patients with high psychiatric severity and/or a poor social support system are predicted to have a better outcome in inpatient treatment, while patients with low psychiatric severity and/or a good social support system may do well as outpatients without incurring the higher costs of inpatient treatment.

Furthermore, preliminary results from a study of ~180 inpatient rehabs and ~120 outpatient rehabs indicated that outpatient facilities were 4 times more likely to be early treatment failures. While the determination of long-term follow-up status of these failures is currently underway, this finding underscores the potential risk of outpatient drop out cases compared to inpatient substance abuse treatment programs and the importance of addressing the issue of early attrition in conducting outcome analyses.

Inpatient or outpatient drug rehab questions

Do you still have questions about inpatient or outpatient drug rehab? Please ask us your questions below. We’ll do our best to respond to you personally.

Reference Sources: NCBI: Inpatient vs outpatient treatment for substance dependence revisited
SAMHSA: Substance use disorders
NIH: An Overview of Outpatient and Inpatient Detoxification
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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