Research has shown most people need at least three months of treatment to reduce or stop their substance use. However, the best results are seen when patients remain engaged in treatment for even longer amounts of time.
Long-term addiction treatment doesn’t have to involve an expensive or intense treatment program. In fact, sometimes the most effective (and affordable) addiction treatment begins in outpatient care, depending on the patient’s needs and situation.
You can think about addiction treatment services as a cascade of care ranging from high to low intensity. Not everyone needs high-intensity services to start their care, but if they do their long-term treatment plan should move them down the cascade of care into less intensive services to support management of their disease while moving back into normal life. Said differently, addiction is managed over the long-term, not in an acute rehabilitation stint. This means your treatment type should change based on your needs.
There are different types of treatment for addiction. They are listed from the least intensive to the most intensive.
- Outpatient: Counseling, and possible medication treatment for substance use problems provided at an office or clinic. Time spent varies by the patient’s needs and may range from 1 to 8 hours per week.
- Intensive Outpatient: A program that provides counseling, medical, and/or psychiatric treatments at a clinic, center, or hospital facility. Adults attend for at least 9 hours per week; adolescents for 6. Services often occurs in daytime or evening blocks of time.
- Residential: These programs are often called “rehab” and can vary in stay from several days to 6-12 months. Patients live and receive services onsite, including counseling, recovery coaching, medical/mental health treatment, and medication management (as needed). Residential care can be necessary due to the severity of the addiction or other health conditions, a history of relapses, unstable living arrangements or a poor support network.
- Hospital Inpatient: 24-hour inpatient hospital care where medical care is the focus. Counseling and recovery support services are also available; often includes withdrawal management, sometimes known as “detox.”
Below are other components of an addiction treatment plan that might be recommended. Remember, every person’s experience with substance use disorder is unique, so treatment plans are most successful when they are personalized to meet an individual’s unique needs.
- Withdrawal Management (Detox or Detoxification): Attempting to quit a substance "cold turkey" can be dangerous — and sometimes deadly — for people who are addicted to alcohol, opioids, or benzodiazepines. Therefore, treatment may include an initial period of supervised withdrawal management, sometimes referred to as “detoxification,” during which the physical symptoms of substance use withdrawal are monitored and may be safely controlled through the use of FDA-approved medications. Withdrawal management may take place at an inpatient treatment facility or at an outpatient program under the supervision of trained healthcare staff. Learn more about the science of addiction.
- Counseling and Behavioral Therapy: Therapy helps patients address and learn healthy ways to identify and change problematic behavior, cope with past trauma, improve family and other relationships, and enter and maintain lasting recovery. Therapies are also useful in addressing other mental health challenges, which can go hand in hand with addiction. A wide range of behavioral therapies are available, and a healthcare professional can help determine which type is most appropriate based on an individual’s unique needs. Options include:
- Mental Health Monitoring: Programs watch for and are prepared to treat both substance use and mental health issues. Psychiatrists and counselors work together on-site or through referral to address mental health conditions.
- Mental Health Treatment: Mental Health Integrated programs treat both substance use and mental health issues together. Onsite program staff are trained to help with mental health problems that are active and serious.
- Medications for Opioid Use Disorder: Patients with an opioid use disorder may manage their condition with FDA-approved medication. These include methadone which is dispensed at licensed opioid treatment programs (OTPs) or buprenorphine and naltrexone which are available at some clinics or prescriber’s offices. Learn more about medications for addiction treatment.
- Support Groups: Support groups include 12-Step programs, such as Alcoholics Anonymous or Narcotics Anonymous, as well as programs that use Self-Management and Recovery Training (SMART) approaches or other peer counseling techniques. These programs provide opportunities for people in recovery to connect with one another in a supportive, safe environment. While peer support programs can be a helpful resource for some people in recovery, they don't work for everyone and should not be used in place of tested and proven behavioral therapies and/or medications for addiction treatment. Learn more about support groups.
Researchers agree that no matter where you receive addiction treatment, the care should include certain components that are shown to help improve patient's results. The Shatterproof National Principles of Care© for addiction treatment outline the practices that you should look for in all addiction treatment.
- Components of Comprehensive Drug Addiction Treatment (National Institute on Drug Abuse, 2016)
- Complications of Alcohol Withdrawal (Trevisan, LA, et al., 1998)
- Yes, people can die from opiate withdrawal (Larney & Farrell, 2016)
- Comorbidity: Substance Use and Other Mental Disorders (National Institute on Drug Abuse)
- Medication and Counseling Treatment (Substance Abuse and Mental Health Services Administration, 2019)