Outpatient vs. Inpatient Rehabs

Outpatient treatment

Outpatient rehab involves daily treatment, such as therapy, counseling, or group sessions, at a clinic or facility. People who choose outpatient treatment can continue to live at home as they recover, allowing them to take care of children or family members, keep up with their jobs, and stay on track in school. Outpatient care typically costs less than inpatient rehab, but the level of support may be less intensive.

Most programs involve individual or group counseling and use a step-down approach, which means sessions become less intensive and frequent as you grow during treatment. These programs help patients overcome their drug or alcohol dependence and then maintain their recovery over the long-term.

Things to consider about outpatient treatment

There are several benefits to outpatient treatment that make it the best choice for many people:

• You can live in your home while receiving treatment. This works if your family and friends are a support system.
• The cost of treatment is typically much lower for outpatient care compared to inpatient care.
• There are many different types of counseling and therapy offered in this setting; you can choose the level of intensity of care that works best for you.
• Appointments can be made in the evenings or on weekends to accommodate work schedules.
• Some outpatient programs can treat patients with co-occurring problems or disorders, such as depression, eating disorders, bipolar disorder, or post-traumatic stress disorder.

However, outpatient care may not be the best choice for you if:

• You experience constant urges to use. Outpatient facilities are not open round-the-clock and do not always offer 24-hour support.
• You have a hard time showing up to group sessions on your own. The success of outpatient rehab depends on your ability to regularly attend and participate in sessions. If you feel that you need more structured and monitored treatment, you may want to consider an inpatient facility.
• You need treatment for multiple disorders, and you need medical attention. Some outpatient programs may not be able to administer medications or offer intensive, multifaceted recovery programs for complicated addictions.​

Inpatient treatment

Inpatient rehab is also called residential rehab because you live at the rehab facility. Inpatient rehab can be effective for people with severe problems with drugs or alcohol, and especially people who are dealing with other mental health conditions. Living at the rehab program facility helps you avoid the temptations and influences in your daily life that trigger your substance use. Living in a healthy environment supports your recovery.

Licensed inpatient facilities offer 24-hour support and intensive care. They incorporate three phases of recovery into their treatment plans: detox, reflection, and growth. They are focused on helping patients learn to adopt drug- or alcohol-free lifestyles after treatment. Many of these programs involve a step-down approach to help patients transition from inpatient care to individual or group counseling outside of the facility.

There are both short-term and long-term residential rehab programs. Patients typically stay at long-term residential facilities from six months to a year, while short-term facilities require stays of about three to six weeks.

Things to consider about inpatient treatment

Inpatient rehab centers offer several benefits that make them the best option for some people:

• Both short-term and long-term inpatient rehab programs are designed to help you with detoxification and prepare you for life after treatment.
• Residential facilities provide care 24 hours a day, usually in nonhospital settings. You are never alone while working to overcome your addiction.
• Treatment is highly structured and focuses on all aspects of addiction. This might include social factors — such as relationships and lifestyle — and psychological factors related to your personal history and situation.
• Safe housing and medical attention are available 24 hours a day. This is especially important for patients with severe problems that may be complicated by other mental health conditions or disorders.

Residential or inpatient rehab requires a larger commitment than outpatient programs do. Keep in mind these tips when deciding which drug and alcohol rehab program may work for you:

• Inpatient rehab requires you to separate from your daily life. This means that you might have to find care for your children or family members. You’ll most likely have to take leave from your job or school while you are in a facility.
• Treatment is highly structured and can be challenging. Your schedule will be decided for you by the staff. Some people find it can be difficult to transition to the rigid agenda and the intensity of treatment that make inpatient care effective.
• Costs are often higher for inpatient rehab compared to outpatient rehab. It’s important to remember that the cost of treatment is always less than the cost of addiction.
• Some inpatient rehab programs don't offer medications to maintain recovery upon discharge. This can increase the risk of resumption of substance use after treatment, and when your body is no longer used to using drugs or alcohol, the risk of overdose can be higher. Try to choose an inpatient rehab that provides support with medications for substance use disorders.

Transitioning back to everyday life after life in an inpatient rehab facility can be stressful. Make sure you make a recovery plan to help you deal with stressors, including ongoing outpatient treatment and the support of family and friends.

Content reviewed by Dr. Jasleen Salwan, MD, MPH, FASAM, February 2023.