Just as addiction does not discriminate and impacts all types of people, so addiction treatment must not be a one-size-fits-all model. While there is an ideal continuum of care that starts with the most intensive and supported care and ends with the least amount of treatment and support over a long period of time, to truly help and support suffering from addiction, there needs to be a personalized continuum that specifically supports that individual’s clinical needs, community and social needs, basic life needs, education and career, and overall situation. Here are the different levels of treatment and recovery support in an addiction treatment continuum of care.
Detox is often the first step for an individual in their treatment and recovery journey. Detoxification is a process to separate an individual physically and safely from substances. With 24/7 medical care and support of doctors and nurses (as well as clinical professionals and support staff such as therapist assistants or behavioral health technicians), an individual will be detoxed typically over a 7-to-10-day period of time, receive FDA-approved medications to help manage withdrawal symptoms, and get to a place where they are medically stabilized physically and emotionally.
Inpatient rehab or residential treatment is traditionally a level of care that lasts just about a month. Usually a 28-day program or a 30-day program, individuals will go to an inpatient facility or a residential treatment center campus and begin primary treatment for addiction. Many inpatient or residential treatment centers include the detox process as part of that month-long treatment experience. Some do not have the ability to detox and rather will refer a patient out to be detoxed and medically stabilized, and then admit them into residential treatment. Inpatient rehab or residential treatment is an acute phase of treatment where a person stays in the facility and receives 24/7 support. A patient will often receive group therapy and individual therapy, as well as psychiatry. There are often educational lectures. Outside meetings may be brought into the facility by individuals in recovery in the evening or over the weekend. There is often usually a family education program that occurs during a weekend while the identified patient is in treatment.
Extended care treatment is often the most structured option as an aftercare recommendation post-inpatient rehab. Extended care can sometimes refer to longer inpatient or residential treatment stays, which is more of an extended residential treatment, but most often extended care refers to programs that offer an outpatient level of care such as partial hospitalization (PHP) or intensive outpatient (IOP) and combine it with a structured living component. Some extended care treatment programs are most clinically driven and offer a highly structured living component, while others are less structured and instead combine an IOP level of care with an associated recovery house. Either way, most extended care addiction treatment programs last for at least 90 days and many of them longer. Extended care is meant to be a community-reintegration model of care that comprehensively supports a patient back into their life with clinical services, structured living, accountability, and life skills development.
PARTIAL HOSPITILIZATION (PHP)
Partial hospitalization (PHP) treatment is an outpatient level of care where patients do not live within the treatment model. Some people may attend PHP programs while living at home, while others may live at non-affiliated sober livings or recovery houses while attended PHP. Partial hospitalization programs usually occur either 5 days per week or 7 days per week, several hours each day. Patients receive a mix of group therapy, individual therapy, psychiatry, case management, and family therapy while in PHP.
INTENSIVE OUTPATIENT (IOP)
Intensive outpatient (IOP) treatment is an outpatient level of addiction treatment that typically occurs a minimum of 9 clinical hours a week. IOP is often either an aftercare next step once a patient completes detox or residential treatment or can also be an initial access point to care if an individual meets the criteria for IOP rather than inpatient rehab or PHP. Patients that attend IOP treatment programs often either live at home or in a sober living environment, and many are able to still work or attend college classes. Some IOP programs offer just group therapy several days per week, while more comprehensive IOP treatment programs will also incorporate individual therapy, family therapy, and psychiatry into their programming.
Outpatient treatment for addiction can take the form of either individual or group therapy, or both. Outpatient treatment can occur through individual therapy with a clinician, or in a multiple groups per week setting. Outpatient is typically the next step for a patient that was initially attending a PHP treatment or IOP treatment program.
MEDICATION-ASSISTED TREATMENT (MAT)
Medication-Assisted Treatment (MAT) is the use of FDA-approved medications to provide ongoing therapeutic support for patients overcoming addiction. Often, MAT is used for patients that suffer from opioid addiction, opioid use disorder, alcohol use disorder, or alcoholism. Best practices and best outcomes for patients utilizing medication-assisted treatment occur when MAT is used in combination with counseling and therapy. For example, a patient might be on MAT while attending treatment in a PHP or IOP treatment program setting.
Individual therapy is an outpatient level of care where an individual visits a therapist for a session. This can occur in different time intervals, such as weekly sessions, biweekly sessions, or monthly sessions. Individual therapy can take the form of general therapy, specialized therapy, counseling, marriage or family therapy, or any number of ways with one or more therapist with different specialties.
Group therapy is an outpatient level of care where an individual attends groups facilitated by a clinician. Similar to individual therapy, this can occur at different intervals and with group therapists and facilitators with different specialty focuses. Group therapy is therapy facilitated in a group setting alongside clients dealing with similar issues.
Another example of outpatient treatment, psychiatry is when a patient sees a medical doctor that specializes in psychiatry. A patient could also see a psychiatric nurse practitioner. This is often for co-occurring mental health issues, where the psychiatrist or psych nurse practitioner will be able to prescribe appropriate medications, as well as perform some individual therapy.
RECOVERY HOUSE/SOBER HOME/HALFWAY HOUSE
Sober living a structured sober living environment that patients can live at and receive support at different stages of an addiction treatment continuum of care. While there are different names of these living environments, such as sober home, recovery house, sober living, or halfway house, they are offer a similar function: to offer a person new to recovery a necessary structured and supportive living environment. Most of these recovery residences include curfews, accountability through drug testing and daily meetings, house chores, and other rules that residents must follow.
PEER RECOVERY SUPPORT
Another piece of the addiction treatment continuum of care that can be found throughout different levels of care and in different stages is peer recovery support or peer recovery coaching. Peer recovery support services are supportive services offered by individuals that are also in recovery and have received a peer recovery certification. While this is not a clinical licensure, peer recovery support specialists have gone through intensive training and supervisor to be able to step in and offer a host of different support services to individuals in treatment or in early recovery. Some of these services include peer recovery coaching, life skills development, case management, or simply support with integrating into the local community-based recovery community.
COMMUNITY-BASED RECOVERY FELLOWSHIPS AND ORGANIZATIONS
Community-based recovery fellowships and organizations are not clinical services and are often free community-based support that are in an individual’s local area. The best example of this would be the 12-Step fellowships like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA.) Other examples are recovery meetings that meet in recovery centers but not affiliated with any specific organization. Additional examples would be SMART Recovery, Refuge Recovery, Celebrate Recovery, or other recovery-oriented meetings not affiliated with an organization or fellowship.
If you or someone you know needs help for addiction or co-occurring disorders, please give us a call. Innovo Detox offers the latest in evidence-based medical, psychiatric, and clinical care for those in need of detox and medical stabilization in Pennsylvania and the surrounding Mid-Atlantic area. If we aren’t the best fit for you or a loved one, we will take the necessary time to work with you to find a detox, rehab, treatment center or provider that better fits your needs. Please give us a call at (717) 619-3260 or email our team at [email protected]. For more information on our company or services, please visit our website at www.innovodetox.com.