While most attention in the media these days is devoted to opioid abuse, it is important to remember that the most abused drug in the country is alcohol. Although both inpatient and outpatient alcoholism treatment programs are available in almost all US locations, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), fewer than 10% of the millions of Americans who suffer from alcohol abuse disorder (AUD) receive rehabilitation services in a professionally-led addiction treatment environment.
One treatment option that is becoming more popular is inpatient care, in which treatment for alcoholism is provided in a residential setting. These in-house alcohol treatment centers typically require patients to live at the facility for a fixed period, typically between 30 and 90 days. This time spent in a distraction- and temptation-free environment enables doctors, therapists, and the patients themselves to focus completely on rehabilitation, and thus increase their chances of success.
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What is inpatient alcohol rehabilitation?
Residential alcohol rehab involves “checking in” to a residential facility, which can either be a discrete and isolated wing of a larger hospital or health complex, or a standalone facility. An individual essentially puts the life on hold for the period of time they are in rehab, and commit to staying for an agreed-upon period of time. Inpatient treatment – and thus taking a time out from their daily life – can be very effective for those who really want to become sober, especially those who have tried other approaches that didn’t work for them.
The actual length of time spent at an inpatient facility will vary depending on individual circumstances, but the first part of the stay will involve a period of medically supervised detoxification. The detoxification process is followed by other forms of therapy and activities designed to help resident patients examine beliefs or negative self-concepts that may be damaging them and perpetuating their addiction. These therapies seek to eliminate destructive patterns of behavior and replace them with new, healthier patterns.
What Types of Alcohol Inpatient Treatment Exist?
There are two basic types of inpatient rehab centers:
- Government– or state-funded facilities, which tend to be focused on providing help to people with low incomes and/or no health insurance to help pay for rehabilitation. Services at these facilities are either free or based on the income. They do not necessarily represent a low level of care because they are closely monitored to ensure that their staff is composed of qualified professionals and that they are providing mandated levels of rehabilitation care.
- Private facilities, which often provide a higher quality of treatment for alcoholism, and are more often covered by private health insurance. They have a staff that is available around the clock to attend to the needs. Many of these facilities provide healthy alternatives to alcohol use, such as sports, nature trails, horseback riding, or other group activities. Some are truly luxurious, with food and accommodations that rival 4- and 5-star resorts. Naturally, these types of rehab facilities cost more, but if an individual has a private health insurance that was purchased through the Healthcare Marketplace (Obamacare), chances are it will completely cover treatment of alcohol addiction.
Both types of centers offer fulltime inpatient rehab services, outpatient services, and partial hospitalization. Partial hospitalization services include a range of intensive and structured activities for people with alcoholism, including behavioral treatment and medication management, for at least 20 hours per week based on an individualized treatment plan.
In some states, a third option is possible, non-profit treatment. These inpatient alcohol rehab centers charge either no fees or lower fees than private centers, but they may have long waiting lists, and one may have to undergo some kind of assessment to make sure a person qualifies for their programs.
What Happens in an Alcohol Inpatient Rehab Center?
Although individual treatment regimens vary from center to center, an individual can expect the following when they check in for a period of inpatient alcohol treatment:
- Initial examination. Because a patient’s health is the facility’s #1 priority, they will receive a full physical and psychological examination. This will help the doctors and counselors design a treatment program that is tailored to the person’s needs and that gives them the highest likelihood of success.
- Detox. Unless an individual has gone through a detox program immediately prior to checking in, the first week of the stay in a residential alcohol treatment center will probably involve a period of medically-supervised detoxification. This is typically the most difficult part of recovery because the body has to deal with the physiological effects of stopping alcohol use. These effects can sometimes be unpleasant, so if necessary they are managed with the help of medications administered by physicians experienced in recovery.
- Sleeping arrangements depend on the facility and its specific approach. Some inpatient alcohol rehab centers require patients to have roommates to avoid feelings of isolation; others offer private rooms.
- Eating arrangements may similarly vary. Some facilities have group sit-down meals, and in others, patients have kitchens where they can prepare their foods. Be sure to let the staff know about any special nutritional needs one may have.
- Relationships – In most in-house alcohol treatment centers, relationships between patients are not encouraged, and may be forbidden. This is to ensure that the primary focus remains on recovery.
- Access to phones and email may be restricted in some facilities. In others, especially those providing treatment options longer than 30 days, individual computers and phones may be allowed.
- Contact with friends and family. Some facilities may advise not staying in constant contact with friends and relatives during inpatient treatment, especially if they may trigger relapses. However, other facilities allow and encourage family members to play an active role in the recovery process.
Types of Therapy
Depending on the facility and the treatment plan, individual counseling and therapies will be provided, which can include:
- One-one-one individual therapy/counseling
- Group therapy
- Family therapy
- Cognitive behavioral therapy to eliminate destructive patterns
- Introduction to follow-up care, in which an individual is introduced to programs one can continue with after the in-house treatment is complete.
These programs increase the chances of successful rehabilitation when the patients leave the inpatient alcohol treatment center and transition back to “life in the real world.”
How to Choose the Best Alcohol Residential Treatment?
If an individual has weighed the options between outpatient and inpatient care and decided that inpatient treatment for alcoholism is the best choice, the next step is to choose where to get that treatment. It is important to not make a rushed decision when choosing an inpatient alcohol rehab option, because the more comfortable a person is with the program they choose, the better it will work for them.
It is better t do the homework and investigate several different rehab options, especially for private treatment. Think of this as similar to choosing a college, and use the opportunity to ask a number of important questions. For example:
- Always ask about accreditation. Are all staff (and the facility itself) licensed and accredited on a state or national level? Most important, does the center itself specialize in alcohol treatment? (If it does NOT, consider other options.)
- Ask for a list of therapies and treatments provided. Make sure they treat both the physical and the psychological aspects of alcohol addiction. Ask the facility to send a sample treatment plan, in writing.
- Ask how long a stay they recommend. The most common length of stay at inpatient alcohol rehabilitation centers is 28 days, but in some cases, a longer stay can increase the chances of achieving sobriety.
- Ask what the goal of the program is. Different treatment programs have different goals of their own; make sure the facility’s goal is the same as the individual’s.
- Ask about relapse rates. If the facility cannot supply them for patients who have completed their recovery program, or if they seem reluctant about discussing them, keep looking. Ask what they do to relapses.
- Do they offer family services and ongoing support groups? These programs can greatly increase the chances of recovery after the individual returns home.
- Make sure one can afford the care they offer. For example, a person wants to ensure that the insurance covers all or most of the treatment. Be sure to ask about copays and other costs.
- Ask about amenities that are important to the individual. For example, availability of gyms or sports facilities, horseback riding, luxurious grounds, chef-made meals, etc. This may seem unimportant now, but how comfortable the person is at the facility can be a huge boost to the chances of making it successful.
- If possible, visit the facility. An individual is, after all, going to spend some time there, so they should get to know it and make sure they will be happy there.