When most people think about drug rehab, they picture inpatient rehabilitation facilities. However, there are many misconceptions about inpatient rehab and how it differs from other rehab facilities. Therefore, it is imperative that patients fully understand inpatient rehab centers before selecting a facility for inpatient substance abuse treatment.
What Is Inpatient Rehab?
Inpatient rehab treatment is considered the most intensive form of rehab. Inpatient rehab facilities allow the patients to live on-site while receiving concentrated therapy targeted to their needs. They are often dual diagnosis inpatient treatment centers, which means they treat both the disease of addiction and co-occurring disorders that might fuel that condition. These dual diagnosis rehab centers tend to offer set programs defined by a length and are somewhat clinical in their setting.
Since addiction is a disease that affects the body, mind, and spirit, inpatient treatment centers usually adopt a holistic approach to treatment. Several professionals such as physicians, nurses, psychiatrists, psychologists, addiction counselors, family therapists, nutritionists, fitness specialists, case managers, and other therapists work together to help the client fight against addiction. Such inpatient programs offer the highest level of treatment and care, including medically supervised detox and other treatment options. The levels of stay are different for each client depending on their cases and requirements.
Inpatient rehab facilities also offer unique accommodations and many other amenities based on their overall structure and campuses.
Principles Of Effective Addiction Treatment
According to the National Institute on Drug Abuse, there are certain principles that effective addiction treatment should adhere to. These include the following:
- Addiction is a disease that affects brain function and behaviors, but it is treatable.
- There is no one addiction treatment for everyone; treatment has to be tailored to each individual’s unique requirements.
- Treatment should be made readily available to improve positive outcomes.
- Effective treatment strategy involves treating the addiction problem and addressing the underlying causes and triggers of addiction.
- Remaining in treatment for an adequate period is essential for better recovery rates and relapse prevention.
- Behavioral therapies such as individual therapy and group therapy should be added to the treatment plan to make treatment successful.
- Medication-assisted treatment is essential for certain patients, along with concurrent behavioral therapies and counseling.
- A patient’s treatment plan should be continually assessed and adapted to ensure that the best possible treatment is offered according to the client’s changing needs.
- Patients of addiction should be assessed for co-occurring disorders since many drug addicts also have mental health disorders.
- Involuntary treatment is also as effective as voluntary treatment.
- During treatment, patients should be closely monitored to check for any drug use to prevent lapses.
- Inpatient treatment centers should test patients for infectious diseases and link them to proper treatment if tested positive.
What Does Inpatient Rehabilitation Program Include?
An inpatient rehabilitation program is a residential treatment program where clients stay for different durations for their addiction and mental disorders treatment. They leave the center only after the completion of their treatment. Inpatient rehab is different from outpatient treatment programs in which clients only come to the treatment center for a few hours for their therapies and counseling sessions. With this understanding of the differences in mind, potential patients will most likely want to know what an inpatient center looks like. As is the case with all forms of rehab, this varies between facilities. For example, VA inpatient care will not be like inpatient rehab for drugs from a private clinic. However, VA drug rehabilitation has some commonalities, too.
Course Of Treatment
The course of treatment at an inpatient drug rehab center begins with the patient assessment, also commonly referred to as intake. At this time, the staff will go over the patient’s medical history, learn about the substances they are abusing, and work to determine if there are any co-occurring disorders present. This step can include surveys, blood and urine testing, psychological interviewing, and other diagnostics the facility feels are needed.
Once the assessment is complete, the rehab staff will create a treatment plan. This plan will start with detox and withdrawal management if the patient requires these therapies to stabilize and move into a better headspace for recovery. The next steps will be after the inpatient detox program is completed — this could be stepping down into another form of rehab therapies or transitioning into aftercare.
Because inpatient rehab for drugs facilities tends to focus on more traditional approaches, their therapy offerings are generally more limited than inpatient treatment centers.
Common approaches include:
- Evidence-Based Psychotherapy: This is the type of therapy most people picture when thinking about psychologists. It is commonly called talk therapy.
- Cognitive-Behavioral Therapy: This is individual therapy where the therapist focuses on challenging cognitive distortions fuel substance abuse.
- Dialectical Behavioral Therapy: This is a form of cognitive therapy where clients learn new skills to effectively manage their emotions.
- Motivational Interviewing: The therapist guides the patient in exploring why they feel motivated to change their behaviors.
- Acceptance Commitment Therapy: Clients are taught to accept certain unpleasant thoughts and emotions and move on in this therapy.
- Motivational Enhancement Therapy: This builds on motivational interviewing by giving direct feedback to the patient on how to enhance or strengthen their motivations to remain clean.
- Medication Management: Pharmaceuticals are used to either replace the drug of addiction or to curb cravings. In some cases, multiple medications are used to both replace the substance abuse and curb cravings simultaneously.
- Recreational Therapy: Inpatient drug rehab offers several amenities and recreational therapies to patients to improve their physical and mental health. This includes yoga, meditation, sports, recreation, music, arts, equine therapy, and other holistic therapies.
- Individual, Family, and Group Therapy: These individual and group counseling sessions help patients to better communicate with the therapist, which aids in their treatment.
- Interpersonal Therapy: Interpersonal therapy focuses on gaining insight into the patient’s pattern of past and present relationships and using them to help the client transfer newly learned interpersonal patterns to other relationships outside of therapy.
- 12-Step Facilitation: In this approach, the body, mind, and spirit of the patient are treated as a whole based on the 12 steps of Alcoholics Anonymous.
Because all inpatient rehabs for substance abuse are free to design their own programs, a facility may offer additional programs, such as physical therapy, animal therapy, music therapy, and more. However, these should not be expected when looking at inpatient facilities.
Specialized Inpatient Drug Rehab Programs
Since each person is different with individual and unique needs, addiction treatment programs should be tailored to each patient’s specific needs. Usually, inpatient centers offer specialized programs for specific groups of people, so the treatment programs and therapies can be tailored accordingly.
Some of these specialized rehab programs include:
- Patients who have relapsed
- Patients with a history of trauma
- First responders
- Older adults
- Christian Bible-based:
- LGBTQ+ community:
Length Of Inpatient Rehab Treatment
The duration of inpatient rehab is not universal. Every facility will offer different programs, each with its own length. Typical durations are as follows:
- One week or less short-term inpatient drug rehab for withdrawal management and detoxification before transitioning to another type of facility
- 30-day inpatient rehab program for lesser addictions or before transitioning into another type of facility
- 90-day inpatient rehabilitation for more severe addictions that require significant physical stabilization and medication management, which can then allow the patient to transition to another facility or return home
Typical lengths of stay and the intensity of programs are detailed below:
|Inpatient Program||Length Of Stay||Intensity Of Program|
|Medical Detox||3-7 days||24-hour monitoring|
|Inpatient Treatment||30-90 days||24 hours a day, 7 days a week|
|Partial Hospital Program||2 to 4 weeks||3-5 days a week, 4 to 6 hours a day|
|Intensive outpatient program||4 to 6 weeks||3 to 5 days a week, 3 to 4 hours a day|
|Outpatient/ Aftercare Program||As needed||1 to 2 days a week|
Inpatient Substance Abuse Treatment Schedule
The schedule of a typical day in one of these rehab facilities depends on the needs of the patient, where they are in their recovery, and the choices of the facility.
An example of what a patient might experience is as follows:
|8:00 A.M.||Wake up and get ready for the day|
|8:30 A.M.||Eat breakfast with other residents|
|9:30 A.M.||Have an individual counseling session|
|11:00 A.M.||Engage in group therapy|
|12:00 P.M.||Eat lunch with other residents|
|2:00 P.M.||Supervised free time|
|3:00 P.M.||Have an individual counseling session or meeting with a medical doctor|
|4:00 P.M.||Focus on fitness|
|6:00 P.M.||Eat dinner with other residents|
|8:00 P.M.||Have a group discussion|
|9:00 P.M.||Supervised free time|
|10:00 P.M.||Lights out|
It is a good idea for patients to ask a facility what their daily rehab schedule will look like prior to enrolling in the program.
Benefits Of Inpatient Rehab Treatment
Whether a patient is considering inpatient drug rehab for teenagers, men, or just a general facility, there are certain benefits that are universal. These include:
- Medical Support: Getting clean from drugs can cause significant stress on the body that, without medical support, can turn deadly.
- Structure: When trying to make a significant life change, having a rigid structure can make it much easier.
- Nutritional Help: When patients arrive at the facility, they tend to have been living in a universally unhealthy manner. Nutritional staff ensures the patient eats detoxifying foods and also learns about healthy eating.
- Community: Through group therapy sessions and living with fellow recovering people with substance use disorder, patients are able to establish a new community that understands and supports them in their journey.
- Continuous Support: Patients are able to reach out for help at all hours of the day and night and are fully supervised to ensure they are not making harmful decisions.
- Controlled Environment: Inside an inpatient center, there is no access to drugs and alcohol, and the triggers for use are mostly or fully eliminated, giving the patient a safe place to start their journey.
- Self-Focus: Because the patient is removed from daily life, their stressors and responsibilities outside of their recovery are gone. This allows them to truly focus on themselves and their needs, making it more likely that they will get to the root of their addiction.
While these benefits are numerous, this does not mean that inpatient treatment is ideal for all patients, nor does it mean that it is the only rehab a person will require. However, it should be considered.
Inpatient Rehabilitation Success Rates
While there are clear benefits, patients will no doubt wonder if those translate into success. Sadly, no facility or addiction treatment has a 100 percent success rate, and there is always the chance that a patient will relapse. However, there are indications that starting with inpatient rehab centers yields the best results.
The highest success rates for drug addiction recovery are seen by rehabs that combine medical treatment with mental health therapies — which is what inpatient rehabs do. However, statistics indicate that shorter stays result in poorer outcomes, meaning that inpatient rehab needs to either be lengthier than the typical 30 days or must be followed by a treatment at a residential facility.
No matter what program is chosen, drug rehab has a relapse rate between 40 and 60 percent. This can sound disheartening, but the truth is that it is more effective than treatments for conditions such as hypertension and asthma and only slightly less effective than therapies for diabetes. In other words, if addiction is merely looked at as a medical condition, residential rehab and all forms of rehab are actually quite successful.
A recent study was carried out on two groups of clients where one group had greater severity of alcohol and drug abuse problems, and they were provided with the full continuum of care in residential rehab. On the other hand, the other group had relatively lesser severity of addiction issues, and they were offered the partial continuum of care. Outcome analysis after 3 and 9 months indicated that the residential rehab group showed greater improvements in alcohol, drug, and psychiatric problems severity as compared to the other group.
Another study about the effectiveness of the length of residential rehab suggested that the duration of continuing care should ideally be between 3 and 6 months to ensure better sobriety success rates. In some cases, the length may be extended up to 12 months, depending on the individuals’ case and requirements.
According to this report by the National Institute on Drug Abuse, participation of drug addicts in inpatient treatment programs that are less than 90 days is of limited effectiveness, whereas treatment lasting significantly longer is recommended for maintaining positive outcomes.
Factors To Consider While Choosing An Inpatient Treatment Center
Choosing an inpatient treatment center for oneself or a loved one can be an overwhelming task with so many things to look out for. However, there are certain factors which one needs to consider in order to be sure whether that facility suits them or not. Some of these factors are discussed below:
- One of the main factors to consider is the level of comfort that the center provides. If the client feels relaxed and calm, he/she would better be able to focus on their recovery and commit to it. It is important that the accommodations be comfortable, the staff be caring and forthcoming, and the facility be gender-specific if that is the client’s requirement.
- Another important factor is that the treatment center should be experienced and licensed experts in their fields. This means that the center should be accredited, and the staff members should hold active licenses in their respective areas of practice. The team of professionals at the center should be able to provide the care and support to motivate the client to continue on the path to recovery.
- The location of the treatment center also plays a pivotal role in choosing a particular center. Sometimes, one wants a local service, whereas, at other times, one would want to be at a distance away from their usual environment and triggers.
- The treatment center should be able to offer a broad range of evidence-based and holistic treatment services so that not only is the patient treated physically, but their underlying issues and triggers are also addressed. This means providing the required education and skills to stay adamant on recovery as well as providing the required support through individual, family, and group counseling to address mental health also.
- Another important factor to consider is the type of follow-up and aftercare support that the center provides. If the center is unable to transition its clients to continued care, then the treatment is less likely to be beneficial.
- Another important factor is the cost of treatment and whether they accept insurance or not. Some private inpatient treatment facilities might not be affordable by many, so it is an important factor to consider if the cost can be managed by insurance or not.
Inpatient vs. Residential Rehab
It is common for people to use residential rehab and residential rehab interchangeably. This is understandable as the two types of rehab are, in fact, quite similar. However, there are characteristics that set them apart.
|INPATIENT REHAB||RESIDENTIAL REHAB|
|Length of stay is set by program (60 days, 90 days, etc)||Length of stay is open-ended and can be determined by the patient|
|Medical services are wide-ranging||Medical services are more limited|
|The facilities are more clinical in nature||The facilities are more home-like|
|More traditional therapies are used||A holistic approach is taken|
|Supervision is intense, with patients monitored 24 hours a day||Patients are not closely monitored and may even be allowed to leave the facilities during the day|
|Places the greatest emphasis on stabilizing the patient||Places the greatest emphasis on the mindset of the patient|
|Less likely to offer luxury accommodations||Often offers luxury accommodations|
Many patients will start with one and then step down to the other. For example, a female patient might need women’s inpatient treatment to get physically stabilized. Once physically well after a women-only drug facility, she could transition to a residential facility, leaving once she feels mentally prepared to stay sober in the outside world.
Cost Of Inpatient Treatment At A Rehab Center
The cost of inpatient treatment varies significantly across facilities. For example, many Christian rehabs are free of cost or offer sliding-scale fees. On the other end of the spectrum, private luxury clinics can charge upwards of $10,000 for a month of care. Inpatient drug treatment cost comes down to the facility selected, insurance coverage, and access to grants and other funding.
Inpatient Treatment Center Without Insurance
Most basic inpatient treatment programs cost about $5,000 for a 30-day program. For someone who is paying without insurance, this might be adjusted by the facility to make it more affordable. It is important that patients who are paying for the full or partial cost of treatment get a detailed explanation of the costs prior to enrollment.
Why this is so important is that it is possible that the rehab facility will quote a price that is strictly for the bed, food, and standard therapies. However, additional fees could be tacked on for things like medication, special diets, private rooms, detoxification, and more. It is vital that patients get a detailed breakdown of inpatient substance abuse treatment costs, so they are not caught off guard.
Insurance Coverage For Inpatient Treatment
Inpatient drug treatment may or may not be covered by insurance. The Affordable Healthcare Act mandates that insurance companies, both public and private, make drug rehab part of their basic healthcare coverage. However, it does not specify that inpatient care must be covered—just drug rehab in general. With that said, people with private insurance, for the time being, should be covered in part or in full for at least some form of rehab, even if it is not inpatient.
Medicare inpatient rehabilitation coverage does exist; it is covered under Medicare Part A. To be eligible, the patient must meet the Medicare guidelines for inpatient rehabilitation.
They are as follows:
- The provider must deem that the services are medically necessary
- The patient must receive care at a Medicare-approved facility
- The provider must set up a plan of care
Medicaid inpatient treatment coverage is similar. The provider the patient uses must approve the treatment, and the care must be given at an inpatient treatment center that accepts Medicaid.
For patients unable to pay out of pocket and who do not have insurance coverage, there are free inpatient drug rehabs as well as those who use sliding scale fees. These may be private drug centers or state-funded rehab facilities. Other options include sponsorship by a person, charity, or other organization and applying for grants.
Stopping Substance Abuse Through Rehab
No matter the needs or budget of a patient, there is a rehab facility that will work for them. Whether this is inpatient, outpatient, or something else completely, what matters is getting treated. Those suffering from addiction should seek help before it is too late.
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- Greenfield, L., Burgdorf, K., Chen, X., Porowski, A., Roberts, T., & Herrell, J. (2004). Effectiveness of long‐term residential substance abuse treatment for women: findings from three national studies. The American journal of drug and alcohol abuse, 30(3), 537-550. https://www.ncbi.nlm.nih.gov/pubmed/15540492.
- How effective is drug addiction treatment? | National Institute on Drug Abuse. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment.
- Principles of Drug Addiction Treatment: A Research-Based Guide. Drugabuse.gov. (2018). https://www.drugabuse.gov/download/675/principles-drug-addiction-treatment-research-based-guide-third-edition.pdf?v=74dad603627bab89b93193918330c223.
- McKay, J. R. (2009). Continuing care research: What we have learned and where we are going. Journal of substance abuse treatment, 36(2), 131-145. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670779/
- Proctor, S. L., & Herschman, P. L. (2014). The continuing care model of substance use treatment: What works, and when is "enough," "enough?". Psychiatry journal, 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007701/
- How long does drug addiction treatment usually last? | National Institute on Drug Abuse. National Institute on Drug Abuse. Retrieved 26 September 2021, from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment-usually-last.
- Goka, R. S., & Arakaki, A. H. (1991). Centers of excellence: choosing the appropriate rehabilitation center. Journal of insurance medicine (New York, NY), 23(1), 66-69. https://pubmed.ncbi.nlm.nih.gov/10148471/