Medical Reviewer

Sendra Yang

About the Reviewer

Addiction is a chronic, but treatable neuropsychological disorder defined by the intense urge to engage in certain behaviors. Over time, repetitive use of drugs and alcohol can alter brain function in ways that increase cravings and weaken self-control. These changes take place over time and can lead to unhealthy thought and behavior patterns, including the persistent impulse to use drugs and alcohol, despite substantial harm and other negative consequences.

Just as it takes time to develop an addiction, it takes time to address these complex issues and create new habits and thoughts that support recovery. While there are many types of drug and alcohol treatment available, research suggests that there are significant benefits to long-term drug rehab. The National Institute on Drug Abuse (NIDA), reports that treatment that is more than 90 days is linked to more positive outcomes than shorter treatment in many cases.

In fact, during a NIDA-sponsored study, researchers tracked long-term rehab users for five years after they completed drug rehab. Amongst users who had completed six months or more of addiction treatment, cocaine use decreased by 83%, problem alcohol use decreased by 90%, and suicidal thoughts or attempts decreased by 96%. In turn, full-time employment had increased by 46%.

According to the American Society of Addiction Medicine, addiction involves connections between brain circuits, genetics, the environment, and a person’s life experiences. A history of trauma or co-occurring mental health conditions can also impact a person’s experience of addiction. Long-term rehab provides a safe place for people to focus on healing all aspects of their addiction through a variety of therapies. With time and space away from their environment, they can make long-lasting lifestyle changes.

What is Long-term Drug Rehab?

Long-term residential rehab refers to addiction treatment facilities where patients live on-site and receive 24-hour therapeutic and medical support. Whereas some inpatient rehab programs are housed within a hospital, long-term drug treatment programs usually have their own facility that’s dedicated to alcohol or drug rehab.

A typical long-term inpatient residential treatment program is 3-12 months, though some rehab centers offer programs that are even longer. Long-term drug rehab can also refer to outpatient treatment programs, as well as Intensive Outpatient Programs (IOPs), where the patient continues to receive treatment over the course of several months or years.

How Long-term Drug Rehab Works

In most long-term addiction treatment programs, the patient begins with medically supervised drug or alcohol detox, which can take up to ten days. During this time, the patient may experience withdrawal symptoms as the body rids itself of drugs and alcohol.

Common withdrawal symptoms can include vomiting, fever, body aches, shaking, high blood pressure, and seizures. In some cases, these withdrawal symptoms can be life-threatening. Depending on the substances abused and the severity of the withdrawal symptoms, the detoxification process may include medication-assisted treatment, where a physician prescribes medications to help ease the withdrawal process. In addition to over-the-counter drugs such as Tylenol and Aspirin, medications are available to help treat withdrawal symptoms from alcohol, benzodiazepines, nicotine, opioids, barbiturates, and other sedatives.

Once detoxification is complete, patients will begin a long-term treatment plan, which generally includes a variety of different addiction treatment therapies. Common therapies for drug and alcohol addiction include:

Individual therapy
Couples and family therapy
Group therapy
Holistic therapies (including, meditation, yoga and mindfulness)
Experiential therapies (including art therapy, adventure and wilderness therapy, and equine therapy)
Relapse prevention
Somatic and neuroscientific therapies (including EMDR and sensorimotor psychotherapy, which are used to address trauma)
12-step programs

In addition to providing inpatient rehab, many long-term addiction treatment facilities offer outpatient rehab for those who’ve completed their inpatient treatment but still need the structure that outpatient care provides.

Since long-term rehab typically takes 3-12 months, this provides individuals with the opportunity to go through detox, bond with therapists and staff, meet and form connections with residents, and process what they’re learned in therapy.

What Can I Expect in Long-term Rehab?

While there’s a variety of different treatment models that are used in long-term rehabs, one of the most popular is the therapeutic community (TC) model. Therapeutic communities are designed to facilitate entire lifestyle changes so that individuals can go on to lead a full, productive substance-free life after treatment.

Within TCs, addiction is viewed in the context of an individual’s social and psychological deficits. Therefore, treatment is focused on developing personal accountability and responsibility. The treatment process is extremely structured and can be confrontational at times, with therapeutic exercises which are designed to help residents examine damaging beliefs, self-concepts, and destructive patterns of behavior. The goal of these activities is to help residents develop new coping mechanisms and positive ways of interacting with others.

The patient will begin the long-term rehab process with minimal freedom and an extremely structured daily schedule. However, as they move through the treatment program, they’ll gradually gain more privileges, which may include visits from friends, family, and communication with the outside world. In some cases, the resident may be granted permission to leave the rehab center to attend 12-step meetings or other activities that support their recovery.

In addition to addiction treatment, the TC model often offers psychosocial education, which includes job training and other skills, which is designed to help people in recovery reintegrate as productive members of society after they complete treatment. As a result, the National Institute on Drug Abuse (NIDA) reports that the therapeutic community model of addiction treatment can be effective for patients with co-occurring psychiatric disorders, and other special needs, including adolescents, women, homeless individuals, and individuals who’ve had interactions with the criminal justice system.

The Benefits of Long-term Addiction Treatment Centers

As mentioned above, addiction doesn’t happen overnight. Instead, many people develop a substance abuse disorder over many months or years. Therefore, it makes sense that it would take an extended period of time to treat the physical symptoms, along with the underlying social and psychological causes of addiction.

Long-term residential treatment centers provide patients with more time to integrate and digest what they’ve learned in treatment, which is often correlated with long-term, sustained recovery. In fact, according to NIDA, research has shown that inpatient and outpatient rehab programs that are under 90 days are less effective than long-term rehab in maintaining positive outcomes.

That said, it’s also important to understand that success can be defined in a wider sense (not just total abstinence). The Office of National Drug Control Policy, for example, states that someone getting effective addiction treatment should demonstrate some of the following characteristics:

Less and less frequent substance use, and longer periods of time between relapses.
Better personal relationships with loved ones such as family members and friends.
Better job situation (or education situation, including enrollment and attendance).
Better physical health, as measured by fewer visits to medical institutions.
Better mental health, as measured by improved mood and behavior.

Therefore, total abstinence isn’t the only measure of success when it comes to addiction treatment. A treatment program is still considered to be effective if it results in these kinds of changes.

Who is Long-Term Rehab Best For?

Drug and alcohol rehab is not one-size-fits-all. Different kinds of addiction treatment programs will be effective for different people.

Long-term inpatient treatment tends to be a good option for people who have struggled with addiction for extended periods of time and have not been able to maintain sobriety after previous treatment programs. Since post-traumatic stress syndrome (PTSD) is one of the most common root causes of drug and alcohol addiction, long-term rehab provides more time and space for individuals to address trauma and integrate what they’ve learned in addiction treatment therapy, so they can apply it to life post-treatment.

Long-term rehab can also be particularly beneficial to people who are addicted to opioids. According to the American Society of Addiction Medicine, long-term treatment is often required to overcome addiction to opioids because those who attend shorter addiction treatment programs have higher rates of relapse. Additionally, NIDA states that 12 months is the minimum amount of time required for methadone maintenance. In fact, many individuals continue to benefit from methadone maintenance for many years.

Additionally, long-term rehab programs can also be helpful for people with a dual diagnosis that includes mental or behavioral health conditions such as bipolar disorder, depression, bulimia, and anorexia. Since long-term rehab often provides trauma-focused therapies alongside psychosocial education, it can be beneficial to populations with special needs, such as those who have experienced homelessness, incarceration, LGBTQI+ individuals, and women. For example, one comparative study found that women who spent more than 6 months in treatment had higher rates of abstinence than those who participated in shorter rehab programs.

How do I Pay for Long-Term Drug Rehab?

Under the Affordable Care Act in the United States, substance abuse treatment must be covered under ACA insurance plans. ACA plans also can’t disqualify you for having a pre-existing substance use disorder or cap spending on addiction treatment. Many private medical insurance providers also offer addiction treatment coverage to varying degrees.

Other ways to pay for treatment include the following:

Medicare and Medicaid: Those who qualify can get inpatient rehab covered, depending on the facility.
Financial aid and/or sliding scale payments: Some long-term drug rehab centers offer a sliding scale according to income.
Grants and subsidies: Some types of treatment are covered for certain populations. The Substance Abuse & Mental Health Services Association (SAMHSA) provides grants for drug addiction treatment and more. Additionally, tax credits and subsidized addiction treatment may be available, depending on the state.
Other health insurance: Veterans Affairs (VA) Health Care and other workplace health insurance plans may provide some coverage for long-term rehab.

When researching which rehab options, consult your insurance provider to find out what kind of coverage is available.

What if Long-term Rehab Does Not Work For Me?

While long-term rehab has shown to be effective in treating substance abuse disorders, not everyone has the personal or financial resources that allow them to spend 3-12 months away from home, school, or work.

However, even if someone is ready and available to enter long-term rehab, there’s no guarantee that they’ll be able to find space in the program of their choice. For people suffering from a substance use disorder, the most important thing is to get the help they need. In other words, the most effective treatment is the one you commit to.

If long-term drug rehab isn’t a good fit, there are several other effective substance abuse treatment options to consider.

Short-term inpatient programs: These residential treatment programs provide many of the same benefits as long-term drug rehab without the extended time commitment. Patients live on-site and receive around-the-clock medical supervision, either in a hospital setting or a standalone rehab center. Treatment typically lasts between 28-90 days.
Intensive outpatient programs (IOPs): Designed for people who don’t require around-the-clock medical supervision, IOPs provide individuals with many of the same therapies as an inpatient program, while also allowing patients to live at home. IOPs are often combined with inpatient rehab programs, to help people make the transition back to their communities and families.
Outpatient treatment programs: This form of drug and alcohol rehab allows patients to live at home or in a sober living house, while still working or going to school. During this type of treatment, patients commonly visit a rehab center, hospital, clinic or mental health services provider on a regular basis, during specific hours on a daily or weekly basis. To provide flexibility, outpatient rehab programs often offer evening and weekend hours.
12-step programs: These support groups are mutual aid programs that support recovery from substance addictions, behavioral addictions, and compulsions. They include Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Since they’re internationally available and free of charge, entering into a 12-step program can be a valuable first step to overcoming the addiction because they provide peer support and accountability for overcoming addiction.

What Happens After Long-term Alcohol or Drug Rehab?

Once long-term rehab is complete, it is essential to have a plan for effective aftercare. Treatment providers can help patients stay accountable and motivated to stay sober once they have returned to everyday life.

A “steps down” approach is typically recommended following a long-term residential addiction treatment program. This may include continuing treatment at an intensive outpatient program, alongside 12-step support groups and continued therapy.

Recovery is a lifelong process, and long-term drug rehab can provide you with a solid basis for a healthy, productive future. Regardless of what kind of treatment you choose, know that you’re not alone and that help is widely available. If you or someone you love needs help finding the right rehab center for you, contact us. We’re here to help.