Inpatient drug rehab refers to a level of treatment in which clients reside at a treatment facility devoted to allowing for the most comprehensive level of care and support possible. One of the main goals of inpatient rehab is to provide a refuge from a client’s outside environment, free from temptations and triggers, so that he or she may be 100% focused on building a foundation for long-term recovery. Although inpatient rehab is generally recommended for clients with the most severe cases of alcoholism or addiction, individuals may also choose inpatient for a variety of other reasons.
What is Inpatient Drug Rehab?
Inpatient programs provide the highest level of care available, with supervision and support available 24 hours a day and administered by professionals who are certified and trained in a broad assortment of fields and specializations. Comprehensive assessments are often performed upon intake and many facilities also provide medically supervised detoxification if needed. If the facility doesn’t provide these services, clients first go to a detox center to be medically cleared.
Clients committing to inpatient treatment become residents of the providing facility, living in assigned rooms, eating meals within the center, and going to structured one-on-one and group therapy sessions a number of times per day. Additional therapeutic activities incorporated into the daily regimen can vary based on the type of facility and length of stay; examples include family visitation and counseling, wellness and nutrition seminars, workshops for developing coping skills, guided meditations, and team building activities.
How Long Does It Last?
While the average stay in inpatient rehab is 30 days, most facilities offer 60-day, 90-day, or even longer programs. Length of stay depends on several factors, such the severity of the addiction, existence of any co-occurring mental health conditions (such as clinical depression or bipolar disorder), and whether or not the client has attempted a rehab program in the past. The National Institute on Drug Abuse (NIDA) recommends that clients remain in rehab (inpatient, outpatient or a combination of the two), for no less than 90 days.
According to the NIDA publication “Understanding Drug Abuse and Addiction: What Science Says,” “Research has shown unequivocally that good outcomes are contingent on adequate lengths of treatment. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited or no effectiveness, and treatments lasting significantly longer often are indicated. For methadone maintenance, 12 months of treatment is the minimum, and some opiate-addicted individuals will continue to benefit from methadone maintenance treatment over a period of years.” Furthermore, a study published in the Journal of Substance Abuse Treatment found that, “Longer duration of treatment and provision of structured continuing care is associated with better treatment outcomes.”
Therapies Used in Treatment
A number of inpatient programs employ experimental methods in their approach to addiction treatment, many of which have not been scientifically proven to be effective. As a rule, it is always best to seek programs adhering to evidence-based protocols in the treatment models that they utilize. Examples of the more common evidence-based therapies found in inpatient rehabs are as follows:
- Medication-Assisted Treatment (MAT), a general term for the use of medications in conjunction with behavioral therapies and counseling in the treatment of substance abuse.
- Cognitive Behavioral Therapy (CBT), a psycho social therapy aimed toward improving mental health by the elimination of negative cognitive distortions and emotional roadblocks as well as the development and/or improvement of coping mechanisms.
- Dialectical Behavioral Therapy (DBT), a psycho therapeutic process in which therapists and patients work with acceptance and change-oriented strategies to develop healthier problem resolution ideas and skills.
- Contingency Management Interventions/Motivational Incentives, a behavioral approach based on a system of rewards for positive and constructive behaviors.
- Motivational Enhancement Therapy (MET), a methodology designed to quickly evoke a patient’s motivation for positive change.
Who is Inpatient Rehab Right For?
Every individual’s situation is different, and ideally a trusted professional such as a family physician will refer clients to inpatient rehab based on perceived need. The following is a list of possible reasons why an inpatient program may be a viable course of action:
- The client previously attempted outpatient rehab and was not successful in remaining free from his or her drug of choice.
- The client has co-occurring disorders.
- The client has a history of abusing multiple substances simultaneously.
- The client’s external (living) situation is such that it is difficult, if not impossible, for him or her to avoid temptations to abuse his drug of choice (e.g., cohabiting with other addicts or living in an environment that is generally unsupportive to achieving and maintaining recovery).
- Outpatient drug rehab programs are less accessible to the client than inpatient rehab.
- The client has been determined, either via professional assessment or past experience, to be incapable of remaining abstinent from drugs or alcohol without the highest level of care and supervision available.
Benefits of Inpatient Treatment
Inpatient treatment programs provide round-the-clock care and provide an elaborate framework giving clients the greatest chance of a successful recovery. Additional benefits of inpatient care include the following:
- It provides a comfortable environment which is safe from outside stressors and distractions that could potentially fuel substance abuse.
- Medical professionals are continuously present to ensure health, safety, and emotional well-being at all times.
- Clients have the benefit of a support system of counselors and fellow clients for the valuable exchange of encouragement which will ideally continue throughout the entire treatment process.
- Highly structured daily schedules invariably lead to clients developing or re-learning organizational skills that will benefit them in the real world.
- Well-tested and scientifically-proven approaches to treatment, tailored to the needs of the individual, ensure that each client progresses at his or her own pace and is fully ready to re-acclimate to life beyond rehab when the time comes.
When clients arrive to undergo the preliminary evaluation process, they are generally expected to complete intake assessments and interviews which usually include a lengthy battery of questions pertaining to substance abuse, medical and psychological history, and other details pertinent to the client’s case. At this time it may be determined that the client should undergo medical detox, in which case he or she will be ideally temporarily housed in a separate unit until detox procedures have been completed. The client should be as open and transparent as possible during this phase, in order that the most comprehensive treatment plan can be customized to best address his or her needs.
Once the client has transitioned into inpatient, a typical day may look like the following example:
7:00 a.m. Wake up
7:15 a.m. Bed checks to ensure that all residents are awake and ready for the day’s activities
7:30 a.m. Breakfast
8 a.m. Morning medication administered to each client and daily chores assigned
9 a.m. Daily check-in meeting for all residents and discussion of plans for the day
10:30 a.m. Primary Caseload meetings (group as well as one-on-one with therapists)
12 p.m. Lunch (generally with other residents; occasionally with therapist)
1:30 p.m. Wellness seminar or working group on nutrition and exercise
2 p.m. Individual meeting with therapist to assess progress and establish goals
3 p.m. “Back to basics” workshop focusing on developing skills for reintegrating into society
5 p.m. Gym time or other physical fitness activity (jogging, hiking, et cetera)
6 p.m. Dinner
6:30 p.m. Communal meditation or reflection time in common area with other residents
7:30 p.m. Residents are transported off-site to 12-step meeting
10 p.m. Brief community meeting to discuss daily victories and lessons learned
11 p.m. Bed checks/end of day
How Much Does Residential Treatment Cost?
The cost of inpatient treatment can vary substantially from one facility to another. Some programs, particularly those which are government-run, may be free, while certain private facilities can cost hundreds, if not thousands, of dollars per day. On average, inpatient rehab costs around $6,000 for a 30-day program, with well-known “deluxe” treatment centers charging $20,000 or more for premium versions of similar services. For clients requiring 60- or 90-day programs, costs can easily range from $12,000 to $60,000. The good news is that most rehabs do offer financial aid, accept insurance or have other financing options.
Insurance is the most common method for financing inpatient rehab. The amount which insurance carriers are willing to cover depends upon the insurer, the patient’s plan, and what agreements may exist between the rehab and the insurer. It is critical to ascertain these details prior to client enrollment, so as to avoid potentially unresolvable financial headaches later.
Plenty of free, or low-income, rehabs are available in many areas. While they are not nearly as “luxurious” as many private rehab facilities, they offer many of the same core services.
Regardless of whether a rehab facility is recognized by whichever insurance plan a client may have, many offer financing options that are amenable to those of all income levels. Many inpatient facilities offer assistance with crowd-sourcing initiatives (such as GoFundMe) in order to alleviate the financial strain that rehab may bring in terms of the program’s price tag as well as the “opportunity cost” of the client having been unable to provide for loved ones for the duration of the inpatient stay.
Regardless of the patient’s ability to finance rehab in the short term, it is paramount that all involved realize that this step in the patient’s recovery is quite possibly the most important investment that can be made in his or her future. 30-90 days of inpatient treatment may mean the difference between a hopeless case and a miracle, and it’s hard to put a price tag on that.