Outpatient Alcohol and Drug Rehab

Author

Rita Milios

About the Author

Medical Reviewer

Sendra Yang

About the Reviewer

If you or a loved one are considering an alcohol or drug treatment program, you have many options to choose from, each with certain benefits and certain limitations. Alcohol and drug rehabs provide multiple types of programs and interventions to help people achieve and maintain abstinence. You can find rehab facilities providing evidence-based clinical treatment, inpatient/residential treatment, outpatient treatment, holistic treatment, faith-based treatment, and peer-support programs. To decide which rehab best fits your needs, you’ll need to consider such factors as cost, accessibility, types of treatment, and services offered. Finding the best match will increase the likelihood of your successful treatment.

Inpatient, or residential treatment, is where program participants live in the facility for the duration of their program and receive 24/7 care. It offers a controlled, safe environment, a specific routine, room and board, medication management, counseling, and peer support. The type of services vary according to cost, amenities, length of stay, and other factors.

According to the National Center for Drug Abuse Statistics, the average cost for inpatient rehab in the U.S. is about $6,000 per month.¹ Programs are typically 28 days to 90 days in duration. For many people, inpatient treatment is not a viable option, not only because of the cost, but also because of the need to be absent from work, school, or family responsibilities. In such cases, outpatient alcohol or drug rehab is a good choice. Both inpatient and outpatient drug rehab programs typically include a combination of psychological counseling and group therapy in addition to drug abuse and relapse prevention education, and they often follow a 12-Step treatment model.^3,4

What is Outpatient Alcohol and Drug Rehab?

There are three types of outpatient treatment, all providing services during daytime hours, so program participants do not live at the facility while taking part in the program. This allows more flexibility to accommodate work, school, or family responsibilities.

Standard Outpatient Treatment takes place in various settings, including hospitals, community mental health centers, and designated addiction rehab facilities. A typical treatment schedule is about 3-4 hours per day, 3-4 days per week, for an average of 10 weeks. Standard outpatient treatment allows the most flexibility but also puts more responsibility on the client to maintain sobriety. It is best for those with moderate, not severe, addiction.⁴

Intensive Outpatient Program (IOP) treatment is more structured and intense than standard outpatient and is best for those needing more care than standard outpatient treatment, but not requiring 24-hour management.⁴ IOP programs meet between 9 and 30 hours per week, over 3-5 days, and variations depend on client needs. Programs may last 2 months to 1 year.

Partial Hospitalization Programs (PHP) offer the highest intensity of outpatient treatment and seek to supply most of the services of inpatient treatment, without the need for an in-facility residency.⁴ PHP programs often have full day programs 4-5 days per week, generally lasting 8-12 weeks.

Goals for all types of outpatient treatment include:⁴

Achieve abstinence.
Learn new coping and problem-solving skills to support abstinence.
Address psychological and psycho-social problems that contributed to addiction.
Develop a positive support network.

What Therapies Are Used in Outpatient Rehab?

Therapies used in outpatient treatment vary according to the facility. Some offer specialized therapies such as Trauma Therapy, Holistic Therapy, Art Therapy, or Faith-based approaches. However, most facilities also offer some form of these standard psychological therapies:

Cognitive Behavioral Therapy (CBT) is the most common psychological therapy used in outpatient treatment. It is often used in a group setting, but it can be used in individual therapy sessions as well. CBT teaches clients to recognize distorted thinking patterns and how they are causing problems. CBT strategies then help clients change their thinking toward more realistic and helpful ideas.
Rational Emotive Behavior Therapy (REBT) is a subset of Cognitive Behavioral Therapy. Whereas CBT focuses mainly on rational thinking, REBT emphasizes the need to understand and reflect on the emotions and beliefs that underlie irrational thoughts. The ABC method of cognitive behavioral therapy is then used to dispute and neutralize the negative or self-defeating emotion. (A = an Activating event or situation that triggers negative thoughts and emotions. B = Beliefs that the person holds about the activating event. C = consequences– the behavioral responses that result from the beliefs.)
Contingency Management is a method of increasing motivation for clients to avoid drug or alcohol use. As an example, upon a negative (clean) drug screen, a client may receive a reward of a prize or gift card.
Motivational Interviewing is a counseling method that addresses ambivalent feelings and insecurities and helps a client find the internal motivation to make life changes. It uses open-ended questions, active listening, empathy, and affirmative support to help clients increase their readiness for change.
Family and/or Couples Therapy involves family members in the treatment process. Family interaction increases client accountability for their actions, reinforces their commitment, and provides support from the most important people in their lives.

What Are the Benefits of Outpatient Rehab?

Maintain employment and school commitments: With outpatient rehab, you do not stay overnight at a facility. So, you can continue to take part in outside activities, such as work, school, caring for family, or other important responsibilities.
Lower cost than inpatient rehab: Outpatient rehab costs are significantly lower than inpatient treatment.
Treatment tailored to fit your schedule: Most outpatient treatment programs offer several levels of treatment and options so that they can accommodate the differing needs of clients. Many times, a choice of day or evening sessions is available, and treatment plans may be tailored to help clients meet their obligations.
Maintaining positive, supportive relationships at home: The ability to be home each night can help you maintain family support and encourage you to be responsible and committed to your sobriety.
Build community with program peers who can become sober friends. Since you’ll need to break ties with former using friends, finding new friends with the common intention to remain sober will provide new friendships, support, and accountability partners.
Build upon the skills learned during residential treatment: If you attend outpatient after leaving an inpatient program, it will provide a good opportunity to practice and further develop the skills you learned there.

How Much Does Outpatient Treatment Cost?

Treatment costs for outpatient will vary, according to the type of program, the location of the facility, the duration of the program, and what level of care you need. If you need detox services, or if you have a co-occurring mental illness that requires medication management, you are more likely to be a candidate for inpatient treatment or partial hospitalization treatment, which are more costly. According to the National Drug Helpline, the current average costs for rehab are:²

Detox /Residential Care: $250-$900 per day; or $5,300 -$80,000 depending on the length of the program (28-day, 60-day, 90-day)
Intensive Outpatient (IOP): average 30 days – $3,100-$10,000
Outpatient (30 days, no overnights): $1,400-$11,000

If you have insurance, your policy will likely cover treatment for substance use disorder. You will need to check with your provider to determine how much of the cost your health plan covers, and how much your co-payment may be. You can also check with the facilities you are investigating to see if they provide aid in assessing your out-of-pocket costs.

Some low-cost and state-funded treatment programs are available, although there may be a waiting list for the program you choose. Information about such programs can be accessed at the SAMHSA National Helpline.⁵

Is Outpatient Rehab Right For You?

When deciding whether you should choose inpatient or outpatient treatment, you should consult with your doctor or counselor for advice, Also, consider the following questions:⁶

How severe is your substance use disorder? Do you need detox and/or medication?
Do you have a co-occurring mental health disorder?

(If you answer is “yes” to either of the questions above, you will more likely need the 24/7 support that inpatient treatment provides.)

How strong is your family support system? Is your home environment an asset?
Is your living situation stable? Do you have a safe, consistent place to live?
Are you transitioning out of inpatient treatment?

(If you answered “yes” to the above 3 questions, then outpatient treatment would be a viable option for you. But if your home environment would pose a risk to your sobriety, you might want to seek other options–either inpatient treatment or alterative housing for the duration of your treatment.)

You can’t or don’t want to quit work or take a leave of absence.
You want to be close to loved ones.
You are confident that you can avoid drugs or alcohol within your environment.
You’re seeking additional support outside of your family and current peer group.
You can’t afford an inpatient treatment program, but you want to take steps towards overcoming an addiction.

If your answer is “yes” to the final 5 questions above, then outpatient rehab treatment would likely be of benefit to you.

Resources:

National Center for Drug Abuse Statistics. Drug Abuse Statistics https://drugabusestatistics.org/

National Drug Helpline. Cost of Dug Rehab in 2023 https://drughelpline.org/rehab-cost/
National Institutes of Health Library of Medicine/ SAMHSA/CSAT. Treatment Improvement Protocols, Chapter 3: Intensive Outpatient Treatment and the Continuum of Care https://www.ncbi.nlm.nih.gov/books/NBK64088/
National Institutes of Health/National Library of Medicine. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence National Institutes of Health/National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152944/
Substance Abuse and Mental Health Services Association. SAMSHA National Helpline https://www.samhsa.gov/find-help/national-helpline
Kaiser Permanente Health Encyclopedia. Inpatient and Outpatient Treatment for Substance Use Disorder Kaiser Permanente Health Encyclopedia https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.inpatient-and-outpatient-treatment-for-substance-use-disorder.ad1101