If you’re struggling with a drug or alcohol addiction, it’s important to get help as quickly as possible. Addictions wreck lives and every day of delay could cause untold harm to your relationships, career and physical and mental health.
It’s also important to get the right help however, as there are different kinds of treatment available. Rehab or rehabilitation is a catch-all term for a programme of treatments designed to help an addict to break their dependence on drugs or alcohol. The two main broad types of rehab are inpatient and outpatient rehab.
What are the differences between inpatient and outpatient rehabs?
When considering the pros and cons of inpatient vs outpatient rehab, you first have to know the differences between these two types of treatment.
Simply put, inpatient rehab requires the person seeking treatment to do so as an inpatient – someone who stays in the facility as a patient or resident while they undergo treatment. Once you are checked in you do not leave the treatment or rehab centre for the duration of the programme. The length of your stay can vary but 28 days is pretty typical.
If you seek treatment at an outpatient rehab you will not be a resident and will go home after your treatment sessions. This type of rehab can last longer overall, often between three and six months, although again this can vary quite widely. Outpatient rehab could be seen as ‘part-time’ rehab, with the patient attending several hours of treatments sessions per week.
What to expect from inpatient rehab
At an inpatient or residential rehab clinic you will be there for 24 hours a day. This means you will have professional support available round the clock but it is also more restrictive. Inpatient rehab generally starts with a supervised detox, during which the toxic substance (i.e. the drugs or alcohol) is processed out of your system. This is a crucial phase of beating addiction and can be difficult and potentially dangerous to go through alone. In a residential detox clinic your health will be monitored and there will be medical, emotional and moral support on hand.
Following the detox process there will be a full programme of follow-up treatments aimed at providing you with the tools you need to remain clean and sober. Every day will tend to be structured, with regularly scheduled therapies, workshops and other sessions. These could include individual therapy and counselling sessions, group therapy and workshops and educational courses covering addiction, health and lifestyle issues. There might also be other therapies such as meditation and art therapy available.
What to expect from outpatient rehab
During outpatient rehab you will have various sessions that it is your responsibility to attend. During the detox phase, you are likely to have daily appointments and you may be prescribed medication to help you to deal with the cravings and withdrawal symptoms. The vast majority of drug and alcohol services provided by the NHS are outpatient-based so appointments may be at a hospital or other medical facility. Your GP may also be involved in monitoring and treating you. After this detox period you may also have access to various therapies, workshops, programmes and group support sessions. Some of these may be provided by charities, community groups and similar organisations.
Drug rehab inpatient vs outpatient
You should remember that both of these approaches are designed to achieve the best possible outcomes for the people struggling with addiction issues. Some individuals are more suited to one or the other and there are a number of factors that you need to bear in mind when considering outpatient vs inpatient rehab.
Inpatient rehab puts you in a situation where you can focus entirely on beating your addiction and getting well. There will be 24-hour support including appropriate medical and psychiatric care when required. More time can be devoted to treatment programmes and you will be in a non-judgemental setting surrounded by experts and other residents who are going through similar experiences. You are also away from the people and places that may be triggers for your drinking or drug use.
Outpatient rehabs offer much more flexibility and this may be important if you are a functioning addict with a job, have a family or simply do not want to take an absence from your ‘normal’ life. This might also be the better option if your level of drinking or substance misuse is comparatively light.
Another important consideration might be cost. As mentioned previously, almost all NHS and community programmes are outpatient-based and where free residential places are available, there is usually a substantial waiting list.
There are some cons to outpatient treatment however. It is not as intensive and you might not have support immediately available when you need it. You may still be exposed to the same triggers and it will be your responsibility to attend sessions, which can be difficult if you are leading a chaotic lifestyle.
Inpatient vs outpatient rehab success rates
As already mentioned above inpatient rehab is not suitable for everybody, but a number of studies suggest that residential treatment tends to have better outcomes for people with a serious drug or alcohol problem.
One important and much-quoted study is the National Treatment Outcome Research Study (NTORS) by the Department of Health.
This looked at inpatient vs outpatient drug rehab and found that nearly half (47%) of those treated in residential rehab services had achieved abstinence after five years. This compared to around a third (35%) of patients using community-based services. The study also noted that those using the inpatient services included some of “the most severely disturbed and they made some of the greatest treatment gains”.
The 2006 Drug Outcome Research Study (DORIS) followed more than a thousand drug users in Scotland to see if they were still clean at least 90 days after treatment. Around a quarter of those using residential rehab services were completely abstinent, compared to just 6% using community-based services.
There are numerous factors to consider when thinking about Inpatient vs Outpatient Rehab but in terms of outcome alone, residential rehabs appear to be more effective.