Is Inpatient Rehab Better Than Outpatient Rehab?

bigstock-Young-couple-meeting-financial-36668986One of the first decisions that many families have to make when seeking out the best possible drug rehab program for their addicted loved one is whether to choose an outpatient treatment program or an inpatient treatment option. Because inpatient, or residential, care is more expensive and provides round-the-clock care, many assume that it is the best possible treatment solution. Though it is considered the “gold standard” treatment option for those seeking recovery, outpatient treatment programs can be an effective choice as well. It all depends upon the circumstances.

For example, according to a study published in the journal Drug and Alcohol Dependence, residential drug treatment was shown to be the ideal choice for young adults who were dependent upon opioids (e.g., heroin and prescription painkillers). Compared to participants who took part in an outpatient treatment program, those who opted to spend a month in an inpatient treatment facility fared better in recovery, meaning that they were more likely to remain relapse-free for a longer period of time.

Dr. Zev Schuman-Olivier of Massachusetts General Hospital was lead author of the study. According to Reuters, he said: “Given evidence that outpatient treatment for opioid dependence in young adults is not as effective as it is in older adults, we need alternatives to protect this vulnerable population.”

The Study

Just over 290 dependent adults between the ages of 18 and 24 were included in the study. They were all enrolled in an inpatient treatment program that utilized the 12-step method of treatment for 30 days. About 25 percent were dependent upon opiate drugs, and 20 percent abused opiate drugs. The other 55 percent were dependent upon or regularly abusing other substances, including alcohol.

Researchers found that about 29 percent of the participants who were opiate-dependent and about 22 percent of participants who struggled with opiate abuse were still drug-free a year after leaving treatment. These results were compared to another study in which it was found that only 17 percent of participants who enrolled in an outpatient treatment program were still abstinent after one year had passed.

Said Schuman-Olivier: “This study is important because it stresses the need for parents to advocate for residential treatment when that moment arises for an emerging adult when they think about going into treatment. If someone can be encouraged to go into residential treatment at that time, then there is a likelihood that it will have a longer lasting effect than if they go to outpatient treatment.”

‘Window of Willingness’

Schuman-Olivier referred to the “window of willingness” in which an addicted person may be more likely to make drastic changes and accept a big step like inpatient rehab. This window of time that could increase the likelihood that an addicted person will accept help may follow a disruptive event like:

  • Minor relapse after attempted sobriety
  • Overdose or medical emergency caused by drug use
  • Loss of a friend or loved one to drug overdose
  • Arrest or other legal issue caused by drug use or behavior under the influence
  • Threat of loss due to drug use (e.g., custody of children, job loss, etc.)

Though these are undoubtedly times of crisis, they all present prime opportunities to highlight the need for immediate and effective treatment. Many addicted people who would otherwise be reluctant to leave friends or make such an overwhelming change in their lives may be more inclined to recognize the need for such a drastic shift in the wake of such an event. Residential care is effective in part because it is such a total turnaround for how the person is managing his daily life, offering 24-hour assistance to the patient who is ready to take the leap and change his life.

Do What’s Right for You

Ultimately, however, even if inpatient care is the ideal first choice, the fact is that not everyone can manage it. It may be too much of a time commitment, too expensive, or there may be another issue that simply doesn’t make it a viable option for someone’s life. Is the answer then to avoid treatment completely?

Absolutely not. Intensive outpatient care offers almost as much in terms of therapeutic intensity and support to the patient. Drug tests help to ensure that patients are maintaining the integrity of the program even when they are not under the watchful eye of therapists and medical professionals. In fact, some prefer outpatient treatment because they feel it gives them the opportunity to progress and grow in recovery on a “trial-by-fire” basis. That is, though they are still dealing with outside stressors and triggers for relapse, they have the daily connection with intensive recovery to help them manage these issues hands-on and in the moment so that they never feel they have to overcome the urge to drink or get high alone.

Additionally, if the patient continues to live at home while attending outpatient care, family members may be able to play a more active role in their loved one’s recovery and amplify their experience in treatment by learning how best to be supportive during the treatment process and beyond.

Ultimately, there is no one set or standard path to a life free from active addiction. Everyone is different, and more important than taking an all-or-nothing approach is the ability to be flexible and choose the best possible treatment option according to the needs of the individual. In every case, any level of treatment or intervention is always better than active addiction.