“Substance use treatment is very individualized – Not every therapy or every medication works for every single person. You have to find what works for you. I help each patient figure out what options will help them be most successful.”
Substance abuse treatment programs vary based on an individual’s needs and the severity of their addiction. Some people may complete treatment on an outpatient basis, while others may need more intensive care, such as residential treatment. A team of addiction professionals can work with an individual to determine which substance abuse treatment program is best for them.
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Types of Addiction Treatment Programs
There are multiple types of addiction treatment programs. Some people may pass through various phases of treatment, whereas others may only require one or two levels of care.
A medical detox program is the first step for someone who is beginning treatment for a severe addiction to substances like heroin, alcohol or benzodiazepines. In medical detox, patients are supervised by trained health professionals who can monitor symptoms and ensure that patients remain safe while withdrawing from drugs or alcohol.
In a medical detox program, staff can provide medications to ease the discomfort of withdrawal as drugs and alcohol are leaving the body. For example, experts report that people who are withdrawing from heroin may take lofexidine to alleviate withdrawal symptoms. People may also take buprenorphine or methadone during medical detox. It’s important to keep in mind that medication is only used during withdrawal when clinically cleared by a medical professional.
Medications can be used during the withdrawal process in medical detox, and they can also be a part of an ongoing medication-assisted treatment program. Medication-assisted treatment involves using medications in tandem with counseling during the recovery process.
Medication-assisted treatment is typically used to treat addictions to illicit opioids, prescription opioids and alcohol. Medications can help control cravings and stabilize both brain chemistry and bodily functioning. According to research, medication-assisted treatment can help people stay in treatment, reduce opiate abuse, increase survival rates and decrease criminal activity. Much like with medical detox, methadone and buprenorphine are commonly prescribed in medication-assisted treatments for opioid addiction. Disulfiram and acamprosate may be used for the treatment of alcohol abuse.
Inpatient rehab is typically provided in a hospital or a clinic that specializes in inpatient treatment. In this type of treatment setting, medical professionals supervise patients and have 24-hour access to nurses. People participating in inpatient treatment often receive medications and counseling services and participate in group therapy.
Inpatient treatment typically involves ongoing assessment of the addiction and monitoring of goals. Once a patient has completed inpatient treatment, staff create a discharge plan and the patient is moved to another treatment setting, such as ongoing outpatient therapy.
Residential rehab is similar to inpatient treatment but is typically longer-lasting. According to the National Institute on Drug Abuse (NIDA), residential services usually occur outside of a hospital setting, meaning residential facilities provide more of a home-like environment. People receiving residential care reside at the treatment facility on a full-time basis.
Stays in residential rehab can last for a few weeks or several months, with the goal of helping people develop healthy social skills and change ineffectual behaviors. However, the length of treatment is comprehensive and can vary widely depending on both the program and the individual’s needs.
Partial Hospitalization Program
A partial hospitalization program offers an alternative to inpatient or residential treatment. According to The Association for Ambulatory Behavioral Healthcare, these programs are offered either in hospitals or freestanding clinics and provide intensive services. People who participate in a partial hospitalization program may receive treatment during days, evenings, or weekends, and they return home at night. If a supportive home environment isn’t available, clients may live in a sober living facility.
Partial hospitalization is suitable for patients who are not a danger to themselves but still require intensive treatment. In these programs, people spend more time in treatment than those in traditional outpatient programs, but they may be able to live at home and get treatment through a teletherapy app.
Intensive Outpatient Treatment
Intensive outpatient treatment involves group treatment sessions as well as individual counseling. People who are engaged in intensive outpatient treatment may also take medications and receive medication management services. Depending on the program, clients may live off-site at home or in sober living housing. Online counseling is also common for this level of care.
Intensive outpatient programs are an alternative to hospitalization or inpatient programs. In some cases, people will begin an intensive outpatient program after transitioning out of an inpatient setting. According to research, intensive outpatient programs provide at least nine hours of service per week, but some programs may be more intensive.
Outpatient rehab is a step down from intensive outpatient treatment. Per the American Society of Addiction Medicine, someone in outpatient treatment receives less than nine hours of services each week.
Similar to intensive outpatient programs, outpatient rehab typically involves individual and group counseling as well as access to medication and medical services. In outpatient programs, people schedule appointments at times that fit their schedules, and they can continue to work in the community and live at home throughout treatment. Outpatient programs offer flexibility, which is a benefit of this type of treatment.
Dual diagnosis treatment is provided to individuals who have both an addiction and a mental health condition. For example, a person who lives with opioid addiction and bipolar disorder would be a candidate for dual diagnosis treatment.
With this form of treatment, people receive integrated services that address both addiction and mental health conditions. People in dual diagnosis services receive counseling, supportive services and medications. Treatment plans must consider both the mental health condition and the addiction to be effective. For instance, if a person receives treatment for addiction, but underlying depression is not treated, the person may relapse to drug use as a form of self-medication.
Court-ordered treatment is given as a legal consequence for drug-related offenses, and comes with consequences for noncompliance. Studies show that court-ordered treatment is just as effective, if not more so than voluntary addiction treatment. may take many forms and often is conducted in the same setting as voluntary treatment. The specific requirements of treatment vary with each unique court sentence. In some cases, treatment may be given as an alternative to incarceration or as a way to reduce the length of incarceration or probation.
Depending on the level of offense, types of court-ordered treatment include educations programs, group counseling, outpatient programs, community-based programs and residential programs.
Some treatment facilities approach addiction recovery through the lens of spirituality. The most well-known community support group, Alcoholics Anonymous (AA), was founded on strong religious principles and continues to promote faith-based healing to its 2 million members around the world.
If you believe that spiritual principles could benefit your recovery, you can easily find treatment programs that implement these principles alongside traditional medicine. Research shows that recovering patients with higher levels of spirituality exhibit positive qualities such as increased optimism, lower anxiety and higher resilience to stress. By helping a person in recovery find inner strength, faith-based rehab facilities hope to fortify their path to sobriety.
Aftercare includes services that people participate in to maintain lasting sobriety after completing a treatment program. Aftercare services may involve ongoing counseling, participation in support groups, or linkage to case management or peer support services. Aftercare plays an important role in preventing relapse. According to research, aftercare is more effective when people participate in it for longer periods of time.
Short-Term vs Long-Term Addiction Treatment
- Short-term treatment typically lasts around 30 days, but treatment of this length may not always be effective. NIDA reports that short-term residential programs are typically intensive, and it is necessary for people to transition into an outpatient program after completing one.
- Long-term treatment typically lasts somewhere between three and 12 months. Long-term residential treatment takes place in a home-like setting, and people have access to medical care 24 hours a day. A common model for long-term treatment is the therapeutic community, and people in this type of program typically stay in treatment for six to 12 months. Long-term treatment usually begins with detox from drugs, and then a person transitions into the program, which is initially strict and follows a structured schedule with rigid rules. As people make progress in treatment, they are awarded more flexibility.
Addiction Treatment Process
Addiction treatment is a process that typically occurs in phases. For example, the treatment process for addiction typically begins with an intake appointment and continues from there.
The following are typical steps in an addiction treatment program:
- Intake: The intake process involves an addiction professional gathering information to admit you into a treatment program. For instance, the professional will discuss your health history and likely perform a basic medical examination. Basic information, such as date of birth, income, family background and employment history will also be gathered during the intake process.
- Screening & Assessment: During the screening and assessment phase of treatment, a professional will use a tool such as the Drug Abuse Screening Test (DAST) to determine the extent of a person’s problems with drug abuse. These tools involve a brief interview and efficiently provide the treatment team with information about a person’s substance use. Using screening and assessment results, the professional team can determine what further evaluations are necessary.
- Evaluation: After the screening and assessment are completed, a full substance abuse evaluation will be completed. This evaluation will be more comprehensive. During this evaluation, a clinician will gather information about your history of substance abuse, including when you first began using, what substances you have used and how frequently and in what quantities you have used. The clinician will also discuss symptoms of your substance abuse, such as whether or not you experience withdrawal, what physical consequences you have experienced as a result of substance abuse and whether you have experienced legal difficulties or troubles at work or home due to drugs. A clinician may utilize an evaluation tool such as the Addiction Severity Index (ASI) to gather comprehensive information about your substance use and its consequences.
- Developing a Treatment Plan: After a full evaluation is completed, a clinician will work with you to develop a treatment plan. Addiction treatment plans address areas of need, such as abstaining from drugs and obtaining employment, as well as what services or resources will be utilized to address these areas. A treatment plan also states long-term goals and shorter-term objectives. Experts report that treatment plans should also make use of a client’s strengths.