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Inpatient vs Outpatient Rehab
Pros & Cons

Addiction treatment programmes can be neatly divided into one of two categories: inpatient vs outpatient rehab. Within these two categories, there are numerous options to choose from – making it all the more important to understand the range of possibilities.
Residential treatment programmes typically last between 28 (or 30) and 90 days. They are designed to provide 24-hour care within a structured and supportive environment, and are ideal for moderate to severe addictions, or people suffering from a mental health disorder as well as an additional substance or behavioural addiction.
Generally speaking, outpatient treatment programmes provide rehab services for those who are suffering from less severe addictions, and want to continue living at home. Outside of the treatment programme, life may continue as normal. Outpatient clients can attend group and individual therapy sessions several times a week, and may meet with other treatment professionals for other medical or psychological needs to further their recovery.
The decision to seek inpatient or outpatient rehab is an important one. Understanding the difference between the two will help you select the best option for you or your loved one.
In this article, you’ll learn more about:

What is the difference between inpatient & outpatient rehab?

The main difference concerning inpatient vs outpatient treatment is in the intensity of care and attention that you will receive. As a client in an inpatient programme, you can expect to have access to 24-hour medical supervision while receiving treatment for your addiction. Outpatient programmes offer a far lower threshold of medical support and intervention.
Although both methods of treatment can be effective, each works differently. Because addiction is different in every person, it is essential to choose a programme that meets your individual needs and gives you the highest chance of recovery.

Levels of care for addiction disorders

The primary treatment setting is divided into two categories (inpatient and outpatient treatment), but the level of care provided varies from centre to centre. According to the American Society of Addiction Medicine, there are five main levels of treatment for addiction disorders.¹

LevelServiceDescription
0.5Early Intervention Services
  • Level 0.5 treatment is designed for those who may be at risk of developing an addiction but do not yet display symptoms that warrant admittance to a rehab programme.
  • Treatment could include drug and alcohol education as well as preventive therapy.
IOutpatient Treatment
  • Level I involves treatment in an outpatient environment.
  • This level is suitable for those who are not suffering from a severe addiction and can still maintain their normal lifestyles while attending treatment. 
  • Clients learn how to implement positive behavioural changes to manage their addiction.
IIIntensive Outpatient Services/ Partial Hospitalisation
  • Level II treatment consists of medical and psychiatric consultations, psychopharmacological treatment, symptoms management, and access to 24-hour crisis support.
  • This level of care can include partial hospitalisation and referrals to higher levels or care, if needed.  
IIIResidential and Inpatient Treatment
  • If someone is deemed as needing Level III treatments and services, they will be referred to an inpatient programme. 
  • Level III clients will receive comprehensive care in a structured environment with 24-hour supervision and support.
IVMedically Managed Intensive Inpatient Treatment
  • The most thorough and comprehensive of treatment levels, Level IV clients will benefit from expert, 24-hour medical services and the highest level of support from their core medical team.
  • Treatment is delivered under a defined set of policies and includes dedicated hospital-based facilities with inpatient beds.

What is outpatient rehab?

Outpatient rehabilitation programmes tend to be less rigorous than their inpatient counterparts. Your outpatient programme will take part in the community, so you will still be able to maintain your normal daily routine while you undergo treatment in a local facility.
Depending on the type of treatment, you may be required to attend your treatment sessions for nine or more hours per week; however, this can depend on numerous factors such as the severity of your addiction, your availability, your response to treatment, and other factors. Often preferred by those who are suffering from a mild addiction disorder, outpatient programmes tend to last three to six months, but can also be extended to over a year.
There are two main types of outpatient programmes: Day treatment and Intensive Outpatient Programme (IOP).

Day treatment

Day treatment includes full-day schedules 5 to 7 days per week and may treat patients with co-morbid mental illness.² This type of treatment allows clients to receive focused, professional treatment even while living at home. It is intended for those who have already given up their addictive behaviour and gone through withdrawal. By using standard forms of evidence-based treatment, this type of outpatient care can move clients toward recovery without entirely separating them from their day-to-day lives.

Intensive Outpatient Programme (IOP)

IOPs ensure clients are given medical and psychological help during their recovery process. Clients only need to go to a rehab centre or hospital for treatment sessions, such as individual and group counselling, behavioural therapy, relapse prevention education, and additional treatments. IOPs generally require clients to attend a treatment facility for a minimum of nine hours per week, and tend to be more invasive than day treatment.

Who is best suited to outpatient rehab?

Outpatient rehab is suitable for those who are suffering from a relatively mild addiction. If you have personal and professional obligations, and can realistically commit to overcoming your addiction while still in your daily environment, then an outpatient rehab programme could be right for you. With the right treatment programme and a supportive environment at home, outpatient care lets you take those first positive steps on the road to recovery.

Pros of outpatient rehab

  • Live at home while you receive treatment 
  • More affordable than inpatient treatment
  • Immediate social support from your family and friends
  • Being able to practice your recovery in a real-life situation
  • Flexible treatment options
  • No disruption to your everyday life

Cons of outpatient rehab

  • Lack of continuous medical and emotional support 
  • Being in your usual environment can expose you to triggers, leading to a relapse
  • Less chance of being able to identify and actively manage co-occurring mental health conditions
  • The detox process can be more difficult
  • Clients with a dual diagnosis likely need to coordinate their own care, as addiction and mental health treatments are undergone separately

What is inpatient treatment?

Inpatient recovery programmes (also commonly known as residential rehabs) involve addiction treatment in a dedicated residential rehab facility. Providing 24-hour medical care and emotional support, inpatient treatment centres generally also offer medically assisted detoxification. However, it’s best to ask if your rehab centre of choice offers this service before opting for treatment with them.
Once you have completed the detoxification process, you will embark on a treatment programme that has been carefully designed to ensure the highest possible likelihood of a full recovery. This treatment programme may involve a 12-step approach, behavioural therapy, the matrix model, relapse prevention, or a combination of these. An average inpatient rehab programme may last from 28, 60 to 90 days, depending on various factors such as the severity of your addiction and your response to treatment.
The types of inpatient programmes can be further divided into the following:³
  • Short-term residential treatment: typically lasts between 1 – 3 months and treatment often consists of medical detoxification in combination with behavioural therapy
  • Long-term residential treatment: typically refers to treatment of 3 months or longer, and may last as long as 12 months
  • Low-intensity residential treatment: refers to a secondary stage of treatment where clients live in a semi-controlled environment and continue to receive support

Who is best suited to inpatient rehab?

Inpatient rehab is designed for those with moderate to severe addiction problems. Rehab at an inpatient centre will give you a break from your day-to-day responsibilities, like employment and your interpersonal relationships, so that you can fully focus on your recovery.

Pros of inpatient rehab

  • Constant access to medical care and emotional support 
  • Specifically designed to treat serious addictions and co-morbid disorders
  • Removal from environments that can trigger cravings and lead to relapse
  • Supplementary activities that actively promote wellness and abstinence from harmful substances
  • A sense of belonging and community, as the intimate setting provides an opportunity to bond with fellow clients and counsellors

Cons of inpatient rehab

  • Higher costs due to the comprehensive nature of accommodation and treatment
  • Inability to continue active employment during your treatment 
  • Cut off from the outside world, causing a disruption to everyday routine and making it more difficult to receive support from friends and family
  • Some insurance companies are reluctant to pay costs for inpatient treatment programmes
Inpatient rehab is best suited for individuals who:4
  • Are chronic drinkers with a high level of dependence and a long history of drinking
  • Are long-term drug users and suffer significant harms from use
  • Lack social support and whose social networks are conducive to continued drug use
  • Have active mental disorders, such as unresolved anxiety or depression
  • Have mental health symptoms that need overnight support and “as needed” medication
  • Have used a large classes of drugs or abused substances at an early age
  • Have experienced overdoses and had a high levels of suicidal ideation
  • Have a history of failed attempts at inpatient or outpatient treatment, either for alcohol, drugs, or mental health treatment

Inpatient vs outpatient treatment success rates

There is no standardised way to measure the success of treatment centres, so be wary of centres that claim to have higher success rates than others. Many providers of addiction treatment programmes base their success rates on completion of their programmes, sobriety rates immediately after treatment, client interviews, internal studies, and other such methods.
Due to the nature of addiction, relapses are common. However, that does not mean rehab programmes are ineffective, or that someone is a failure for not being able to overcome their addiction. Beating an addiction can be a long process, and rehab programmes – both inpatient and outpatient – may have a role to play.
The range and quality of care options as well as the support of a strong community are crucial factors in a successful recovery. Rehab programmes that foster a sense of community during the treatment process are more likely to see their clients achieve long-term sobriety, by helping them feel they are part of a like-minded group of people who are all facing the same types of challenges.
If you or your loved one are considering specialist addiction treatment at an inpatient centre, we recommend looking for licenced and reputable providers that can offer the following:
  • Dedicated health care services for both medical and emotional needs, that are available 24 hours per day in a safe, alcohol or drug-free environment
  • Personalised treatment options that include the three steps of addiction treatment: detox, reflection, and growth
  • Comprehensive and active treatment services in the form of individual counselling, group counselling, and referral to support networks
  • A multidisciplinary clinical team that includes psychologists, nurses, occupational therapists, pharmacists, social workers, as well as support and administrative staff 

Is inpatient or outpatient rehab better?

Individual treatment outcomes vary dramatically according to the specific nature of your addiction and the quality of the treatment you receive, as well as the competence and experience of your assigned addiction treatment team. Generally, we find that inpatient programmes provide a more comprehensive and well-rounded approach to treating addictions. 

However, outpatient programmes allow you to remain within your support network and normal routine while you undergo treatment. That’s why most effective treatment category tends to vary according to your particular circumstances.

This initial assessment should focus on identifying the presenting problems and personal needs of the client and whether the treatment facility is able to meet those needs
A longer stay in treatment (whether inpatient or outpatient) provides you with ample opportunities to develop coping mechanisms and skills to avoid a potential relapse.
Programmes that provide focused and thorough treatment plans tend to have a higher rate of success.
Programmes that offer a wider range of holistic treatment techniques tend to have a higher client retention rate as they make the rehab process much easier and more relaxing for the clients5
The important feature is continuity of care over a long period of time, and this perspective is consistent with emerging models of recovery-oriented systems of care.

choosing the right treatment setting

When choosing the right rehab programme for you or a loved one, we recommend taking a hard look at the following questions:
  • Budget
    • Is the treatment programme affordable?
    • Will insurance cover the full duration of treatment?
    • Are there any extra costs that I should know about?
  • Severity of condition
    • How long has addiction been an issue for you?
    • Are there any co-occurring disorders present?
    • Does the severity of my condition warrant a higher level of care?
    • Do I need access to 24-hour medical care and support?
  • Support system
    • Do I have a strong support system at home?
    • How would I respond to treatment in a group setting?
  • Environment/triggers
    • Would being away from my normal environment and its associated triggers be beneficial for me?
    • What triggers my addiction? How can I remove myself from that situation?
  • Treatment offerings
    • Does my treatment provider care for my specific needs?
    • Does the treatment facility have the necessary expertise and protocols to deal with medical emergencies?
    • Does the treatment programme include relapse prevention strategies and continuing care?
    • Does the treatment facility employ a multidisciplinary team who have had specialist training in managing addictive disorders?

Deciding to tackle your addiction is the first big step on the road to recovery. If you or a loved one are dealing with addiction, our experienced team of clinical consultants can help. Call us today for a confidential discussion about inpatient vs outpatient treatment, and the right option for you.

Author
Brett Thornton
Counsellor
About the Author
  1. “What Are the ASAM Levels of Care?” ASAM Continuum, American Society of Addiction Medicine, 4 Nov. 2019, www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/. 
  2. McCarty, Dennis et al. “Substance Abuse Intensive Outpatient Programs: Assessing the Evidence.” Psychiatric Services (Washington, D.C.) vol. 65,6 (2014): 718-26. doi:10.1176/appi.ps.201300249
  3. Evans, Barry. “Drug and Alcohol Treatment Guidelines for Residential Settings.” 2007, NSW Department of Health. 
  4. The Victorian Government. (2018). About Residential Rehabilitation. State of Victoria, Department of Health and Human Services. Retrieved from www2.health.vic.gov.au/alcohol-and-drugs/aod-treatment-services/aod-residential-treatment 
  5. Traditional, Alternative, or Complementary Therapies, in Addiction Treatment (TATAC) Report: National and State Profiles.National Association of State Alcohol and Drug Abuse Directors, 2015, pp. 1–15,Traditional, Alternative, or Complementary Therapies, in Addiction Treatment (TATAC) Report: National and State Profiles.

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