Inpatient vs Outpatient Rehab: Compare Treatment Options

With so many options available, in and out of state, the search for the right addiction treatment program can be overwhelming. Each treatment center has its pros and cons, and what type of program is right for you may not be right for someone else. Making the decision between inpatient vs outpatient rehab will depend on several factors, such as your insurance coverage, financial situation, the severity of your addiction, past treatment experiences, and more.

In this article:

• What is the Difference Between Inpatient and Outpatient Rehab?
• Inpatient vs Outpatient Rehab: How to Choose the Right One For You
• Does Insurance Cover Inpatient and Outpatient?
• Speak to a Professional About Inpatient vs Outpatient Rehab

What is the Difference Between Inpatient and Outpatient Rehab?

There are several differences between inpatient and outpatient rehab, but the main difference is that with inpatient treatment, you live at the facility for the duration of your program, and with outpatient care, you attend therapy during the day and return home during non-treatment hours (usually the evening).¹

At inpatient rehab, you receive around-the-clock care, and outpatient treatment, which ranges in intensity, includes a set number of hours on a predetermined schedule.

The level of addiction care you need is determined by your addiction, mental health, physical health, financial resources, and more. Generally, the more severe your substance use disorder, the more intensive treatment is recommended. Getting the right type of treatment is important for treatment to be effective.²

Inpatient Rehab

Inpatient rehab, or residential treatment, involves living at the treatment facility for the length of your program, which may last anywhere from 30 to 90 days, although some may be longer if needed.

Each inpatient center offers different features and amenities, and some have different specialties. For example, one inpatient center may only treat opioid addictions while another program specializes in dual diagnosis or co-occurring disorders. Some programs may offer upscale features like spa treatment and massage therapy while others are more traditional.

Programs might offer different types of therapies and therapeutic activities. While there are differences between programs, they have similarities as well, such as:^1,2

• Structure: Inpatient rehabs are highly structured. There tends to be a daily schedule that clients follow.
• Therapeutic activities: You may have therapeutic activities, such as therapeutic outings or experiential activities, outside of individual and group therapy. For example, participating in recreational therapy is one way to discover new ways of having fun.
• Cognitive behavioral therapy (CBT): Many kinds of therapy can be used to treat addictions, but CBT is common. CBT is a type of therapy that aims to help you change your behavior by changing the way you think. CBT can also be used to help you develop coping skills and can be offered on an individual or group basis.
• 12-step meetings: Many residential centers for substance use integrate 12-step meetings into the treatment program.
• Group counseling: Group counseling is a powerful treatment tool because it allows you to receive and give feedback to peers who are in a similar situation as you are. It also allows you to learn and practice new skills in safe environment.
• Treatment planning: At the beginning of treatment, the residential staff will create a treatment plan with you. A treatment plan is where you get to share your goals for treatment. From there, the staff will plan out a strategy for how to help you accomplish these goals. This is a collaborative process, which means you get a say in your treatment.
• Aftercare/discharge planning: Toward the end of treatment, residential staff will help you create a plan for how you can protect your recovery once you leave rehab. This plan might include referrals to an outpatient treatment program, 12-step meetings, sober living, or other recovery-related services.

Inpatient programs may also cater to specific populations, such as people experiencing homelessness, teens, women, members of the LGBTQ+ community, or court-ordered individuals.¹

Who Inpatient Treatment May Be a Good Fit For

No matter who you are, inpatient rehab can be a good first step in your recovery process. Inpatient rehab focuses on the beginning phase of recovery. Recovery occurs in phases, and the first phase is to help you control your substance use or stop using completely.³

Inpatient rehab is a good place to take this first step if you:^1,4,5

• Have limited social support
• Need consistent support and accountability to stay sober or engaged in treatment
• Can take off time from work or school. Some treatment programs may help you to file disability claims or submit the necessary documentation to your school or work so that you can attend treatment
• Need medical support and supervision to detox safely. Detoxing from some substances can be dangerous. Detoxing in inpatient rehab can make sure this process is done safely and most comfortably.
• Have a severe alcohol or drug addiction
• Have a co-occurring mental health disorder (dual diagnosis)
• Have a comorbid medical condition
• Have previously dropped out of outpatient treatment

Outpatient Rehab

Outpatient rehab allows you to attend treatment while living at home or in a sober living environment. This might be a good treatment option if you have a lot of social support and are able to keep yourself medically and physically safe while detoxing.¹

It might also be possible to continue working while in outpatient treatment since outpatient rehab is less intensive than inpatient. Outpatient treatment can occur in several settings, with varying degrees of structure and intensiveness, including:

• Partial Hospitalization (PHP): PHP is the most intensive outpatient rehab. Typically, PHP programs provide treatment anywhere from five to six days a week, up to seven hours a day. They are often used as step-down care after completing an inpatient program.
• Intensive Outpatient (IOP): IOP programs tend to take place three to five days per week for three hours per day. They also serve as a good step-down option for someone who has completed inpatient and still wants support.
• Standard Outpatient: The least intensive outpatient option, standard outpatient may involve a couple of hours of care per week, for one or two days per week.

PHPs and IOPs can offer some of the same services that inpatient programs offer, such as individual and group therapy. The main difference between inpatient and outpatient is how much care is provided and at what intensity. Outpatient treatment is less intensive, which means less support is offered and you have the flexibility and freedom to return home. While this is helpful for some people, it can increase the risk of relapse for others.

Inpatient vs Outpatient Rehab: How to Choose the Right One For You

Deciding between inpatient vs outpatient rehab can be difficult. When making this decision, you can ask a doctor or therapist for their opinion. They may conduct an assessment to determine which level of care is right for you.

This assessment may include an evaluation of various factors, such as:

• Your substance use patterns
• Your treatment history
• Your mental health and physical health
• Your withdrawal history
• Risk of severe withdrawal symptoms
• Length of substance use
• Family history of substance use disorders and mental health conditions

Your doctor may then use this information to refer you to an inpatient or outpatient rehab, depending on their determination.

When comparing inpatient vs. outpatient rehab, you should also consider what is financially feasible for you. Typically, the more intensive the treatment is, the more it will cost.

Also, you may need to consider if you can take time off work to attend inpatient treatment. Sometimes filing for disability is an option, which can help financially. However, if this isn’t an option, finding treatment that is affordable for you is important to consider as well.

If you have insurance, most addiction treatment facilities accept insurance to help pay for rehab. You will have to call your insurance company to learn more about your particular plan and to what extent it covers treatment. You may be surprised at how much is covered.

Does Insurance Cover Inpatient and Outpatient?

Yes, insurance most likely covers inpatient or outpatient addiction treatment. This is thanks to two federal laws.
The Mental Health Parity and Addiction Equity Act of 2008 requires health insurers to cover mental health and substance addiction treatment to the same extent that they cover medical and surgical treatment.

Additionally, the Affordable Care Act (ACA) is a 2014 health insurance reform that required health insurance companies sold on the Health Insurance Exchange or provided by Medicaid to provide coverage for ten essential health benefits, which included treatment for substance use disorders.

Of course, everyone’s insurance plan and coverage are different, so you’ll want to follow up with your provider to learn if you have partial or full coverage.

Some treatment centers may not take insurance, and you would be required to pay cash. However, many centers do accept health insurance, so you will want to make sure to ask the rehabs that you’re considering.

Speak to a Professional About Inpatient vs Outpatient Rehab

If you still need help choosing a program, you can always consult your doctor or therapist. They can schedule an assessment and refer you to an inpatient or outpatient program. You could also call our confidential helpline at 866-968-5444Who Answers? to speak to a rehab support specialist. We are available 24/7 to help you find the right inpatient or outpatient rehab for you.

Resources

1. National Institutes of Health. (January 2018). Types of Treatment Programs.
2. National Institute on Drug Abuse. (December 2012). Principles of Drug Addiction Treatment
3. Guenzel, N. & McCharge, D. (July 18, 2021). Addiction Relapse Prevention.
4. Substance Abuse and Mental Health Services Administration. (November 4, 2021). MAT Medications, Counseling, and Related Conditions.
5. National Library of Medicine. (n.d.)  Opioid Misuse and Addiction.