Which is Right? Inpatient Rehab vs. Outpatient
The substance abuse treatment world has evolved quite a bit over the years. As a result, people have more options than ever when it comes to the kind of rehab program they can choose. Careful consideration should be given to the type of care that is needed to treat the individual, with lifestyle factors and matters of convenience factoring in but the treatment approach being the primary consideration.
Both inpatient and outpatient treatment can provide individuals struggling with substance abuse and addiction with comprehensive, effective treatment. The choice between which is right – inpatient or outpatient – depends on the specifics of the individual’s situation.
Inpatient rehab programs are intensive treatment options that allow clients to live on the treatment campus. Residential care has its perks. While nearly all rehab programs offer some kind of support group participation onsite, some inpatient facilities may also transport clients to offsite meetings, like Narcotics Anonymous. This can help clients get acclimated to these groups and set up a lifestyle that is supportive of recovery while they are still in residential treatment. Once they graduate from a residential program, they’ll already be accustomed to attending these meetings out in the community.
A National Institute on Alcohol Abuse and Alcoholism study reported on the three-year post-treatment outcomes of different approaches, noting a 51 percent abstinence rate among individuals who chose to participate in both formal treatment and Alcoholics Anonymous, compared to just 26 percent for those who chose formal treatment only. Group interaction is a big part of any treatment program, but inpatient clients may have more access to it merely because they are cohabitating with peers and can form relationships with them outside of structured group activities.
Likewise, there are potential downsides to this type of treatment, too. For starters, it will disrupt clients’ daily lives a great deal. Most people who are treated for substance abuse do have jobs, contrary to popular belief. While illicit drug abuse is more common in those who work less or don’t at all, it isn’t by a significant margin. The Federal Reserve Bank of St. Louis notes 8 percent of people who work fulltime reported past-month drug abuse between 2005 and 2011 while 10 percent of part-time workers did and 18 percent of people who were unemployed did.
Thus, many people with substance abuse issues work. Taking time off from their jobs isn’t a problem legally
Employers are required to extend up to 12 weeks off per year for substance abuse treatment to employees in need of it.
However, many people don’t want to open that can of worms at their place of employment. They fear their bosses may view them differently and get angry with them, or that coworkers will find out about their personal problems. Furthermore, not everyone can afford to take lengthy periods of time off work either. Oftentimes, inpatient programs last from 28 to 90 days, or longer.
Inpatient rehab can have both positive and negative effects on a client’s home life, too. For those with a family at home, a partner may be relieved to have more stability in the home during the struggling individual’s absence. In addition, spouses and significant others generally appreciate that their loved ones are getting help.
For those with children at home, it can be stressful for a partner to go from being part of a team to single parenthood. Sometimes, this stress can bleed over into hostility and resentment toward the individual in rehab. The National Council on Child Abuse and Family Violence reports over 8 million American children are living with at least one parent who abuses drugs or alcohol. Oftentimes, couples counseling or family therapy may be part of inpatient treatment to address issues that may come up due to the ongoing addiction and treatment.
It’s important to consider each person’s needs while planning the approach toward treatment. Inpatient treatment is the best choice for:
- Individuals who have previously attempted outpatient treatment and relapsed
- People who are at risk of severe side effects during detox that require constant medical supervision
- Individuals in need of a shorter, but more intensive, treatment program
- Those who may be heavily exposed to environments where drug and alcohol abuse are still prevalent
- People suffering from severe co-occurring mental health disorders or other illnesses
Outpatient treatment is more popular throughout the US. The most likely reasons for this are related to time and cost. According to the Substance Abuse and Mental Health Services Administration, 81.6 percent of people in treatment in 2013 were attending on an outpatient basis. Simply put, outpatient treatment is far more flexible and feasible for most people. While many are desperate for treatment by the time they seek it, most still have life obligations they must meet. If people have kids at home, jobs to hold down, or care for elderly family members, they generally try outpatient rehab, provided it’s an adequate method of treatment for their specific situations.
Individuals who may find outpatient treatment to be more appropriate for their situation include:
- Those who cannot take time off from work or family life
- People with addictions to milder substances, like marijuana
- Individuals who do not need medical detox
- Clients who do not have insurance coverage or who need a more affordable treatment option
Many people find long-term recovery with outpatient care. They attend treatment 3-5 times a week. During their trips to the rehab center, they may participate in support group meetings, individual and group therapy sessions, and alternative and holistic therapies. Family involvement is still important, some would say even more important, when the individual is living at home during rehab. Often, outpatient programs will offer the option for loved ones to attend therapy sessions once a week to work on issues that substance abuse has caused within the family and to further support the client.
Often, additional therapy options, such as yoga and equine-assisted therapy, aren’t readily available to individuals who are only seeking treatment on an outpatient basis.
Completion rates can differ between inpatient and outpatient treatment. Treatment completion seems to be somewhat less likely among individuals enrolled in outpatient treatment. SAMHSA reported only 38 percent of individuals admitted to outpatient treatment in 2010 completed it. Among inpatient clients that year, 52 percent finished short-term inpatient treatment and 46 percent completed long-term inpatient rehab.