Several types of treatment programs are available:
- Inpatient treatment
- Residential programs
- Partial hospitalization or day treatment
- Outpatient and intensive outpatient programs
- Methadone clinics (also called opioid treatment programs)
Inpatient treatment is provided in special units of hospitals or medical clinics and offers both detoxification and rehabilitation services. Several years ago, many hospital-based treatment programs existed. Today, because of changes in insurance coverage, inpatient treatment is no longer as common as it used to be. People who have a mental disorder or serious medical problems, as well as a substance use disorder, are the ones most likely to receive inpatient treatment. Adolescents may also need the structure of inpatient treatment to make sure a full assessment of their substance use and mental disorders can be done.
Residential programs provide a living environment with treatment services. Several models of residential treatment (such as the therapeutic community) exist, and treatment in these programs lasts from a month to a year or more. The programs differ in some ways, but they are similar in many ways.
Residential programs often have phases of treatment, with different expectations and activities during each phase. For example, in the first phase, an adult’s contact with family, friends, and their job may be restricted. An adolescent may be able to have contact with his or her parents but not with friends or with school. This restriction helps the person become part of the treatment community and adjust to the treatment setting. In a later phase, a person may be able to start working again, going “home” to the facility every evening. If your loved one is in a residential treatment program, it is important that you know and understand the program’s rules and expectations. Often residential programs last long enough to offer General Equivalency Diploma (GED) preparation classes, training in job-seeking skills, and even career training. In residential programs for adolescents, the participants attend school as a part of the program. Some residential programs are designed to enable women who need treatment to bring their children with them. These programs offer child care and parenting classes.
Residential programs are best for people who do not have stable living or employment situations and/or have limited or no family support. Residential treatment may help people with very serious substance use disorders who have been unable to get and stay sober or drug-free in other treatment.
Partial Hospitalization or Day Treatment Programs
Partial hospitalization or day treatment programs also may be provided in hospitals or free-standing clinics. In these programs, the person attends treatment for four to eight hours per day but lives at home. These programs usually last for at least three months and work best for people who have a stable, supportive home environment.
Outpatient and Intensive Outpatient Programs
Outpatient and intensive outpatient programs provide treatment at a program site, but the person lives elsewhere (usually at home). Outpatient treatment is offered in a variety of places: health clinics, community mental health clinics, counselors’ offices, hospital clinics, local health department offices, or residential programs with outpatient clinics. Many meet in the evenings and on weekends so participants can go to school or work. Outpatient treatment programs have different requirements for attendance. Some programs require daily attendance; others meet only one to three times per week.
All alcohol and drug abuse treatment is voluntary, although there may be legal consequences for leaving if the person is in treatment, for example, as part of probation or parole. If you choose to leave and, treatment has not been completed, the treatment staff may ask you to sign papers stating that you are leaving treatment against medical advice. The staff also will try to find out why you want to leave early and will try to address any concerns you have.
Intensive outpatient treatment programs require a person to attend nine to 20 hours of treatment activities per week. Outpatient programs last from about two months to one year. People who do best in an outpatient program are willing to attend counseling sessions regularly, have supportive friends or family members, have a place to live, and have some form of transportation to get to treatment sessions (some programs will provide transportation if needed).
Opioid Treatment Programs
Opioid treatment programs (OTPs) sometimes known as methadone clinics offer medication-assisted outpatient treatment for people who are dependent on opioid drugs (such as heroin, OxyContin®, or vicodin). These programs use a medication, such as methadone or LAAM, to help a person not use illicit opioids. OTPs provide counseling and other services along with the medication.