About Drug Treatment
There are many different types of treatment for drug addiction, with the one of the main differences being inpatient versus outpatient. The type of treatment that is required will be determined based off individual circumstances, including the drug of abuse and the length of time the individual has been using.
Outpatient vs Inpatient Treatment
One of the first things to consider when seeking treatment is whether inpatient care is needed or if outpatient care is more suitable. Inpatient rehab is more intense and requires one to live at the facility for a certain amount of time. Outpatient treatment allows individuals to live at home while receiving treatment.
- Medical and psychosocial assessment: A treatment team will evaluate each patient’s medical, psychological, and social health and create an individual comprehensive treatment plan.
- Detox: A medical team will monitor and guide each individual through the withdrawal process, which often includes the use of medications.
- Pharmacotherapy: When appropriate, a medical team may administer certain medications to help manage withdrawal symptoms, as well as those that treat substance dependence or co-occurring mental health disorders.
- Group meetings and group therapy: Most programs hold group meetings on a daily basis. Group therapy might also take place in the form of a 12-step (e.g., AA, NA) or secular-based (e.g., SMART Recovery) approach.
- Individual counseling: Individuals will meet with a therapist or drug abuse counselor to address your drug use patterns and any mental health concerns.
- Other amenities: Some facilities have amenities like acupuncture, yoga, equine-assisted therapy, spa treatment, or specialized nutrition programs.
- Relapse prevention and discharge planning: One of the most important parts of treatment is planning aftercare, which addresses strategies to prevent relapse and outlines resources for continued support.
- Medical monitoring: Despite being outpatient, some treatment programs, such as partial hospitalization programs (PHP), will provide access to medical services to ensure any conditions and potential complications are addressed in a timely manner.
- Individual therapy: Individuals may meet with a psychotherapist or drug counselor to address behaviors associated with drug use.
- Group therapy: Many programs will provide group therapy in the form of a 12-step or secular orientation.
Types of Inpatient Treatment
As mentioned earlier, inpatient treatment requires living at a facility for a certain amount of time, depending on individual circumstances. There are 2 different options:
- Inpatient treatment hospital.
- Inpatient or residential rehab/recovery center.
This is designed for individuals who need significant medical attention during the detox process. They are treated and closely monitored by a medical team for several days to weeks, after which they will then typically move to a rehab/recovery center for continued care.
Residential Rehab/Recovery Center
These programs typically last for 30-90 days. Individuals live at the facility, which has both pros and cons.
On the one hand, they are removed from the temptations and triggers of the outside world, and can focus on their recovery while receiving 24-7 monitoring and care; on the other hand, they may have to leave behind work, family, and other obligations.
Types of Outpatient Treatment
There are a number of different options when undergoing outpatient treatment. These include:
- Partial hospitalization.
- Intensive outpatient (IOP).
- Outpatient substance abuse program.
- Psychotherapy or counseling.
- Support groups.
In a partial hospitalization program, patients will spend most of the day and most days of the week at a treatment center but will return home at night. This offers the benefit of having many of the services of an inpatient program with more flexibility.
Those enrolled in an IOP program, you’ll attend treatment sessions for a significant portion of the day, for several days throughout the week—10-12 hours per week, on average.
IOP utilizes many of the same services as inpatient care, such as individual and group therapy.
Outpatient Substance Abuse Program
With outpatient substance abuse programs, individuals visit the treatment center less often (e.g., 1-2 times per week), and receive services such as individual therapy, group therapy, or medical monitoring.
Psychotherapy or Counseling
Individuals may choose to seek out a psychologist, drug abuse counselor, or marriage and family therapist. This allows for a more intense focus on their individual patterns and mental health concerns.
Includes 12-step groups and secular/self empowerment-based groups such as SMART Recovery.
Types of Therapy
An important part of inpatient and outpatient treatment is therapy. Whether it be individual counseling or group therapy sessions, theses are integral in your recovery.
Individual Therapeutic Approaches
Cognitive-Behavioral Therapy (CBT)
CBT is the most widely used psychotherapeutic approach in treating substance abuse. It first teaches them to recognize and monitor your beliefs about:
- Themselves (e.g., “I will never be able to stop using drugs”).
- Others (e.g., “my friends will hate me if I quit”).
- The world (e.g., “there is no room for a person like me in society”).
It then teaches them how to counteract these negative thoughts and faulty belief systems with more accurate, positive thinking. CBT also evaluates the environmental factors that both trigger and reinforce their drug use, teaching them to better manage both their internal and external triggers for drug use.
Motivational Interviewing (MI)
MI is a collaborative, non-confrontational approach between the therapist and patient. MI helps a patient recognize the pros and cons of continuing to use drugs, ultimately letting them arrive at a decision on their own about whether or not to change.
Mindfulness-based therapies like dialectical behavioral therapy (DBT) and mindfulness-based relapse prevention (MBRP) have been used to treat substance use disorders.
Mindfulness is present-moment focused attention that is curious, nonjudgmental, and kind. Practicing mindfulness can help individuals become aware and more resilient towards distressing thoughts, feelings, and body sensations—ultimately gaining the ability to choose an alternative behavior to using a drug.
Contingency Management/Motivational Incentives
Contingency management or motivational incentive approaches use a rewards-based program to reinforce abstinence from drugs.
Patients learn to:
- Identify high-risk situations.
- Change their perceptions about themselves and others who use drugs.
- Learn and employ self-management strategies.
- Use specific techniques to manage cravings when they arise.
Medication is often used in the treatment of addiction. Opioid addiction, for example, may be treated with:
Alcohol dependence may be treated with:
Treatment for co-occurring psychiatric conditions such as anxiety and depression may also be treated with medications like selective serotonin reuptake inhibitors (SSRIs).
Choosing a Treatment Center
It pays to do your research when looking for a drug treatment center. Below is a quick reference guide for things to ask about:
- Inclusion of medical/detox services.
- Treatment of co-occurring psychiatric disorders.
- Credentials of staff members.
- The center’s policy on family inclusion.
- Length of program.
- Relapse prevention/aftercare planning.
- Services offered.
- Treatment methodologies.
- Religious orientation, if any.
- Amenities and services.
- McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689-1695.
- Marlatt, G. A., & George, W. H. (1984). Relapse prevention: Introduction and overview of the model. British journal of addiction, 79(3), 261-273.