The National Institute on Drug Abuse (NIDA) lists several components in their Principles of Effective Treatment, outlining approaches to help people struggling with addiction to drugs or alcohol. Because addiction is a chronic disease of the brain, involving relapse, it is important that people have easy access to evidence-based treatment options, which are customized to meet individual needs. The core principles of effective addiction treatment are detox, rehabilitation, and ongoing support after completing rehabilitation.
The type of rehabilitation program that will benefit a person will vary greatly. Some people have not struggled with addiction to a substance for long, and have support from friends and family at home, so they can go through an outpatient treatment program, which requires fewer than 10 hours of participation per week, and focuses on education and group therapy. Other people need medical support not just for detox, but during rehabilitation as well, and this means inpatient treatment with 24/7 medical supervision.
Residential treatment, also called inpatient treatment, allows the person struggling with addiction to live in a safe, drug-free space while they focus on changing their behaviors toward intoxicating substances. A specialty facility provides a room – typically shared with at least one other resident – group therapy, meals, group activities, a drug-free environment, case management, relapse prevention education, and often, other specialty treatments. These additional treatments may include:
- Individual therapy
- Complementary medicine
- Art therapy
- Nutrition counseling, along with customized meals
- Job retraining or educational opportunities
Long-term residential treatment provides a home, food, and treatment for much longer – sometimes, as long as six months to one year.
These specialty facilities may focus on people with particular medical needs who are recovering from substance abuse or those with co-occurring substance abuse and mental illness. They may focus on a 12-Step approach in a community setting on a long-term basis.
Short-term residential treatment may only last for 3-6 weeks, giving the individual time to stabilize their physical and mental health before transferring the person to outpatient treatment, which lasts for longer. Most short-term residential programs involve a modified 12-Step treatment approach. Because the intent of this type of residential treatment is for the person to quickly be able to live on their own, therapy sessions are intense and consistent. Self-reflection through group sessions and journaling are important aspects of short-term residential treatment.
Partial hospitalization is a more medically focused form of short-term residential treatment, keeping the individual in the hospital for a few days or weeks, depending on their medical needs. Once the person has stabilized, they are referred to longer-term treatment through an outpatient program. Psychotherapy is a component of this process, along with education from a social worker or case manager.
Residential treatments are ideal for people who do not have supportive home environments, who cannot stop compulsive behaviors to acquire drugs or alcohol on their own, or who are triggered by their existing environment, which is detrimental to their sobriety. In an inpatient treatment facility, healthy meals are provided; supervision and social support are available; clients are surrounded by others going through similar life changes; and there is no access to intoxicating substances.
Sometimes, people who relapsed after attempting outpatient treatment move into a residential program to address their behavioral struggles in more depth. Other people choose inpatient treatment in an attempt to “get it right” the first time. Determining the actual level of care a person needs involves a conversation between them and their doctor or case manager. Many people successfully maintain their jobs, family obligations, and social lives while completing outpatient treatment; others will require different levels of help, which residential programs can provide.
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