Deciding to attend rehab is a great first step towards long-term recovery, but deciding between inpatient and outpatient can be a difficult choice. Both inpatient and outpatient treatment centers have positives and negatives that need to be considered before making a choice.
Inpatient treatment centers require the patient to stay at the treatment center for an extended period, typically between 30-90 days. Outpatient treatment centers are when the patient goes to the treatment center for a few hours each day, after treatment they can go where they please.Outpatient rehab centers usually start with treatment 4-5 days a week and taper down to one day a week as the patient progresses in their recovery.
Most of the articles written about inpatient and outpatient rehabs are written or sponsored by treatment centers.I have no affiliation with any treatment center. I am writing this solely as a recovering addict who has done extensive research and attended multiple rehabs, both as a patient and as a volunteer.
What Are The Pros and Cons Of Outpatient Rehab?
1. Can Live At Home While Still Attending Treatment
Living at home during treatment can be a huge benefit to many people especially if the patient has kids or a family that is dependent on their support. Trying to find suitable care for kids or pets for 30-90 days if you attend an inpatient can be very difficult and costly. Having the ability to live at home with the family is a huge benefit, as long as the home environment is a good drug and alcohol-free place.
2. Outpatient Is Substantially Cheaper Than Inpatient
Inpatient treatment centers are very expensive. They range in price from $5000-$100,000 for a month’s stay depending on the facility. Insurance should help cover some of the cost, but they don’t cover the whole cost or in many cases even half the cost.
Because they don’t have to pay for food, 24/7 care/supervision, and room & board outpatient centers are substantially cheaper than inpatient treatment centers.
3. Patient’s Can Continue To Attend Work or School
Taking 30 days off of work or school is not reasonable for many people to attend an inpatient treatment center. Outpatient care allows patients to still maintain employment or school.
Depending on the severity of the person’s addiction it may be a good idea to take a break from work or school to focus on recovery.
I needed to focus all my energy on recovery, but many people do better if they can still attend school or work during their treatment. Also, some patients have kids of family members that depend on their income to survive. Continuing to work for some people is necessary.
4. Flexible Hours and Times
Many Outpatient treatment centers offer treatment in the evenings and on weekends to help accommodate the people that still have to go to work or school.
Many outpatient centers have groups on Friday and Saturday nights. This helps people who have to work during the day, but it also gives patients a place to be during two of the most triggering times. Friday and Saturday nights can be a triggering time for addicts and alcoholics. Most of us addicts and alcoholics think about partying and drinking when we think of the weekend. Having a group at 7 pm on Friday is a major benefit of outpatient treatment centers.
5. Have Daily Access To Your Outside Support Network
Many addicts and alcoholics have a great support system of friends and family that are behind them 100% in the sobriety journey. Outpatient treatment allows these patients to go home at night and be with their support network.Although inpatient rehabs allow visits and phone calls it’s not the same as sitting to dinner with your family and kids.
6. Outpatients Have Numerous Levels of Care
Outpatient programs have the flexibility to offer many stages and levels of care over a longer period than inpatient programs. Many inpatients are 28-90 days of intense care then the patient is done.
Outpatient programs can offer treatment 5 days a week for 3 months, then 3 days a week for 2 months, and finally 1 day a week for 1-2 months. This approach helps people stay sober longer and also gradually rebuild their lives while practicing what they learn at treatment.
7. Patients Can Practice What They Learn Immediately
During treatment, patients are taught about coping skills, avoiding triggers, and dealing with drug and alcohol cravings. If the patient has a craving that evening they can put what they learned into effect right away.
“Staying sober at an inpatient rehab is easy, everything is structured and set up for you. There are no tempetations. The true test is when you’re out on the street. I can talk the talk all day at inpatient, but what I do 2 months later when someone offers me coke or I pass the liquor store is the true test”
– RD Recovering Addict and Alcoholic, Peer Recovery Counselor
One specific lesson we had during my outpatient treatment was about learning to say NO. Many of us addicts and alcoholics have a hard time saying NO to people or situations. We need to learn to say No and be comfortable not explaining ourselves.I was able to put this lesson into practice within minutes of leaving treatment for the day.
8. Many Outpatients Offer Family Treatment Days/Sessions
Many of us addicts have family or a significant other that triggers us or is difficult to live with. Outpatient rehabs usually have a therapy day when you can bring the family with you. Your wife/husband, parents, kids, or whoever can come in with you and you can all hash out your issues.
Some inpatients offer this as well but inpatient rehabs, in many cases, are far away from the person’s home, this would require the family to make a long drive.
Cons Of Outpatient Rehab Treatment Centers
1. Up To The Patient To Remain Sober After Treatment Each Day
Depending on the severity of a person’s addiction they may need more care than a few hours a day. When treatment is over for the day patients are free to go.If they don’t have a stable and positive home environment, all those triggers and relapse situations are going to be very hard to avoid.
With the opioid epidemic raging in our communities one relapse can mean death for many people struggling with substance use disorders. Heading out into the world after just a few hours of treatment may not be enough for many people.
2. Less Intensive Treatment/Therapy
Inpatient rehabs offer very intensive treatment for hours a day. Outpatient treatment is typically a few hours a day, a few days a week. This may not be enough treatment for some people. In many of the outpatient groups I attended, we would focus on one or two people who were having a really hard time. This would take valuable treatment time away from all the other patients.
3. Many Patients Court Ordered, Don’t Take It Seriously
Every outpatient I have been to, 4 as a patient, and 6 as an outside volunteer, have patients court-ordered to be there. Courts, parole, and probation can all order people to attend rehab. In many cases the person is mad they were ordered to go to rehab. This can result in a negative environment for everyone.
This is a major issue many rehabs won’t tell you about. Many times people who don’t want to be at rehab and believe they don’t need treatment are still using drugs and alcohol. Of course, people at every rehab are struggling to stay sober. But that is completely different than people who blatantly don’t care and come into rehab with drugs in their pocket.
4. Lacks A Detox Unit/ Place To Medically Detox
Drug and alcohol users have been using these substances daily for years on end. Coming off these substances can be deadly if not done properly.Outpatient treatment centers don’t offer a safe place for the patient to be monitored 24/7 during the first week of their detox and withdrawal.
For me, this approach never worked. I was using heroin and cocaine daily and knew my outpatient was starting on Monday. I was expected to just be a new person the day the rehab started and detox on my own during the first week of treatment. As soon as the withdrawal symptoms started to kick in I would go out and get more high.
5. Daily Life and Daily Distractions May Affect Recovery
Being in an inpatient setting allows the person to put all their effort towards their recovery and long-term sobriety. Daily distractions such as work, kids, spouse, car trouble, or financial problems often take away from recovery in an outpatient setting.
Putting sobriety first is something many people have to learn the hard way. Every alcoholic and addict will go through denial at some point. If the person has troubles at home or with their kids they may say ” I need a few weeks off treatment, this is more important”. Almost always what ends up happening is the person relapses. The original problem has not been solved and now they create 10 more problems with their relapse.
6. Long Wait For Medications/Doctors Appointments
The majority of outpatient rehabs offer some type of medically assisted detox program. The problem in most cases is the wait.If you call to set up outpatient care today you may be looking at 1-2 months until care is started.
Most outpatients only have 1-2 doctors on staff to treat many patients. If the patient needs to adjust their medications, or get help with a medically assisted detox they may be looking at weeks until they can see the doctor.
This is my biggest concern when it comes to outpatient treatment centers. During the beginning of my last outpatient, I was having intense cravings to use drugs. It was decided to put me on a maintenance medication (suboxone). I was on the verge of relapsing. When we spoke with the doctor I was put on a 6-week waiting list for my appointment. If it wasn’t for an outside doctor I paid cash to go see, I would have relapsed.
Substance Abuse Intensive Outpatient Programs: Assessing the Evidence, Dennis McCarty, Ph.D., Lisa Braude, Ph.D., D. Russell Lyman, Ph.D., Richard H. Dougherty, Ph.D., A.M., Allen S. Daniels, Ed.D., Sushmita Shoma Ghose, Ph.D., and Miriam E. Delphin-Rittmon, Ph.D. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152944/
Kyle Ruggeri, CARC (Certified Addiction Recovery Coach) is a recovering addict/alcoholic. Kyle created Soberdogs Recovery as a way to get accurate and first-hand information about addiction and recovery out to the world. Kyle has been in recovery for over 5 years.
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