Approximately 44 million Americans need substance use treatment annually, according to the National Institute on Drug Abuse. However, only 1.5 percent (4.1 million) received substance use treatment, and an even smaller percentage received treatment at a residential addiction treatment (1.3 million) or outpatient facility (1.8 million).

With such a large treatment gap, this highlights the importance of increasing access to treatment and providing educational resources about what to expect in professional inpatient drug rehab facilities and how to make the decision about choosing the right rehab.

What is Inpatient Drug Rehab?

Inpatient drug rehab (also called residential addiction treatment) is a type of specialist rehabilitative treatment for people with substance use disorders to assist them to stop using drugs and maintain their recovery.

Think of it as staying at a special facility with around-the-clock care and supervision. There is a little more to it than that as each facility offers different levels of care depending on:

• The intensity of care required
• Severity of substance use disorder
• Whether detox is required
• Medical needs
• Co-occurring conditions
• How you are intending to pay for treatment
• Preferences of the client, like autonomy (keeping cell phones and computers), executive treatment, and amenities

It might be helpful to think of treatment as medical care, the more severe the condition, the more specialist treatment you’ll need.

In terms of the standards of medical and behavioral health needs, the American Society of Addiction Medicine (ASAM) has produced a set of guidelines (known as the ASAM Criteria) for the treatment of people with substance use disorder and co-occurring conditions, which we’ll describe below.

ASAM Criteria Continuum for Inpatient Rehab

The five levels of care for people with substance use disorders include

• Level 4 Medical Detox: medically managed inpatient treatment at either a specialist facility or hospital
• Level 3 Residential: usually at a standalone facility, providing different levels of care
  • 3.1 Clinically managed low intensity residential: this might be good for someone with low support needs and with less severe substance use disorder.
  • 3.5 Clinically managed high-intensity residential: this level is for people with more acute substance use disorder, potentially other co-occurring mental health conditions, and someone who needs 24-hour nursing support.
  • 3.7 Medically managed residential: as the name suggests, this type of facility has medical staff on site.
• Level 2 IOP/PHP: these are intensive outpatient facilities ranging in intensity and medical care. The programming might be similar to a residential treatment program, but patients return home at the end of the treatment session.
• Level 1 Outpatient: less intensive outpatient and medically managed outpatient. treatment, usually in a doctor’s office or community clinic.
• Recovery Residence: this is a sober living home, typically for people who have completed an inpatient rehabilitation program.

When searching for inpatient rehabilitation, finding the right treatment center can make a significant difference in your recovery journey.

Inpatient centers focus on residential addiction care and offer a variety of benefits to help you or your loved ones achieve long-term sobriety. Understanding the advantages of inpatient treatment can help you make an informed decision about your recovery path.

Benefits of Inpatient Rehab

Choosing an inpatient rehab facility offers numerous advantages that can significantly impact your recovery process, including:

• Intensive Therapy and Support: Daily access to therapeutic sessions and medical care
• 24/7 Supervision: Constant monitoring ensures safety and addresses immediate needs
• Safe Community: A supportive environment focused on recovery, free from external distractions

How Long is Inpatient Rehab?

The duration of inpatient drug rehab depends, much like the levels of care, on the individual’s needs, whether detox is required, co-occurring conditions, and design of the treatment center programs.

As a rule of thumb, most residential addiction treatment programs are for a minimum of 30 days. Other programs may last for 90 days or even 12 months — these programs are considered long-term residential treatment.

The National Institute on Drug Abuse (NIDA) advises in their principles of effective treatment that remaining in treatment for an adequate period of time is critical. While duration is client need dependent, research indicates that most people with substance use disorders meet at least three months in treatment to see the best outcomes.

How Does Inpatient Rehab Work?

There are several principles to effective treatment. Depending on the type of drug use and needs of the client, an inpatient rehab program may be appropriate, and involves the following key elements:

• Intake and admission: during this period, clients complete paperwork, and turn over their belongings (some rehabs may inspect baggage to ensure that no prohibited items have been packed). Once this process is complete, you’ll be shown to your room or designated area in the facility.
• Assessment: at this stage, you should expect a comprehensive assessment that involves taking a detailed history of your substance use (drug of choice, dose, frequency, duration, etc.); medical history including any co-occurring conditions and medical needs; history of any previous attempts to stop using and symptoms experienced, overall health and symptoms upon admission.
• Detox: depending on the severity of substance use disorder, substance used, and medical needs, you may first enter a detox phase of treatment. This may involve the use of medication to relieve withdrawal symptoms and make the process as comfortable as possible. For individuals with a history of opioid use, research shows that medication-assisted treatment should be the first line of treatment, followed by behavioral therapy. NIDA advises that detox alone is not sufficient to complete treatment; you’ll need to then enter the rehabilitation part of addiction treatment.’
• Rehab: this part of the program involves individual and group therapy, behavioral counseling, skills training, educational groups, and other types of supportive therapy. These may include cognitive behavioral therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), dialectical behavioral therapy (DBT), motivational interviewing, twelve-step facilitation, family therapy, animal-assisted therapy, and other complementary therapies like acupuncture, meditation, and yoga. Think of this stage as enhancing your coping mechanisms, teaching you new skills, and providing you with key knowledge about substance use disorders to prevent returning to use (also called relapse).
• Aftercare/continuing care: typically, you’ll work on an aftercare plan with your therapist/counselor before leaving treatment. Some rehabs have alumni programs and others may require follow up visits and ongoing recovery support meetings. Think of this part as maintaining the critical skills you’ve learned in rehab to maintain your sobriety.

Bottom line: rehab should treat the whole person to be successful, addressing medical, mental, social, occupational, family, and legal needs to help you, or your loved one, succeed in your recovery.

How Much Does Inpatient Rehab Cost?

The cost of residential addiction treatment varies depending on:

• Insurance coverage
• Amenities
• Duration of treatment
• If detox is required
• Location of the facility

Does Insurance Cover Inpatient Rehab?

It depends. Most insurers cover a portion of the cost of addiction treatment. For example, some cover inpatient and outpatient programs, and some do not cover detox. It’s best to call your insurer to find out your level of coverage and out-of-network benefits.

It is possible to get insured under Medicare and Medicaid, but there are certain stipulations.

Medicare covers people over the age of 65 or those who experience disabilities. Whereas Medicaid covers people:

• Over the age of 65 or under 19-years old
• Parents or pregnant people
• Low income individuals and families

Are There Free Inpatient Rehabs?

Most rehabs take insurance or private pay (out of pocket) payments. Some will take Medicare, military insurance, and Medicaid, too. A smaller portion of treatment facilities offer scholarships or sliding scale payment options too for low income individuals and people without insurance.

It is typically state funded and nonprofit rehabs that offer free to low cost treatment options and are most accessible to people with limited funds and coverage.

Inpatient Rehab Services

Inpatient Rehab centers are designed to cater to local needs and provide tailored care. Program types include:

Short-Term and Long-Term Programs

Inpatient rehabilitation often combines therapy with medication management, including individual, group, and family therapy sessions to address the root causes of addiction and support holistic recovery.

• Short-Term: Typically 30 to 90 days, focusing on detoxification and stabilization
• Long-Term: Programs extending beyond 90 days to address underlying causes of addiction and build sustainable recovery skills
• Inpatient Detox: Medically supervised detoxification to manage withdrawal symptoms effectively

Detox Services

Medically supervised detoxification is a critical first step in addiction treatment. This process helps individuals safely manage the physical symptoms of withdrawal while preparing them for the next phase of their recovery journey.

• Management of Withdrawal Symptoms: Professional support to ensure safety and comfort during detox
• Transition to Residential Treatment: Preparation for the next phase of recovery with ongoing medical and psychological support

Pros & Cons of Inpatient Rehab

Pros:

• Receive treatment from addiction specialists
• Can aid the detox process and minimize withdrawal symptoms
• You’ll have medical care in case of complications
• Learn new skills
• Takes you away from the stressors of your home environment, work, and other stressful situations
• Build a recovery community
• Can help provide stabilization for co-occurring conditions
• You won’t have temptations around you
• Feel supported by others going through the same process

Cons:

• Inpatient care is more expensive than outpatient
• Your insurance may not cover the full cost
• You still have to return home after treatment
• You may not be allowed to use your phone or computer
• You will have to take time off work
• You may have to travel for treatment

When to Consider Inpatient vs. Outpatient Rehab

When deciding whether to choose an inpatient or outpatient facility it’s important to understand the client’s individual needs, specifically:

• A need for detox and potential withdrawal symptoms
• Existing medical conditions and potential complications
• Co-occurring mental health conditions
• Readiness to change
• Risk of relapse or continued use
• Whether there is a supportive living environment at home and social supports

If the person has any risk of detox symptoms or complications, and co-occurring conditions it may be necessary to choose an inpatient rehab. You should speak to a medical and addiction treatment professional who can advise you about the appropriate placement and level of care.

Choosing an Inpatient Treatment Program

Inpatient care provides several benefits that can significantly enhance the recovery experience. Depending on your needs, you may choose a local facility or consider traveling for a program that offers specialized care.

Benefits of Choosing a Local Inpatient Treatment Program:

• Community-Based Support: Access to local support groups, therapists, and medical practitioners
• Proximity to Family and Friends: Easier involvement of loved ones in the recovery process with regular visits and support
• Familiarity with Local Resources: Better integration with local support networks and treatment options
• Seamless Transition to Outpatient Care: Gradual shift from inpatient to outpatient support, ensuring continued care and relapse prevention

Benefits of Traveling for a Specialized Inpatient Treatment Program:

• Access to Expertise and Specialized Care: Travel to a facility that offers specialized treatment programs tailored to specific addictions, co-occurring disorders, or unique therapeutic approaches not available locally.
• Focused Recovery Environment: Distance from familiar environments and triggers can provide a fresh start, allowing individuals to focus entirely on their recovery without external distractions.
• Increased Motivation for Change: The commitment to travel for treatment can be a significant step in the recovery process, reinforcing the seriousness of the decision to seek help and promoting a mindset of change.

Inpatient Rehab Care Team

In an inpatient rehabilitation setting, patients benefit from a team of professionals working together to address all aspects of addiction, and ensure a comprehensive approach to treatment. A typical inpatient care team may consist of:

• Medical Doctors and Psychiatrists
  • Provide medical supervision and manage any co-occurring physical or mental health conditions.
  • Oversee detoxification and prescribe medications to assist with withdrawal symptoms and ongoing treatment.
• Therapists and Counselors
  • Offer individual, group, and family therapy sessions to help patients explore the root causes of addiction.
  • Provide coping strategies, emotional support, and guidance throughout the recovery process.
• Nurses
  • Ensure 24/7 medical care and monitoring, administering medications, and addressing any immediate health concerns.
  • Assist in managing the physical aspects of withdrawal and ongoing health needs.
• Case Managers
  • Coordinate care and services, helping patients navigate their treatment plans and any additional resources.
  • Act as liaisons between the patient, family, and the rest of the care team, ensuring cohesive care.
• Addiction Specialists
  • Focus on the specific aspects of addiction treatment, including relapse prevention strategies and substance abuse education.
  • Work closely with patients to develop personalized recovery plans tailored to their unique needs.
• Nutritionists and Wellness Coaches
  • Provide dietary guidance and support to ensure patients receive proper nutrition during recovery.
  • Offer holistic care options, including fitness programs and wellness activities, to promote overall health.
• Social Workers
  • Assist with post-treatment planning, including the transition to outpatient care or other community resources.
  • Support patients with any social or familial challenges that may impact recovery.
• Peer Support Specialists
  • Individuals with lived experience of addiction who provide mentorship, encouragement, and a relatable perspective on recovery.
  • Help patients build connections within the recovery community and develop support networks.

FAQs

What is an Inpatient Treatment Program?

An inpatient treatment program provides intensive, residential care for individuals struggling with addiction, offering 24/7 supervision and support.

What Types of Addiction Treatments are Available at Your Inpatient Rehab Facility?

Treatments include detoxification, individual and group therapy, medication management, and holistic approaches tailored to specific needs.

How Long Does Inpatient Rehab Typically Last?

Inpatient rehab programs generally last from 30 to 90 days for short-term care, and over 90 days for long-term care, depending on individual needs and addiction severity.

What Should I Bring to Inpatient Treatment?

Typically, you should bring personal hygiene items, comfortable clothing, and any prescribed medications. Avoid bringing valuables or prohibited items.

Can I Receive Visitors During My Stay?

Visiting policies vary by facility. Generally, facilities have scheduled visiting hours and specific rules to ensure a supportive recovery environment.

How Do I Know If I Need Inpatient or Outpatient Care?

The need for inpatient versus outpatient care depends on the severity of your addiction, treatment goals, and individual circumstances. An assessment by a professional can help determine the most appropriate level of care.

Is Inpatient Rehab Covered By Insurance?

Many insurance plans cover inpatient rehab, but coverage varies. Contact the facility to discuss insurance options and payment plans.

Sources

1. National Institute on Drug Abuse. Addiction Treatment. https://nida.nih.gov/nidamed-medical-health-professionals/treatment/addiction-treatment
2. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States. Results from the 2021 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt39443/2021NSDUHFFRRev010323.pdf
3. American Society of Addiction Medicine. (2024). About the ASAM Criteria. https://www.asam.org/asam-criteria/about-the-asam-criteria
4. National Institute of Drug Abuse. (2014). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). https://archives.nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf
5. National Institute of Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction. Treatment and Recovery. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery