The Pros and Cons of Inpatient and Outpatient Rehab

Giving up drugs or alcohol is rarely a simple matter of choice. Many people who are struggling with habitual substance abuse are also dependant on the substance they are using. This means that their bodies or their minds – frequently, both – have become so accustomed to the substance that it has become a necessary means of survival. Once they have reached this point of tolerance, even the most well-intentioned and determined alcohol or drug addicts cannot just decide to set down the vodka, the cocaine, or the prescription opioids and not pick them up again.

For most addicts, quitting means unbearable cravings, withdrawal symptoms that are frightening, uncomfortable, and sometimes dangerous, and perhaps most difficult of all, the need to learn how to cope with the stresses of the world without picking up a bottle, a syringe or a pill.

• Getting through the worst of the withdrawal symptoms safely and with as little discomfort as possible
• Delving into some of the issues that lie beneath the addiction, and either resolving them or learning better ways to manage them
• Mending relationships with loved ones that were damaged either before or during the period of addiction
• Learning life skills and coping techniques that will allow the addict to navigate stressful life events without resorting to drug or alcohol abuse
• Receiving care for coexisting mental illnesses or addictions to multiple substances
• Learning how to keep the body healthy through nutrition and exercise, both during the rehab phase and on an ongoing basis

Rehab facilities and treatment programs exist so that recovering addicts can accomplish several things, including the following:

But just as there are different medications, therapies and treatments for other physical and mental illnesses, there are different kinds of addiction treatment. The one you select depends on your unique set of needs and circumstances.

Rehab is broadly split into two categories: inpatient rehab and outpatient addiction treatment.

Inpatient Rehab

If you enter an inpatient rehab program, you are a resident of the facility for the duration of the treatment. You are given a place to sleep, all of your meals, and some recreational amenities and activities in addition to your appointments with therapists and doctors. One of the biggest benefits to this approach is that you receive round-the-clock care and support, and there is no possibility of relapse during your phase of rehab.

What are the facilities like?

This varies widely from one rehab centre to the next, and this is largely reflected in the cost. Some rehab centres offer basic shared accommodations and canteen-style meals, while others provide luxurious private living quarters and meals prepared by a chef.

Most rehab centres, regardless how basic or luxurious they are, have some features in common. These include the following:

• They recognize that nutrition is a serious concern for many recovering substance abusers, so the meals they provide are balanced and healthy
• They provide a means for their residents to get physical exercise, such as a gym or indoor walking track
• They are designed to be residential facilities rather than hospitals
• They provide some form of recreation, such as movie screenings, games rooms or sporting activities

Are residents allowed to take personal belongings with them?

Although all facilities have restrictions on what their clients can take, some personal effects are not only permitted, but encouraged. We all have some personal items that comfort us, such as favourite books, photographs of loved ones or artists’ supplies.

Some items that may be prohibited include:

• Cell phones, tablets and other electronics
• Drugs or alcohol of any description
• Books or magazines that encourage or glorify substance abuse
• Items of clothing with offensive or discriminatory text, logos or pictures
• Dangerous items, such as blades or firearms

What about medication or medical equipment?

All treatment centres allow prescription medication that is used for specific medical purposes, and that is not detrimental to recovery. Facilities have varying rules surrounding the storage and dispensation of prescription medication.

Clients can bring medical equipment that is needed for their day to day health. Service animals are permitted in all parts of Canada and the United States, but the rules about what documentation should accompany them depends on your state or province.

What happens during inpatient rehab?

In most rehabilitation centres, your treatment program depends on a number of factors, including the following:

• The substance you are addicted to, and the duration of your addiction
• Whether you need to undergo medical detox
• Whether you have coexisting physical or mental illnesses that could impact your recovery
• Whether you have a history of trauma or abuse, either witnessed or experienced
• The health of your relationships with your loved ones
• Whether you are experiencing any stressful life events, such as bereavement or lob loss

The specific therapeutic methods offered vary greatly from one inpatient rehab facility to the next. Some examples of therapies and services that might be offered include:

• Cognitive behavioural therapy
• Individual counselling
• Group therapy
• Family therapy
• Life coaching
• Meditation and/or mindfulness training
• Goal setting and/or time management training
• Nutrition training
• Group or individual fitness training
• Job skills training
• Creative therapies, such as dance, music and art
• Education workshops and seminars
• Team building activities

How much does inpatient rehab cost?

The cost of inpatient treatment depends on the the facilities and amenities offered, the length of your stay, and the therapies provided. While the cost of rehab quoted to you may seem high, it is important to remember that it includes all of your therapy, counselling and medical care, as well as your meals, accommodation and amenities.

If you feel that inpatient rehabilitation is the right option for you, but you fear that you may not be able to afford it, find out if you can cover some of the cost with your medical insurance or through employer payments. Additionally, some rehabilitation centres offer flexible payment terms.

What are the benefits of inpatient treatment?

People sometimes resist inpatient treatment programs because they worry about the disruption to their lives. However, this option has many benefits, including the following:

• The early days of withdrawal and recovery can be fraught with intense cravings. In the safety of a treatment facility, you will not be able to give in to cravings, and you will receive compassionate support during those moments of weakness or frustration.
• Withdrawal symptoms can be frightening and intense, and in some cases, they can put your health or safety at risk. Many inpatient rehab facilities offer medical detox to keep you safe and comfortable during this process.
• When you undertake a drug rehabilitation treatment program, you are essentially deciding to take your life back. This is an intense and emotional experience that can be made easier if you are removed from the stresses of everyday life.
• Being in an inpatient program can also benefit your loved ones, who may need time by themselves to work through the emotional tolls of damaged relationships, while at the same time working with you and your therapists to mend those relationships during family counselling sessions.
• An inpatient rehab facility gives you round the clock support and care, as well as the ability to talk to people who have a first-hand understanding of the challenges of addiction.

Outpatient Rehabilitation

Although inpatient treatment is the ideal choice for almost all people who are trying to recover from substance abuse disorders, it is not a feasible option for everybody.

Outpatient rehab treatment programs provide access to a suite of physical and mental health services while allowing you to continue living at home.

What do outpatient treatment programs include?

Like inpatient options, outpatient treatment plans are customized for the individual, with consideration for several factors, such as the following:

• What substance is the client addicted to, how frequently was the substance being used, and how long has the addiction been going on for?
• How old is the individual, and what is the state of their physical and mental health?
• Is the client taking prescription medications that could impact their recovery?
• What kind of support does the client have with family members and close friends?
• Is the client’s job inherently stressful, how long is the average working day, and is the work schedule set or flexible?
• Has the individual been through rehab before, and if so, how long ago did this happen?

Outpatient rehab services that are offered vary from one program to the next, but may include the following:

• Group therapy: recovering addicts can benefit from interactive sessions that include others who have been through similar experiences or challenges
• Counselling for the addict: most addictions are rooted in context, and by exploring causes such as trauma, abuse or chronic pain, addicts can enhance their recovery and reduce their risk of a relapse
• Counselling for loved ones: family members and close friends can benefit from therapy to help them cope with the impact the addiction had on their lives
• Family counselling: therapy that includes both the addict and loved ones who have been impacted can help mend relationships that were damaged during the period of addiction.

What are the benefits of outpatient rehabilitation?

Some people believe that inpatient rehab is the only effective option, and if they cannot afford this, they will choose to forego rehab entirely and try to overcome the addiction themselves. Other people might tell themselves that this is not the right time for inpatient rehab, so they will go another time.

The reality is that no one should wait to get help. By not going to rehab, you could be at risk of allowing your addiction to get an even firmer hold on you, and for some people, this could prove to be fatal. Even for the most determined people, going it alone can be a challenge.

Studies consistently show that people who go through any kind of rehab program are significantly more likely to succeed in their recovery – and this includes avoiding relapse.

Some benefits of outpatient rehab include the following:

• You can get the help you need without putting your life on hold. You can attend your treatment appointments and still go to work, school and activities
• It is a more affordable option than inpatient rehab, especially for people who do not have medical insurance or the ability to secure employer payments
• The skills and tools that you learn during your outpatient therapy sessions can immediately be put to use in the real world
• You have constant access to your personal support network consisting of family members and close friends
• Like inpatient treatment, your progress is monitored and your treatment plan can be adjusted if needed

So Which One Is Right For Me?

For most people, the more intense inpatient rehab is the most effective option. However, you might be a good candidate for outpatient addiction treatment if the following statements apply:

• You are not at high risk of experiencing intense withdrawal symptoms that could put your health or safety in jeopardy
• You have a solid personal support network
• You can easily avoid people and situations that have been associated with your use of drugs or alcohol
• You can commit to attending all of your outpatient treatment appointments and sessions

Whether you choose inpatient rehab or outpatient addiction treatment, it is important to know that working towards recovery is a full-time job. Your therapists and doctors are there to provide you with help and support, but you will do most of the work yourself.

In addition, regardless of what kind of treatment you select, you are encouraged to ask about addiction aftercare services. Recovery does not end at the moment your rehab is complete: it is a process that can take your whole life. The support provided by an aftercare program can dramatically reduce your risk of relapse and help you through the difficult times.

Photo credit: Portland Prevention. This picture has a Creative Commons attribution license.