Inpatient Treatment
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What Is Inpatient Treatment/Rehab?
Inpatient rehab is an effective treatment method for substance use disorders (SUD). It is available for people with drug use disorders or alcohol use disorder (AUD). Some facilities treat both types of addiction, while some specialize in one or the other.
SUDs occur in a spectrum of severities — meaning that the condition can be classified as mild, moderate, or severe. Inpatient rehab is especially useful for people suffering from “severe” cases. It is also advisable for people suffering from co-occurring disorders. A person with co-occurring disorders suffers from a SUD as well as a mental health disorder, such as alcohol addiction and depression or opioid addiction and anxiety.
Inpatient rehab happens at licensed residential treatment centers. They offer 24-hour comprehensive, structured care including schedules, a substance-free environment, safe housing, and medical attention.
Detoxification is usually the first step in an inpatient rehab treatment program. Programs typically last from 30 to 90 days. However, if further treatment is necessary, additional options are available.
Inpatient treatment centers may use several different therapeutic approaches, but all focus on helping the patient overcome their addiction and go on to live a sober and successful life after treatment.
Types of Therapies Used in Inpatient Rehab
There are many different types of inpatient treatment centers. Some are focused on treating specific types of substance abuse, some focus on particular treatment approaches, while others utilize different methods or have specific patient requirements.
What’s best for one patient may not be the best for another, so it’s important to consider which type of inpatient treatment facility will be best for the individual. This will depend on several factors, including:
- Type of substance use disorder
- Severity of substance use disorder
- Mental health condition
- Age
- Medical history
- Insurance and financial status
There are several different treatment techniques used in inpatient rehabilitation. Some of the most effective methods include:
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a psychotherapy (talk therapy) treatment aimed at changing patterns of thinking and behavior. It is a short term, goal-oriented, evidence-based therapy. The goal is to change people’s behavior by focusing on the thoughts, images, attitudes, and beliefs that cause their problematic behavior.
Dialectic Behavior Therapy
Dialectic behavioral therapy (DBT) is another type of evidence-based psychotherapy treatment. It utilizes cognitive behavioral therapy techniques while focusing on the social aspects of the recovery process. It is designed for people who experience mood swings and other highly emotional reactions in social situations. Patients are encouraged to work through problems with their therapist and support staff, while they do the same with the patient. DBT often involves homework, role-play, and practice.
Contingency management
Contingency management, also called evidence-based therapy, is a type of behavioral therapy that rewards, or “reinforces,” patients for evidence of positive behavioral change. Contingency management is based on behavioral analysis. If someone’s behavior is rewarded shortly after completion, they are more likely to continue practicing that behavior.
Person-Centered Counseling
Person-centered counseling revolves around the patient. In person-centered counseling, the clinician assists the patient by expressing their acceptance with no judgment. They then engage the patient, elicit change talk, and motivate them to make positive changes based on the patient’s goals and desires.
Facilities may use different types of treatment as well. Because addiction is a disorder that affects your body and mind, many licensed team members may be involved, including:
- Doctors
- Nurses
- Psychologists
- Psychiatrists
- Family or marriage therapists
- Addiction counselors
- Wellness and fitness specialists
- Nutritionists
- Continuing care coordinators
- Financial advocates
- Case managers
When to Seek Inpatient Treatment
Inpatient treatment is most effective for people who belong in these four categories:
- People who have a high risk of experiencing withdrawal
- People who are likely to have co-occurring disorders
- People who have experienced a relapse
- People who have tried a less intensive treatment but were unable to stay sober.
Benefits of Inpatient Rehab
Inpatient rehab is beneficial because it provides a patient with a highly structured environment and access to many services and amenities, including:
- Medical support — Detox can be challenging and even life-threatening in severe cases. Inpatient facilities usually provide 24/7 medical assistance.
- Structured programs — Daily, weekly, and monthly schedules help keep patients on track and focused on recovery.
- Sense of community — Many people suffering from substance abuse disorders have had similar experiences. Group therapy and co-living helps people support each other and allows them to practice good behaviors before discharge.
- Nutritional support — Many people need specialized diets to safely recover from detox. Nutrition specialists help make sure their physical health is a priority.
- Aftercare planning — Additional support may be required for individuals when they leave the treatment facility. Caseworkers and counselors will work together to make sure the individual has all the tools and support they need to lead a healthy life.
Inpatient Rehab Timeline
A traditional inpatient drug or alcohol rehab program lasts 30, 60, or 90 days. However, there are long-term options as well.
Inpatient rehabilitation generally involves the following five stages:
- Evaluation — Upon arrival, patients are screened and clinically assessed. This usually takes a couple of hours and includes a urine test and an interview. This evaluation will determine the treatment plan for the patient.
- Detoxification — This is when the body adjusts to functioning without drug(s) or alcohol. This is when withdrawal symptoms are the worst. Some patients may not require detox, but the majority do. They may experience seizures, hallucinations, or delirium tremens during this process.
- Psychological and Medical Treatment — A wide range of psychological and medical treatments, along with one on one or group counseling, may be used, depending on the results of the initial evaluation and a patient’s progress throughout treatment.
- Transition — Leaving an inpatient treatment facility is an intimidating and challenging process. “Step down” programs aim to provide patients with the skills and tools necessary to make the transition into sober life smoothly.
- Maintenance —After inpatient treatment, many people recovering from addiction will start outpatient treatment or another form of support, such as group or individual counseling. The maintenance stage can last for years or even a lifetime.
Preparation for Inpatient Rehab
Getting ready for inpatient rehab can be scary. However, even just minor preparation can help calm your nerves and give you a better chance of having a positive experience. Here are a few things you can do to help put your mind at ease and prepare for your time in rehab:
Tie up loose ends
Taking care of any family and work obligations will make your transition into rehab much smoother. It may be uncomfortable sharing details, but gaining the support of family, friends, and colleagues can go a long way in building a support system that will help you recover. This may include arranging child care, requesting time off of work, and signing up for automatic bill payments.
Pack the essentials
Most clinicians advise bringing only the essentials when packing for inpatient rehab. These include:
- Government issued ID
- Current medications and prescription cards
- Medical insurance card
- Emergency contact information
- Personal hygiene products
- Comfortable clothing
- Credit or debit card
It is also recommended to bring a few comfort items. These may be reminders of your loved ones, books, or an mp3 player, as many facilities don’t allow cell phones, computers, or tablets.
Adjust your attitude
It’s normal to feel scared, angry, or nervous upon enrolling in inpatient rehabilitation. The best attitude to have is one of resolve. Resolve that you’re not going to quit. Feel confident that you’re making a good decision, and know that you will be working towards better health, more financial stability, and better relationships with your loved ones.
Relax
Finding a way to relax and prepare your mind for what’s to come will help you look at this as a positive experience rather than a scary one. Take time to do one of your favorite relaxing activities and try to clear your mind.
Cost and Insurance Coverage for Inpatient Rehab
Inpatient rehabs average around $6,000 for a 30-day program. More prolific centers may charge up to $20,000 for a 30-day program. The total cost average for 60 or 90-day programs ranges from $12,000 to $60,000.
Most inpatient rehab facilities accept insurance, offer financial aid, or provide financing options
Insurance is one of the most common and effective ways of paying for rehab. The amount covered will depend on the insurer, plan, and healthcare provider. Most facilities accept:
- Medicare
- Medicaid
- Private insurance
- State-financed health insurance
- Military insurance
For people who don’t have insurance, or whose plans don’t cover any part of rehab, many treatment facilities (especially nonprofits) offer financial assistance to help offset the cost of treatment. Financing options are also available at most treatment centers.
While many people may be scared of going into debt or spending too much money, it helps to think of rehab as an investment. The costs of addiction are not just financial; they’re physical and mental as well. People who can recover from their substance use disorders (SUD) are in much better shape to take care of themselves and their families financially than those who are still suffering.
Inpatient Rehab vs. Outpatient Rehab
Inpatient rehab is an effective and intensive treatment option, but it might not be right for everyone. Outpatient treatment is an alternative option that doesn’t involve the patient living on the premises.
This is recommended for people who have a low chance of relapse, are highly motivated to get better, and have established support systems in their life.
How to Choose an Inpatient Rehab Center
Choosing the right inpatient rehab center is essential to maximize your chances of recovery. Here are some questions to ask in order to make sure that the facility you choose will provide the type of care you need:
- What types of addictions do they treat?
- What types of therapies do they use?
- What are the policies for patients?
- What are the lengths of treatments available?
- Do they treat co-occurring disorders?
- Do they provide comprehensive aftercare?
- Are they fully licensed and accredited?
- What are the insurance coverage and payment options?
- Where is it located?
If you or someone you love is struggling to quit drugs or alcohol on their own, inpatient rehab can help. You’ll receive medical care, structured support, and a sense of community that only exists in inpatient facilities.
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NIDA. "Teaching Addiction Science." National Institute on Drug Abuse, 11 Feb. 2019, https://www.drugabuse.gov/teaching-addiction-science.
Petry, Nancy M. “Contingency management: what it is and why psychiatrists should want to use it.” The psychiatrist vol. 35,5 (2011): 161-163. doi:10.1192/pb.bp.110.031831
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