Inpatient or Outpatient; Which One Is for Me?
First, the differences between the two:
- - A minimum of 30 days of residential treatment and therapy with 90 days commonly recommended
- - Interaction with other addicts on a daily basis, total focus on recovery and management strategies with minimal distractions
- - Nutritious meals, a regular routine, and other needs are provided – especially important during the first fragile week of sobriety
- - Attention from trained medical staff around the clock – they can respond when crisis emerges
- - Higher success rate than outpatient for serious addictions
- - Less expensive and open-ended, not limited by health insurance or the need to get back to normal activities
- - Less intrusive – someone can “do” outpatient while holding onto a job
- - More likely to be anonymous since attendance can be worked into someone’s schedule and an extended absence doesn’t have to be explained
- - Can be as effective as inpatient treatment for highly motivated addicts
- - More closely represents the real world situation after treatment is over
Both treatment options can be effective
Therapy has the same goals in either setting. Much of the actual treatment is identical, although inpatient can be thought of as more “concentrated.” Furthermore, there is no reason why someone cannot try an outpatient program and if necessary, move to an inpatient situation. Many inpatient programs finish with a period (sometimes called follow-up) that is essentially an outpatient extension of the residential treatment.
Motivation is critical in either situation. This is even more important than the drug or using behavior. Those who are highly motivated to quit, and stay quit, do better.
How to decide
First of all, recognize that this is a medical decision. The advice and counsel of a medical professional is warranted. Even consulting with a therapist at a facility that has both an inpatient and an outpatient program is better than deciding blind.
The second decision point is the nature of the addiction. Sometimes, separating the addict from his or her environment is the only real choice. This person may be unduly pressured by peers or circumstances and need to get away. He or she may be violent or a danger to others. If an addict cannot be trusted or monitored outside of a treatment program, inpatient is needed.
Inpatient treatment is also almost automatic if there will be a detox period that needs oversight. Drugs like heroin and meth usually have difficult withdrawal periods, and withdrawal from a long-term alcohol addiction can be life-threatening. Cocaine and other illegal drugs form a middle ground, with marijuana at the far end of the scale. An addiction to prescription drugs can mean careful detox, depending on the drug. This is an area where talking to a doctor or other professional is a must.
Someone who has been able to detox on his or her own, outside of a facility, still keeps the option of inpatient or outpatient treatment.
Money is also a factor. In the US, it sometimes seems like we get the medical care we can afford, and addiction treatment is no different. Exploring the costs and whether an insurer will foot part of the bill is a must. For some, just missing work is enough of a financial burden to keep them from an inpatient program.
Before deciding, talk to an addiction counselor. You may be surprised by what sources of funding are available. Some communities have grants or low-interest loans available, and some find a collection among family members is enough to get the ball rolling. Churches and employers will often contribute. There are also payment programs that can make the financial burden bearable.
Finally, don’t let the choice between inpatient and outpatient become a way to avoid treatment altogether. Any treatment is better than none. Don’t make the good the enemy of the perfect – get help. Get treatment. Don’t let the crazy continue.