Knowing if Outpatient Rehab is Right for You
Choosing the right type of treatment for a substance use disorder is important. One of the biggest choices is between residential and outpatient rehab. There are pros and cons for each, and there are practical considerations like cost and availability, but this is also a personal choice. To make the best decision, learn more about outpatient care, its benefits and its limitations.
What is Outpatient Treatment?
Outpatient rehab is any type of treatment for substance use disorders that does not have a residential component. Those in treatment stay at home, with family, with friends or in some type of sober living housing. They do not stay in the same facility where treatment is given. This is the main difference between outpatient and inpatient care. The services offered are similar, but the time spent on them is less in outpatient care.
Types of Outpatient Rehab
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 38 percent of patients who are admitted treatment facilities enter traditional outpatient programs, while 12 percent choose intensive outpatient programs (IOPs).1 These are the two main types of outpatient programs, and they differ largely in the amount of time spent in treatment.
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A traditional outpatient program may be as limited as simply attending one or two counseling sessions per week or regular support group meetings, while others may include more varied services like alternative therapies, health care and family therapy. IOPs are more involved and include several sessions per week, often for a few hours at a time. An IOP is likely to have a greater variety of services as well, including individual therapy, group counseling, family psychoeducation, skills development and vocational training, relapse prevention, stress management, support groups, medically-assisted treatment and case management.2
Facts about Outpatient Rehab
The SAMHSA collects information about treatment types and outcomes for substance use disorders1,3:
- Outpatient admissions accounted for 49 percent of all admissions to addiction treatment between 2005 and 2015.
- Eleven percent of outpatient admissions included medically-assisted treatment for opioid drugs.
- Only one percent of patients admitted for detox did so in an outpatient program.
- About one half of all outpatient admissions were the result of referrals through the courts system.
- Thirty-seven percent of clients admitted to traditional outpatient treatment completed the programs. Fourteen percent of those admitted were transferred to another type of care, 31 percent dropped out and eight percent were asked to leave.
- For IOPs, 33 percent of admitted clients completed treatment, while 23 percent were transferred, 26 percent dropped out, and nine percent were asked to leave.
- The median length of stay in traditional outpatient care is 90 days, but 129 days for those who completed treatment.
- The median length of stay for IOPs is 56 days and 84 days for those completing their care.
- For both traditional and intensive outpatient care, alcohol is the most common substance of abuse, followed by marijuana and opioids.
Is Inpatient Better Than Outpatient Rehab?
The answer to this question is not perfectly straightforward. There is no single type of treatment that is best for everyone, so for some people outpatient may be more effective, while for others inpatient care is best. According to research, though, the outcomes are similar. One study that reviewed several other studies concluded that the effectiveness of IOPs was similar to that of residential programs. The researchers concluded that outpatient care is an important part of substance use disorder treatment that should be covered by insurance companies.4
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Benefits of Outpatient Rehab
Choosing outpatient programs over residential treatment is often personal and based on what makes you feel most comfortable. There are also some practical considerations that should be accounted for when making this choice. Several benefits of outpatient care make it the right option for a lot of people:
- Outpatient care allows you to stay at home with supportive family or friends.
- Many people feel more comfortable at home, with people they know or alone, than in a facility with strangers.
- Outpatient programs allow for a more flexible schedule, for work, home responsibilities or school.
- Many outpatient programs offer evening and weekend sessions.
- An outpatient program can be a good way to smoothly extend care, providing a transition from residential care to no treatment at all.
- Outpatient care can also provide a gentler transition from no treatment to receiving care.
- Outpatient treatment programs may be less expensive.
When Outpatient Care Isn’t the Best Choice
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While there are these many benefits to choosing outpatient rehab, and the evidence shows that it can be just as effective as residential care, there are some people for whom this is not the best option. For instance, if you have nowhere safe or supportive to live, it may be difficult to stay sober while in outpatient treatment.
A residential facility provides a supportive and safe environment for those who do not have it elsewhere. Even for those who have a sober place to live, resisting the urge to relapse may be too difficult. Someone who has already relapsed more than once may get more benefit from residential treatment. Insurance may also be a consideration. Some plans may cover more residential care than outpatient costs.
The considerations that need to be made when choosing outpatient rehab are important and should not be taken lightly. Any treatment is better than none, but everyone is different and will respond in unique ways to varying types of programs. Learning more about outpatient rehab and what it has to offer will help you make the right choice for you or for someone you care about.
1Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set 2005 – 2015. https://www.samhsa.gov/data/sites/default/files/2015_Treatment_Episode_Data_Set_National/2015_Treatment_Episode_Data_Set_National.pdf
2Substance Abuse and Mental Health Services Administration. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. https://www.ncbi.nlm.nih.gov/books/NBK64094/
3Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set 2012. https://www.samhsa.gov/data/sites/default/files/2012_Treatment_Episode_Data_Set_Discharge/2012_Treatment_Episode_Data_Set_Discharge.pdf
4Psychiatric Services. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152944/
