Do Outpatient Drug Rehab Programs Work?
Around one out of every 10 adults in the United States abused illicit drugs in the month leading up to the 2014 National Survey on Drug Use and Health (NSDUH). Since addiction affects so many different types of people, and at different levels, it is considered to be a personal disease that requires specialized and individual treatment. The National Institute on Drug Abuse (NIDA) reports that there are over 14,500 specialized facilities to treat drug abuse and addiction within the United States.
In general, there are two main forms of drug rehab: outpatient and inpatient programs. Inpatient, or residential, drug rehab programs require that individuals remain on site for the duration of the treatment program. Individuals will live in a specialized facility receiving around-the-clock care and supervision. This type of program is ideal for those battling significant drug dependence, those who also struggle with mental health or medical disorders, individuals who abuse more than one type of drug or mind-altering substance, those who do not have a stable or supportive home environment, and people who have been through a drug rehab program before.
Drugs like opioids and benzodiazepines, as well as alcohol, can cause significant withdrawal symptoms when the substance processes out of the body, even potentially becoming life-threatening. If dependence on one of these substances is present, medical detox followed by an inpatient rehab program is the optimal form of treatment. Inpatient programs provide a high level and standard of care to allow time to heal in a secure, safe, and supportive environment.
Outpatient programs can provide more flexibility than inpatient programs, allowing individuals the opportunity to keep up with work, family, school, or other obligations as needed. When an individual is not as severely dependent on drugs, and therefore may not need the same heightened level of care, outpatient drug rehab programs may be a good option. For example, an outpatient treatment program is good for those who do not require medical detox or 24-hour care and supervision during treatment and who also have a supportive and healthy home environment.
There are several levels of care within outpatient addiction treatment programs, which can afford individuals varying levels of structure and scheduling. Outpatient programs can also be used a step-down level of care from a residential treatment program to transition individuals back into everyday life slowly.
Outpatient programs may be provided in a wide variety of settings, from hospitals to community centers to the offices of treatment providers to specialized drug rehab facilities. Studies, like one published in the journal Substance Abuse, Treatment, Prevention, and Policy, show that outpatient addiction treatment can be just as effective as residential treatment programs. Overall, active participation in an outpatient drug rehab program improves success rates for addiction recovery.
Services Offered in Outpatient Drug Rehab
Just like inpatient drug rehab, the services offered by outpatient drug rehab centers vary from program to program. Generally speaking, many of the same types of services are provided at both inpatient and outpatient drug rehab centers; they just may differ in their intensity, duration, or frequency. For example, both forms of drug rehab can provide detox services to allow the brain time to process drugs safely out of the body; however, medical detox is a more comprehensive form offered primarily on an inpatient basis. Outpatient drug rehab may still include pharmacological tools and medication management as part of a comprehensive treatment plan. Group and individual therapy sessions are typically part of all addiction treatment programs.
Outpatient therapies may include:
- Cognitive Behavioral Therapy (CBT): Individuals will explore how thoughts and behaviors are connected and work to improve negative behavior patterns by modifying the way they think. Coping strategies and relapse prevention are usually addressed during CBT sessions as well.
- Motivational Interviewing (MI): A person-centered and nonjudgmental approach, MI can help people decide to make changes for themselves, and the therapy reduces ambivalence toward treatment and recovery.
- Intensive family systemic therapy: Often accomplished over a weekend, this form of therapy includes the entire family unit in an effort to improve communication and the workings of the family overall.
- Contingency Management (CM): This form of therapy offers small rewards for remaining drug-free as an incentive to remain abstinent.
Additionally, outpatient treatment programs will encourage participation in a 12-Step or peer support group. Support group meetings can facilitate healthy peer interaction and encouragement with a self-help type of model.
Relapse prevention and educational programs are also often part of outpatient drug rehab. Relapse rates for drug addiction are high – between 40 percent and 60 percent, NIDA publishes – so workshops and relapse prevention services that teach coping mechanisms for stress and potential triggers are integral parts of a drug rehab program. Life skills training, anger management workshops, and parenting classes may also be offered through outpatient drug rehab. Childcare and transportation services as well as treatment for co-occurring mental health disorders may be available. Holistic and adjunctive treatment methods may also be offered through outpatient drug rehab. For more information on what a particular rehab facility has to offer, individuals should check with the specific outpatient treatment center.
Types of Outpatient Drug Rehab
Outpatient drug rehab programs may be desirable for those who do not require around-the-clock medical care and attention, and who need the flexibility of being able to work around their existing schedules and obligations. Outpatient programs are often more likely to be covered by insurance, at least partially, and cost less than residential treatment programs.
There are differing levels of outpatient treatment, ranging from intensive to less so. Traditional outpatient services can vary greatly and will depend on each specific treatment facility and the needs of the person seeking treatment. More intensive and structured programs include intensive outpatient programs (IOPs) and partial hospitalization programs (PHP). These programs may be very similar to inpatient drug rehab programs, with the primary difference being that the person returns home each night.
Partial Hospitalization Programs
A PHP is only a small step down from inpatient drug rehab, and it will often provide highly structured programming for 4-6 hours a day, 3-5 days a week. These programs are optimal for individuals who may still require medical monitoring during the day, but are able to return home each night. Families and caregivers should be on board with the treatment plan and be able to provide a stable and supportive home environment.
Intensive Outpatient Program
IOPs typically offer sessions three days a week for approximately three hours at a time. An IOP may start out with more sessions more often and then taper off as a person progresses through rehab. These programs are designed for individuals who still need the structure and intensity of an inpatient treatment program as well as the flexibility of outpatient rehab. Support systems need to be strong and the home environment should be stable for an IOP to be most effective. The journal Psychiatric Services reports that an IOP can be just as effective as an inpatient drug treatment program in most cases.
Outpatient drug rehab may be an initial form of treatment or be offered through a full continuum of care after completing an inpatient care program. Individuals may also progress between levels of outpatient care. Drug screenings and comprehensive assessments should be done prior to admission into any drug rehab program in order to get a better idea on what the best fit may be. With a variety of options available, outpatient drug rehab can greatly facilitate recovery for active participants.