Treatment Options for Addiction

Treatment Options for Addiction

When it comes to addiction treatment, you have choices. Apart from your insurance and financial needs, there are many things to think about when you choose a facility. Generally, rehab programs begin with detox, which helps you safely clear your body of drugs and alcohol. After that, you’ll probably start inpatient treatment, although outpatient rehabilitation options might work better for you. The best option for you will depend on your personal situation and your preferences. 

It’s important to have a clear picture of what your options are so you can get a better idea of what the recovery process will look like. This way, you’ll be well informed when talking about your needs with any potential healthcare, insurance, or financial providers. Every facility has a different philosophy on treating addiction– some utilize a 12-step model, some utilize holistic therapies, some center entirely around family therapy–you have to figure out what works best for you and your own recovery.

Because programs can differ so dramatically, you’ll need to make sure to call around and find out which type of program will suit your needs. For example, if the idea of a “higher power” is something that doesn’t appeal to you, you might want to look for programs that also incorporate alternative or non-12-step approaches to recovery. Many rehab centers offer virtual or on-site tours so you can get a better idea of what the program will offer.

The First Step is a Detox for Withdrawal Symptoms

When you use alcohol and other drugs a lot (or in high doses), the body and brain become used to their presence and you begin to need those substances just to function.^1,2 Detoxification (detox) is the body’s attempt to process and remove those substances from the system and return it to a natural balance. Detox can also refer to medically-supervised or medically-assisted detoxification. While it can help you achieve short-term sobriety, detox alone won’t keep you sober. Treatment therapy will help you address emotional, behavioral, and social issues that might otherwise interfere with your recovery. Even though it generally doesn’t work as a standalone treatment, detox is an important first step in the process of getting sober and it will help with the many discomforts (and, in some cases, dangers) of withdrawal.^1,2

Inpatient Detox

Medically-Assisted Detox

Medical detox programs are often the first step in recovery. Depending on the drug(s) you’re using, how long you’ve been using them, and how severe your addiction is, you may need to work through carefully reduced doses in order to safely detox. This process minimizes the uncomfortable, and sometimes dangerous, side effects of withdrawal that you may experience. In some instances, you might even be prescribed medication to manage withdrawal symptoms, but this approach often requires careful medical supervision. Some substances, such as alcohol and benzodiazepines, can cause deadly withdrawal complications, so do not try to taper your own doses–leave that to the professionals. Medically-assisted detox keeps you safe. 

After you meet with your doctor for initial evaluation, they will determine your treatment plan and whether you will need medical supervision during detox. Detox programs typically last 7–10 days and cost $600–$1,000 per day.³ Once you are medically cleared by the detox facility, you will enter inpatient or outpatient treatment.

Outpatient Detox

If your addiction is relatively recent or mild, you have a solid support system around you, and you are not at risk of medical dangers from drug withdrawal (such as those associated with alcohol or benzos), outpatient detox can be a great option.² Outpatient detox uses many of the same techniques as inpatient detox to help you get sober, but provides the freedom for you to live at home and attend to your personal or home responsibilities. Outpatient detox can be done at a doctor’s office or substance abuse clinics.²

In some cases, outpatient detox can provide the help and support you need if you have been using opiates/opioids like prescription pain medications or heroin. Opioid withdrawal can be extremely intense, but usually it won’t kill you. This means that, in most instances, you can safely manage the symptoms of painkiller withdrawal in an outpatient environment.² However, the severity of discomfort that opioid withdrawal can cause (such as intense flu-like symptoms) can trigger relapse in a lot of people, so you may want to detox in an inpatient environment where you can get support throughout the awful withdrawal symptoms. 

Types of Inpatient Drug & Alcohol Treatment Facilities

Any services that require you to leave your home, eat, and sleep at the place you receive your treatment is called inpatient. Structured inpatient treatment programs can be very intense, last for a few weeks to a few months, and provide around-the-clock supervision and access to medical and psychological services, when needed.¹ Inpatient treatments might be best for you if: 

• You don’t have support at home. 
• Your issues with substance use are severe. 
• You haven’t been able to stay abstinent with lower levels of care. 

Inpatient treatment programs can be in hospital settings or more comfortable homelike atmospheres, depending on the type of inpatient treatment and the program that you choose.^1,2

Residential Inpatient

Residential inpatient drug rehab is intensive and provides around-the-clock care while you live at the treatment facility. Not only is the level of care much better, you will also have the space you need to focus entirely on recovery. Having a sober, safe place to work through treatment where you don’t have to worry about food, housing, external use triggers, or the temptation of day-to-day home living can be incredibly helpful as you work through recovery. Inpatient addiction treatment usually includes a combination of individual therapy, group counseling, therapeutic medications like antidepressants (when necessary), health education, aftercare planning, and other activities, depending on the facility. These services are designed to help you address the underlying causes of your addiction and adequately prepare you for your transition either out of treatment or into an outpatient program. Inpatient rehab generally lasts 30, 60, or 90 days, and can cost anywhere from $200–$900 per day depending on the facility and length of treatment.³

Short-Term Inpatient

Short-term inpatient treatment options will be helpful for you if you need the structure of an inpatient environment and you don’t have the support you need at home. ¹ These programs tend to follow a 28/30-day, 60-day, or 90-day course with the specific treatment plan tailored to each individual. These programs often have particular time frames, so they tend to be more rigid because they have to provide a great deal of therapy in a short period of time. 

While longer stays are better for long-term success, shorter stays are often chosen for several reasons. First, they tend to be cheaper, and some insurance policies may only cover you for a limited period of time. Second, for individuals who’ve never been to a program, longer stays might seem overwhelming. Third, personal and professional obligations like work or school may make it difficult or impossible to spend much time away from home.  

Long-Term Inpatient

Long-term inpatient programs will vary in total length, but these programs often last 90 days or more. Because treatment is spread out over a longer time, these programs can seem less intense and restrictive than shorter inpatient programs. Programs like these generally take place in non-hospital settings.¹ A long-term inpatient program might be best for you if you have a significant problem with drug abuse, you have relapsed before, or you simply need more time to learn the skills to maintain sobriety. More than 90 days in treatment might seem intimidating, but programs lasting at least 90 days are associated with better results and long-term recovery.¹

Dual Diagnosis Treatment

Mental health and addiction often go hand-in-hand. People with mental health issues may be more likely to abuse drugs to self-medicate symptoms (like drinking to relieve symptoms of anxiety or depression), and people that abuse drugs are more likely to have more mental health issues (alcoholism can create or amplify anxiety or depression problems). Having a dual diagnosis, sometimes called co-occurring conditions, means that you have one or more psychological disorders as well as one or more substance use disorders. Dual diagnoses are pretty common, and they require specialized care to address both issues at the same time. When you only get help for one of these issues and neglect the other, the untreated issue is likely to continue worsening and end up harming your recovery efforts.¹

Dual diagnosis treatment can occur in an inpatient or outpatient setting, but due to the complexity of treatment for co-occurring conditions, the immersive treatment environment and coordinated therapeutic efforts of an inpatient program will probably be better for you in the long run.  

Typical Outpatient Treatment Options for Addiction

Unlike inpatient treatment, an outpatient program allows you to get help during the day while returning home at night. Outpatient treatment programs let you continue to take care of your day-to-day responsibilities while still devoting time to recovery. They are usually longer-lasting and less intense than inpatient treatment, so make sure you feel extremely prepared to face the challenges of sobriety self-motivation before jumping into one. Outpatient treatments vary in structure, frequency, and length, but they all involve you going to regularly scheduled appointments for therapy and counseling (and potentially even medical monitoring).¹ If you’re worried it might be difficult to stay sober without around-the-clock support, you should consider an inpatient program instead.

Partial Hospitalization (PHP)

PHPs play a vital role in drug and alcohol rehabilitation. When it comes to how intense it is compared to other treatment types, these programs fall somewhere in between inpatient and outpatient treatment. PHPs prevent full hospitalization and support your transition from inpatient to outpatient treatment. In a PHP program, you may spend 4–8 hours in treatment per day, at least 5 days a week, for at least 3 months.⁴

Intensive Outpatient (IOP)

IOP treatment is sometimes used as a step-down from inpatient rehab or PHPs. You may go to an IOP before transitioning to standard outpatient treatment and living back at home full-time. IOPs focus on group therapy and are heavily geared towards family therapy to heal the entire family unit. IOP treatment typically lasts for 1–3 weeks, with group and individual therapy sessions 3 times a week.⁴ IOP sessions cost from $100–$500 per session, but exact prices vary depending on length and frequency of treatment.³ You may be able to get a per-session discount if you choose a longer treatment plan.³

General Outpatient

Outpatient care gives you the chance to live at home full-time while you seek treatment for your addiction. You will visit the facility only for therapy sessions—allowing you to take care of responsibilities outside of rehab such as working, going to school, and volunteering in the community. Outpatient programs tend to be cheaper than inpatient programs because they do not provide the same intensive level of care. Outpatient programs can last anywhere from 2 months up to a year.⁴

Aftercare Programs for Long-Term Recovery

Addicts in recovery must continue learning the skills to live a sober lifestyle after the initial treatment program ends. Without a plan, you are more likely to relapse. Follow-up care after treatment is called aftercare. Aftercare options represent a step-down treatment from a higher level of care (like inpatient or outpatient treatment). Aftercare can refer to a long list of professional or nonprofessional options. Like other forms of addiction treatment, aftercare will help you learn to maintain your sobriety and prevent relapse.⁴

Sober Living

After completing rehab, you might be referred to a sober living home (sometimes referred to as halfway houses). Sober living is a safe and drug-free place where you can continue your recovery and prepare to fully transition out of treatment. These communities emphasize developing life skills such as cooking, cleaning, finding work, and avoiding triggers/preventing relapse. It can be incredibly helpful to live among other recovering addicts because everyone is focused on the goal of staying sober. This also means that your neighbors will understand the challenges and struggles that you’re facing much better than people who have never had to stand up to addiction.

Recovery Support Groups

Participation in a 12-step or non-12-step group can be really helpful for addicts going through treatment, but anyone is welcome to join these free group sessions, including people who have never been in treatment before. Even if finances or insurance keep you from enrolling in formal treatment right away, you can still benefit from the supportive community and structure that these groups offer. 

If you’re nervous about joining a group of strangers to talk about your addiction, that’s completely normal. Just remember that the benefits of recovery support groups are widely recognized by treatment professionals. Listening to people who have been sober for a long time can inspire you to change your own behaviors, stop using, and resist relapse. 

Ongoing Therapy

Types of Therapy Utilized in Addiction Treatment

You have many options when it comes to recovery from substance abuse and addiction. Therapy styles differ in their views of how addiction develops and the best ways to treat it. Some types are standalone therapeutic styles while others pick features from several different types and gather them to form a new approach.¹ Different therapists, programs, and organizations will apply different types of therapy based on their beliefs and education.

Cognitive-Behavioral Therapy (CBT)

Proven effective in treating alcohol, marijuana, cocaine, methamphetamine, and nicotine addiction, CBT is a versatile treatment approach that can help you identify risky situations and build healthy coping skills to avoid drugs. CBT works to show you how your thoughts, feelings, and behaviors are interconnected, which helps you control your behaviors. This therapeutic approach creates lasting changes that remain long after you get out of treatment.¹ 

Contingency Management

Proven effective for alcohol, stimulant, opioid, marijuana, and nicotine addictions, contingency management (CM)—sometimes called motivational incentives—offers reinforcement for drug-free behaviors and positive lifestyle changes to help you overcome the temptation to use. For example, if you attend a group meeting, participate in a healthy community activity, or submit a clean urine test, the program will reward you directly with prizes or with the opportunity to win prizes or money in a lottery. Rewards start low and increase with the length of time you stay sober.¹

The Matrix Model

Specifically designed for stimulant addictions, the Matrix Model combines helpful aspects of other programs and treatment types in a structured approach. Working with a far-reaching treatment manual, the supportive and encouraging therapist will guide your participation in individual, group, and family sessions that span many components of recovery. The goal of this model is to build your self-esteem, dignity, and feelings of self-worth by teaching you and your family the skills needed for long-term sobriety.¹ 

Didactic Group Therapy

Didactic group therapy sessions may be referred to as psychoeducational groups. In these groups, the therapist takes on the role of teacher by giving you information about drugs, dependence, addiction, and recovery. Didactic group therapy is similar to a class and often utilizes videos, lectures, and handouts to help you better understand your own addiction problems and challenges.¹³

Holistic Therapies

Holistic means “whole,” and holistic therapies address your entire person and not just your addiction.¹ These therapies frequently incorporate complementary and alternative medicine (CAM) approaches, termed as such because some treatments may be outside of the medical standard. Holistic or CAM methods may be used alongside more traditional medical care to create a comprehensive treatment program.¹⁴ There are many effective holistic therapies you can look for in an addiction treatment program, including:¹⁴

• Art/Music—Use of art and the playing of/listening to music to process and express feelings. 
• Massage/Yoga—Use of touch and movement to benefit the mind, body, and spirit.
• Acupuncture—Use of small needles or electrical impulses to stimulate specific body parts and nerves to improve symptoms.
• Meditation—An approach focused on mindfulness where you pay attention to thoughts, feelings, and body sensations (such as breath) so you can better relax and clear your mind of stresses and worries.
• Animal Assisted (equine, canine, etc.)—Refers to any therapy that employs an animal (such as a horse) to improve skills such as problem-solving and impulse control and to help you process emotions. 

Family Therapy

Family therapy refers to any therapy session that involves one or more people that you have a close relationship with outside of treatment. Addiction often affects people beyond just the addict. Loved ones suffer alongside the addict as the disease progresses because watching someone you care about suffer so much can be incredibly painful, bringing up a wide range of emotions and reactions that must be addressed along with the addiction itself. 

Family or other interpersonal factors may also have contributed to the substance abuse problem in the first place, so if these issues go unaddressed there may be a higher risk of relapse for the addict when they return to the same interpersonal issues. Involving loved ones in the healing process may help set the stage for better support and longer-lasting sobriety.

Family sessions can involve friends, family members, and romantic partners with the goal of: 

• Improving communication.
• Understanding the others’ perspectives.
• Reducing conflict within the relationship.

This form of treatment can be used in combination with individual and group therapy. Family therapy is especially effective with adolescents.¹

12-Step Facilitation

12-step facilitation is a therapeutic treatment strategy to encourage you to participate in 12-step groups outside of treatment. This is not the same as a 12-step support group because it emphasizes the combination of treatment and 12-step rather than either on its own. 12-step facilitation is most helpful for alcoholics as well as stimulant and opioid addicts. This therapy emphasizes the benefits of 12-step group attendance and stresses the importance of acceptance, surrender, and actively pursuing recovery ¹.

Life Skills Development