What is Inpatient Care?

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Inpatient care, sometimes called residential clinical care or residential care, offers round-the-clock treatment for people addicted to drugs or alcohol. It includes a combination of detox programs, medication assisted treatment (MAT), and psychotherapy.

Programs begin with a medical detox and offer patients access to addiction counseling and psychological treatment. These are structured, supervised programs intended to treat severe addiction.

difference between inpatient and outpatient

Programs begin with a medical detox and offer patients access to addiction counseling and psychological treatment. These are structured, supervised programs intended to treat severe addiction.

What is Outpatient Care?

Outpatient services are provided to patients who do not require overnight accommodations, hospital admission, or a hospital stay. Patients might spend up to 12 hours at a treatment facility, but spend their nights at home. 

Many people are familiar with outpatient care because of minor surgeries. Outpatient surgery is one of the most common reasons people seek outpatient treatment, but it’s also an option for those dealing with substance use disorder (SUD).

Outpatient healthcare programs are best suited for people with drug or alcohol addiction who have completed an inpatient program and/or only need sobriety maintenance. 

Additionally, people who cannot afford or commit to round-the-clock care benefit from outpatient programs. These programs offer many of the same types of care offered in inpatient facilities, but provide greater flexibility and the ability to continue everyday life outside of rehab.

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Inpatient vs. Outpatient Care: 9 Main Differences

There are several differences between inpatient and outpatient treatment, including:

1. Treatment Structure

Treatment tends to be more structured with inpatient care because patients are onsite all the time. They receive round-the-clock supervision and do everything at the treatment facility, including eating, sleeping, and attending rehabilitation services. 

Outpatient treatment, on the other hand, has a more flexible structure. However, during the day, both inpatient and outpatient facilities operate similarly. 

Inpatient treatment tends to be more intense than outpatient treatment. For example, outpatient programs offer about 30 to 60 minutes of therapy per day (one to three times a week). Most inpatient treatment programs require patients to attend three or more hours of therapy per day. 

2. Services Offered

Some services offered at both inpatient and outpatient treatment programs include:

  • Initial assessment: Staff assess the current medical condition of the patient and his or her needs. This includes, at minimum, an interview and taking of the patient’s medical history.
  • Drug screening: Patients entering rehab programs undergo a drug test and will likely be subjected to drug tests throughout the program.
  • Medically supervised detox: Patients entering rehab with drugs in their system undergo a medically supervised detox. Staff monitors withdrawal symptoms and medications may or may not be used.
  • Psychotherapy: Counseling is an important part of all rehabilitation programs. Patients receive individual and group therapy to help them identify their triggers for substance use. They also work on learning how to control their substance use when faced with these triggers.
  • Medications: Many treatment programs utilize prescription medications to treat addiction. These medications vary based on the patient’s substance of choice. Additionally, patients might receive anti-anxiety or antidepressant medications.
  • Education: Patients learn about addiction and the effects of substances on their bodies
  • Support: Programs provide access to various services such as housing, education, and vocational training.
  • Education about addiction: Education is an important step during inpatient drug rehab, as it gives clients knowledge about drug use and its effects. Curriculum varies, but many inpatient drug rehabs will at least teach about the cycle of addiction, addiction as a brain disease, and physical effects of drugs on the central nervous system.
  • Support services: Inpatient drug rehabs also connect you with local or regional social services you may need. Housing, education, and vocational skills training may be a part of inpatient drug rehab. 

In addition to the services offered at both inpatient and outpatient facilities, inpatient care also includes:

  • Round-the-clock medical care, observation, and supervision
  • Room and board (overnight sleeping accommodations)
  • Meals

Many inpatient facilities offer access to more support services, such as counseling and therapy. Patients are onsite 24-hours a day, so there’s greater flexibility and more opportunities to participate. Additionally, inpatient programs allow patients to focus entirely on recovery without the distraction or temptation they have in their everyday lives.

3. ‘Under Observation’ vs. Flexibility 

Inpatient treatment offers near-constant observation. Inpatient facilities offer round-the-clock medical supervision. Outpatient programs are more flexible. This can be a benefit or drawback based on a patient’s needs. 

Some people need constant observation and medical attention, while others do better at home in their usual surroundings at night while they attend treatment during the day.

4. Length of Treatment

The length of treatment varies from program to program, regardless of whether a program is inpatient or outpatient. Both inpatient and outpatient treatment might last weeks, months, or longer.

In general, inpatient treatment programs offer 30, 60, or 90 days of care. Some programs only last days or weeks. For instance, an inpatient detox program might last just 48 hours.

Outpatient programs last longer. This is because treatment is less intense. For example, it isn’t round-the-clock care and/or it extends treatment once the detox phase of intensive inpatient treatment is complete. 

5. Success Rates

Success rates of inpatient and outpatient programs vary from person to person. What works for one person might not work for another, even if it’s a great program.

In general, intensive outpatient treatment offers a longer duration of treatment than inpatient treatment. However, over time, patients receive more treatment services (group sessions, education, and individual sessions) in a shorter period during inpatient programs.

Additionally, inpatient programs keep patients in a safe environment for the first three to four weeks of recovery. This is helpful for detox, but it’s not a real-life situation. When a patient can stop using drugs and alcohol while at home, intensive outpatient treatment allows them to practice sobriety in a real-life situation.

Most patients leave inpatient treatment and transfer into an intensive outpatient or traditional outpatient treatment. Since they receive both inpatient and outpatient care, it’s difficult to determine whether one is more successful than the other.

6. Severity of Addiction 

Most people in an inpatient program have a more severe addiction than those in outpatient programs, although this isn’t always the case. Some people who try outpatient treatment and later relapse (or do not experience any initial success) move to an inpatient program for more intensive supervision.

7. Providers in Each Setting 

Inpatient treatment programs provide access to a comprehensive selection of medical care providers. Most inpatient programs provide care from:

  • Medical doctors
  • Psychiatrists
  • Therapists
  • Addiction counselors
  • Case managers
  • Social workers

Outpatient programs vary, but rarely offer access to as wide of a selection of providers, although some do. 

8. Costs

Rehab and detox programs range from hundreds to thousands of dollars per day depending on the program and what it offers. Inpatient programs are almost always more expensive than outpatient programs because the cost includes room and board, round-the-clock supervision, and intensive medical care.

Other factors affecting the cost of a program include: 

  • Duration of program
  • Location
  • Amenities

Health insurance plans cover addiction treatment, but don’t always cover an inpatient stay. You’ll need to speak to your insurance company to determine what types of coverage they provide.

9. Health Insurance Coverage

Health insurance generally covers at least part of the detoxification process. Many provide long-term coverage, especially for outpatient coverage. It is unlikely insurance will cover the cost of amenities not deemed medically necessary unless you’re paying a large premium for more extensive coverage. Additionally, most reputable programs accept health insurance.

Pros and Cons of Inpatient Care

The pros of inpatient care include:

  • More intensive
  • More opportunities to participate in rehab activities
  • Easier medical detox
  • Structured days
  • Removed from stresses of everyday life
  • Round-the-clock supervision from medical professionals
  • Access to wellness programs and holistic therapies

The cons of inpatient care include:

  • More expensive
  • Lack of flexibility and freedom
  • Need to find childcare, maintain employment, and deal with other responsibilities
  • Transition from inpatient to outpatient care and/or regular life is difficult 

Pros and Cons of Outpatient Care

The pros of outpatient care include:

  • Less expensive than inpatient care
  • Access to obligations and responsibility in life
  • Flexibility
  • Patients tend to receive more one-on-one time with counselors because therapy groups are smaller
  • Access to various addiction experts and medical staff
  • The cons of outpatient treatment include:
  • Lack of access to resources for safe medical detox
  • Exposure to the stress in everyday life
  • Less intense than inpatient programs

Is Inpatient or Outpatient Care Right for You?

Determining whether inpatient or outpatient care is right for you can be daunting. You’ll want to consider:

  • Severity of your addiction
  • Finances
  • Out-of-rehab obligations and responsibilities
  • Ability to maintain employment (if currently employed)
  • Health insurance coverage
  • Geographical access to either program
  • Quality of programs in your area
  • Medical needs
  • Co-occurring conditions

If you have tried outpatient care without success, or you have concerns about whether or not detox is safe without medical supervision, it’s best to opt for inpatient care if possible. 

How to Get Started With Treatment

The best way to get started with treatment is to contact your primary care physician and/or assess the treatment programs in your area. Sometimes friends and family are willing to assist in helping you find a program. This is often the case when you are subject to an intervention.

Once you’ve found a treatment program that offers the services you need and suits your current situation, contact the program for more information and to determine the next step.

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Resources +

National Institute on Drug Abuse. “Treatment Approaches for Drug Addiction.” Drugabuse.gov, 2018, www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.

Harvard Health Publishing. “Addiction - Harvard Health.” Harvard Health, Harvard Health, 2019, www.health.harvard.edu/topics/addiction.

Bradbury, Allison. “Behavioral Health Treatments and Services.” Samhsa.gov, 14 Jan. 2019, www.samhsa.gov/find-help/treatment.

“Mental Health and Substance Use Disorders | SAMHSA - Substance Abuse and Mental Health Services Administration.” Samhsa.gov, 14 Jan. 2019, www.samhsa.gov/find-help/disorders.

National Institute on Drug Abuse. “Principles of Effective Treatment.” Drugabuse.gov, 2018, www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment.

McCarty, Dennis, et al. “Substance Abuse Intensive Outpatient Programs: Assessing the Evidence.” Psychiatric Services, vol. 65, no. 6, June 2014, pp. 718–726, www.ncbi.nlm.nih.gov/pmc/articles/PMC4152944/, 10.1176/appi.ps.201300249.

“Inpatient vs. Outpatient: Comparing Two Types of Patient Care.” Sgu.edu, Medical Blog | St. George’s University | The SGU Pulse, 18 June 2019, www.sgu.edu/blog/medical/inpatient-versus-outpatient/.

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