When most people think about drug rehab, they picture inpatient rehabilitation facilities. However, there are a lot of misconceptions about what inpatient rehab is and how it differs from other rehab facilities. It is imperative that patients fully understand inpatient rehab centers before they select a facility for treatment.
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What Is Inpatient Rehab?
Inpatient rehab treatment is considered the most intensive form of rehab. Inpatient rehabilitation facilities allow the patients to live on-site while receiving concentrated therapy targeted to their needs. They are often inpatient dual diagnosis 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 length and are somewhat clinical in their setting.
Inpatient vs. Residential Rehab
It is common for people to use inpatient 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 rehab for getting physically stabilized. Once physically well after women-only drug facility, she could transition to a residential facility, leaving once she feels mentally prepared to stay sober in the outside world.
Inpatient Rehabilitation Program
With this understanding of the differences in mind, potential patients will most likely want to know what inpatient rehab looks like. As is the case with all forms of rehab, this varies between facilities. For example, VA inpatient rehab will not be like inpatient rehab 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 medical history of the patient, 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 any other diagnostics the facility feels is 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 it, move on to the therapies needed to stabilize them and get them into a better headspace for recovery, and finish with what the next steps will be after inpatient treatment is completed — this could be stepping down into another form of rehab or it could be transitioning into aftercare.
Because inpatient rehabilitation facilities tend to focus on more traditional approaches, their therapy offerings are generally more limited than residential 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 that fuel substance abuse.
- Motivational Interviewing: The therapist guides the patient in their exploration of why they feel motivated to change their behaviors.
- 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.
Because all inpatient rehabs for substance abuse are free to design their own programs, it is possible that a facility will offer additional programs, such as physical therapy, animal therapy, music therapy, and more. However, these should not be expected when looking at inpatient facilities.
Length Of Inpatient Treatment
The duration of inpatient drug 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 drug rehab for lesser addictions or before transitioning into another type of facility
- 90-day inpatient rehab 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
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 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 Rehab Statistics
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 treatment 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 treatment needs to either be lengthier than the typical 30 days or it 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, inpatient rehab, and all forms of rehab, are actually quite successful.
Cost Of Inpatient Rehab
The cost of inpatient rehab 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 rehab cost comes down to the facility selected, insurance coverage, and access to grants and other funding.
Inpatient Rehab Without Insurance
Most basic inpatient rehab 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 Rehab
Inpatient drug rehab 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 drug rehab coverage is similar. The provider the patient uses must approve the treatment and the care must be given at an inpatient drug rehab 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.
- Greenfield L, Burgdorf K, Chen X, Porowski A, Roberts T, Herrell J. Effectiveness of long-term residential substance abuse treatment for women: findings from three national studies. American Journal of Drug and Alcohol Abuse. 2004; 30(3): 537-50. https://www.ncbi.nlm.nih.gov/pubmed/15540492.
- Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. 2018. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment.