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Everything You Need to Know About Long-Term Inpatient Rehab

Long-term inpatient rehab is the most comprehensive form of substance abuse treatment.

A long-term program gives you sufficient time to address the issues related to your addiction. Since you will be at the treatment center around the clock, you won’t have access to substances of abuse, and you’ll be protected from many triggers. This is important during the early stages of recovery when you are most vulnerable.

Understanding Different Kinds of Care

Per the National Institute on Drug Abuse (NIDA), there are different kinds of care you can choose from when looking for addiction treatment. The various types of care include:

Outpatient treatment

With outpatient treatment, you do not live in a treatment facility. These programs work best for people who cannot take time off work or who have people at home they care for such as children or elderly family members.

The intensity of services offered varies by institution. Some places may only be equipped to provide you with basic services. Other facilities have services that are just as comprehensive as those provided by inpatient treatment.

Many outpatient programs offer treatment for co-occurring physical or mental health issues.

Short-term inpatient treatment

These programs are intense and can last from three to six weeks. Clients stay at the facility 24 hours a day, seven days per week for the duration of treatment. Many programs are based on a traditional 12-step approach, and they can treat a variety of substance use disorders.

Most short-term residential programs require outpatient treatment after completing the program for best results. Support group participation, such as attendance at Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) meetings, is often part of these programs.

Long-term inpatient treatment

This is a longer form of inpatient treatment. A well-known model is a therapeutic community (TC), which often requires a stay of six to 12 months. 

With inpatient treatment, all parts of the program are focused on some aspect of recovery. The treatment is very structured and can include recreational activities, employment training, individual and group therapy, and activities that encourage socializing in a substance-free setting.  

Whereas a short-term inpatient treatment program gives clients a month or so of comprehensive care, long-term inpatient options provide clients the ability to really build a new life in recovery. The lessons they learn in therapy have sufficient time to take hold and be practiced.

What to Expect from Long-Term Programs

Depending on the substance you were using, you can expect an assessment and possibly detox as the first part of your treatment.

You might receive a medically managed withdrawal, depending on your primary substance of abuse. If you abused opioids, you might start methadone or buprenorphine treatment. 

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Per NIDA, some people require medically assisted treatment (methadone maintenance) for up to 12 months. Others may need methadone maintenance for several years. The inpatient program works with you to devise a treatment schedule that fits your situation.

Therapy will be the primary component of your treatment. You’ll participate in various forms of it, and that’s where you will do the real work of recovery.

With long-term residential treatment, you can:

You may be in long-term rehab due to a court mandate, but you can leave if you choose to regardless of later consequences. In most cases, the treatment center won’t force you to stay.

Many rehab facilities have their own detox facilities. Detox typically takes five to seven days for most substances. Some rehab centers may expect you to go to a specialized clinic and detox before you start rehab.

Every treatment center has a different structure, but most offer education about the nature of substance abuse, self-destructive behaviors that cause it, and workshops that teach you to stay sober and drug-free. Some clients may still be in denial about the extent of their problems when they begin the program. Substance abuse education is meant to help you recognize how much of a problem drug misuse can be.

Inpatient treatment centers will offer individual therapy with an addiction specialist. You will also take part in group therapy that can teach you valuable skills about committing to a sober lifestyle, help you recognize your triggers for substance use, and learn how to ask help from others who are going through the same things you are.

Family therapy involves relatives and other loved ones. Data shows that including friends and family on your recovery journey can improve your chances of success. You and your family will learn about how addiction has affected you all and how to improve communication. This therapy can help to repair relationships that were damaged because of drug use.

Inpatient treatment facilities will also vary. Some will have only basic amenities, while others are luxury buildings. This depends on what you can afford or what your insurance is willing to pay for. 

Still, you are not there for the amenities. Though amenities are nice and can encourage you to stay in treatment for longer, fewer bells and whistles will not impact your recovery. 

Benefits of Long-term Rehab

The benefits of long-term inpatient rehab are many.

Relapse is common even with the best treatment. In a 2017 article from Tonic, several interviewees discussed attending rehab before the age of 21. Though most interviewees had achieved sobriety, some mentioned a few challenges of quitting drugs. Some attended five inpatient facilities, and some attended a short-term program and then a long-term program.

This illustrates the importance of finding a program that works for your situation — one you can stick with. A longer duration of time in treatment is associated with higher rates of success in recovery.

Long-term inpatient rehabilitation can be well worth it from this perspective.

A 2009 study from the Norwegian Institute of Public Health reports that outpatient treatment can be as beneficial as inpatient treatment. Still, inpatient treatment might be better for some people, such as:

The Substance Abuse and Mental Health Services Administration (SAMHSA) states that teenagers could benefit from the structure of long-term inpatient facilities. They may even be able to continue with their high school education or obtain a GED through the program.

These individuals benefit from the safety and stability of long-term residential care.

Relapse after outpatient treatment is often a sign that more comprehensive treatment is needed. Per NIDA, some inpatient facilities may also be able to provide care for co-occurring issues, such as depression or anxiety.

Is It Right for You?

Inpatient rehab is more expensive than outpatient treatment, but it can be worth the extra cost. A longer time in treatment also equates to a higher bill, but again, the benefits of more time in treatment are well worth the extra investment.

If you have insurance, check with your provider about how much time is covered. Your plan may specify a set number of days of residential or inpatient treatment. You can also talk to the treatment facility in question regarding ways to offset the costs of long-term care.

Sources

(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Principles of Effective Treatment. National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide: Types of Treatment Programs. National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

(February 2016) Understanding Drug Abuse and Addiction: What Science Says. National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/6-duration-treatment

Veterans Alcohol and Drug Dependence Rehabilitation Program. Benefits.gov. Retrieved March 2019 from https://www.benefits.gov/benefit/307

(November 2018) Drug and Alcohol Rehab Programs for Beginners. Verywell Mind. Retrieved March 2019 from https://www.verywellmind.com/what-can-i-expect-at-a-drug-and-alcohol-rehab-program-67865

(February 2017) We Asked People What It's Like To Go To Rehab Before Age 21. Tonic. Retrieved March 2019 from https://tonic.vice.com/en_us/article/3djk75/we-asked-people-what-its-like-to-go-to-rehab-before-age-21

(August 2009) Long Term Institutional or Residential Treatment of Patients with Substance Abuse Compared to Short-Term Outpatient Treatment [Internet]. Norwegian Institute of Public Health. Retrieved March 2019 from https://www.ncbi.nlm.nih.gov/pubmed/29320091

(Revised 2014) What is substance abuse treatment? Substance Abuse and Mental Health Services Administration. Retrieved March 2019 from https://store.samhsa.gov/system/files/sma14-4126.pdf

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