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What is Inpatient Treatment?
Inpatient treatment for addiction is often referred to as detoxification or ‘detox.’ This is usually the first, and most vital, step in the addiction recovery process. Many patients avoid or delay seeking treatment for addiction due to fear of the painful withdrawal process. This is why a medically managed inpatient detox stay is so important.
An inpatient facility will medically manage the severe and possibly dangerous withdrawal symptoms that come with drug or alcohol cessation. Medically managed detox protocols also usually involve the use of certain medications to:
- Reduce withdrawal symptoms
- Stabilize the patient
- Make withdrawal less uncomfortable
Short-Term vs. Long-Term Inpatient Treatment
Inpatient treatment is available on a long- and short-term basis, but short-term programs are most often associated with inpatient treatment. Short-term inpatient treatment is an intense but brief program based on a modified 12-step approach.
Originally, residential treatment models included a three- to six-week hospital-based inpatient treatment phase. This was followed by extended outpatient therapy and/or participation in a group program, such as Alcoholics Anonymous (AA).
Long-term in-patient treatment programs, on the other hand, are residential programs. They provide round-the-clock care, generally in non-hospital settings. The best-known residential treatment model is the therapeutic community (TC). Most patients spend between 6 and 12 months in these types of facilities.
What Conditions Do Inpatient Rehab Centers Treat?
Inpatient rehab treats severe drug and alcohol addictions, as well as acute psychiatric disorders. Some patients are dealing with a combination of co-occurring conditions.
Inpatient rehab for detox includes a medically assisted detoxification process. This means their bodies adjust to withdraw from a substance under medical supervision. Medical professionals monitor their condition and intervene if a problem occurs.
Inpatient treatment is for detox and the management of mental health disorders that co-occur with substance use disorder (SUD), previously called addiction.
Generally, admission criteria for inpatient hospitalization due to psychiatric crises are quite strict. The patient must be a danger to themselves or others or be experiencing a psychotic break, i.e., mania, paranoid delusions, or unmanaged schizophrenia, with command hallucinations.
How Long is Inpatient Treatment?
The average detox process for severe substance abuse requires three to seven days of medically managed detoxification, in an inpatient facility. Depending on which withdrawal symptoms and substance being abused, the attending physician will prescribe medication-assisted treatment to manage cravings, and reduce physical withdrawal symptoms.
The length of stay is also dependent on any presenting psychiatric complications, which are concurrent with the substance use disorder.
Patients are sometimes committed to a ‘psychiatric hold’ for 72 hours, due to a suicide attempt, gesture, or suicidal ideation. The patient’s local jurisdiction, along with the attending physician in the inpatient treatment center, determine if they need a court order to commit the patient for a longer period, based upon whether they are still a danger to themselves.
Discharge from inpatient treatment occurs once a patient completes detox or is no longer a danger to themselves or others.
What Happens During Inpatient Treatment?
There are five main steps of inpatient rehabilitation to treat substance use disorders (SUD):
Preparing for Treatment
Treatment begins with a medical evaluation. Immediate issues are addressed before a patient moves forward with care.
Completing a detox stay does not mean that a patient is free or ‘cured’ of their addiction. Many patients relapse immediately after discharging from detox. This doesn’t mean inpatient treatment isn’t worth the investment, though.
Inpatient detoxes, as well as psychiatric inpatient stays, involve some therapeutic programming and a safe place to be medically monitored.
During treatment, patients work alone, one-on-one with therapists, and with groups to address their substance use disorder (SUD). Different therapy types are used based on the patient's specific needs.
This consists of group therapy, usually several times per day, spanning different topics. These therapy sessions might include:
- Substance use programming
- Therapeutic processing groups
- Experiential therapy
- Family therapy
- Skill-building therapy
Patients also meet one-on-one with a therapist to create a treatment plan and step-down plan. The step-down plan determines what comes next, in terms of therapy, once the patient discharges from the psychiatric inpatient unit.
Aftercare varies from patient-to-patient. It also sometimes includes relapse prevention planning. Patients might participate in an outpatient program, such as the 12-step program. Participating in support groups and spending time with family members or loved ones to help maintain sobriety is also recommended.
Statistics & Effectiveness of Treatment
The effectiveness of inpatient programs varies a great deal from patient to patient. For example, one study showed that the homeless population tends to prefer residential programs, which provide a place to live. Similarly, clinicians might refer clients with psychiatric comorbidities to inpatient settings where psychiatric treatment is more readily available.
Other factors also play a role in the effectiveness of various treatment arrangements. A person’s age, circumstances in life, gender, and socio-economic status are also factors.
There appear to be no statistically significant differences between inpatient treatment and other options, but patients with fewer psychiatric comorbidities and less heavy substance use are more likely to reduce their substance use after inpatient treatment participation compared with outpatient drug-free settings.
Data also showed a statistically significant difference in the reduction of use when comparing inpatient, detox, and medication-assisted modalities, but the findings were inconsistent.
Inpatient vs Outpatient Treatment
Inpatient treatment and outpatient treatment have similarities and differences. Many recovery plans begin with inpatient treatment and transition to outpatient as a patient progresses. Inpatient treatment might only be necessary during the detoxification phase of the recovery process.
The primary benefits of inpatient treatment a compared to outpatient treatment include:
- Living arrangements of the patient – inpatient treatment is onsite at a rehabilitation facility
- Comprehensive – inpatient treatment is round-the-clock and provides immediate, ongoing access to a variety of therapies all in one location
- Supervision – inpatients are supervised 24 hours a day
The downside of inpatient treatment is that it is cost-prohibitive to many people. Insurance might cover treatment, but not deem inpatient programs necessary.
When To Seek Treatment
Substance use disorder (SUD) is a chronic disease. This means that even if a person stops using drugs or alcohol for a few days or weeks, or even months, he or she is not cured. Most patients need long-term or repeated care to remain sober.
A person should seek treatment if he or she is ready to:
- Stop using drugs
- Remain drug-free
- Be productive in the family, at work, and in society
Loved ones should encourage someone to seek treatment if:
- Drug or alcohol abuse has interfered with quality of life
- Secondary medical issues have arisen due to drug or alcohol use
- Drug and alcohol have affected personal relationships or interfered with employment or school
- They notice other symptoms of addiction
How Much Does Intensive Inpatient Treatment Cost?
Whether attending an inpatient facility for drug or alcohol rehab, the cost of treatment depends on the location and the length of the program. On average, inpatient treatment can range anywhere between $6,000 (30 days) and $60,000 (60- and 90-days).
There are several ways to pay for treatment as well, including insurance, payment assistance/payment plans, and grants.Sources: