The Different Levels of Care for Addiction Treatment

Drug Rehab: The Different Levels of Care for Addiction Treatment

Last updated on July 1st, 2019 at 01:37 pm

If you or someone you love is headed to rehab, you likely have a lot of questions. Drug addiction can cause an immense amount of turmoil in a family or relationship. We’ll address that later. For now, it’s important to focus on the present.

If you or the person you care about is willing to go, you’ve already conquered the all-important first step. Drug rehabs offer a variety of treatment options and levels of care. Read on as we outline them all for you, so you know what to expect in the days and months ahead.

With hard work, willingness, and the desire to stay clean you or the person you love can stay away from their addictive substance. It’s only then that the addict can begin to re-engage with their own life and all things that use to matter most.

Levels of Care for the Physically Dependent: The Medical Detox

If you or someone you love is addicted to drugs, there is a high likelihood that they will require medical supervision as they detox. Some drugs form more than a habit. Physical withdrawal symptoms are evidence of the body’s physical dependence on the substance.

Understanding this can help friends and loved ones understand how difficult it’s been for the addict. It’s more than a preference to use drugs. Addicted bodies have formed a harmful substance dependence. One that the addict must feed to survive.

Fortunately, with medical supervision, physical dependence can be broken. This is likely to be an uncomfortable time for the addict as they experience the crippling symptoms of withdrawal. These symptoms can include shaking, sleep disruption, muscle aches, nausea, vomiting, and diarrhea.

For regular opiate users, these withdrawal symptoms usually being within 12 hours. If the opiate user is on an opiate blocker like suboxone or methadone, this can vary. Symptoms are more delayed for those taking opiate blockers.

Some doctors will prescribe medication while in medical detox to help lessen extreme symptoms. These may include medications like clonidine. Medications such as NSAIDs may be prescribed to lessen inflammation. Additionally, hydroxyzine medications are also given to lessen the symptoms of nausea.

The worst withdrawal symptoms are seen in alcoholics and those withdrawing from tranquillizers. It is important for these addicts to seek medical supervision for their detox. This is because they are likely to experience hallucinations, seizures, or heart attacks.

Detoxing can be the most difficult stage of recovery for the addict. This is also the time that they are likely to experience their strongest cravings for their substance of choice. However, with proper medical supervision and support, it is possible to rid the body of toxic substance.

Additionally, this can be an important stage of recovery. Why? Because if given the addict the experience to realize how much of a grasp their substance holds on their lives and bodies.

Inpatient Residential Rehabilitation

If your friend or loved one isn’t physically dependent on their addiction, they will likely skip the medical detox step. They can then begin their recovery at an in-patient rehabilitation center.

Depending on the severity of their addiction and their own insurance limits, an addict will typically spend 30, 60, or 90 days in a residential in-patient rehab. Rehab is the perfect opportunity to get the space necessary from familiar people, places, and situations that they normally associate with their addiction.

By changing their “playmates” and “play places,” they can begin to imagine a new life for themselves in this safe space. It is important that friends and loved ones set boundaries and expectations during this time.

Many addicts will be tempted to leave rehab before completing the duration of the stay suggested. If they choose to do so, they shouldn’t be welcomed home with open arms.

You’ll need to create boundaries that encourage the addict to persevere through the moments when their cravings are strongest. Strong cravings can cause addicts to manipulate the facts and create reasons to leave their new drug-free environment.

Allowing the addict to leave rehab before the end of their suggested stay can be considered “enabling” the addict. Promises are only one of the things frequently broken by addicts and creating a reason to leave rehab is a common manipulation.

Loved ones of can support the addict’s attempts to get and stay clean by staying true to their initial expectations and not conceding. Completing the duration of their stay and creating an after-care plan are two components crucial to staying clean.

Paid aftercare groups and free NA meetings are two great ways to stay accountable to recovery after completing a residential inpatient stay.

Sober Living Communities

After completing a residential stay, rehab counselors may suggest transitioning the addict into a sober living facility. This can be a great step for addicts as they return to living life on life’s terms.

Sober livings are typically run similar to an apartment complex. The addict will share a room or live alone in the complex while remaining accountable to stay clean and sober.

Each sober living has a unique set of requirements and rules for tenants. These requirements typically include regular drug testing, curfew, cleaning duties, and employment.

While sober living may not give the addict absolute freedom, it’s a good way to return to ‘normal life’ while remaining accountable.

It can also be a great opportunity for recovering addicts to make new friends who have similar goals and experiences. Creating bonds within the recovery community is important, as those who immediately return to their previous lifestyle are far more likely to fall back into their previous routine and relapse.

The friends and loved ones of addicts may be disappointed initially. It is unlikely that their partners will able to take part in all the activities they once shared.

This is because Sober Living often curtails late night outings and overnight stays. This is only temporary. With love and compromise, new routines can be formed.

Living clean presents many opportunities for new adventures.

“But I Can’t…” Other Options

If your insurance won’t cover in-patient treatment, there are other options available. Intensive outpatient programs, also known as IOP, are programs typically provided by clinics and hospitals at a cost lower than traditional rehab.

These programs meet daily and provide three-to-four hours of daily treatment and can be more workable for people who are the primary caretaker of a child or unable to pay for inpatient residential treatment.

These programs can work just as well if the addict is committed to recovery. However, the likelihood of temptation is far greater when the addict begins the recovery process without the safety of a new environment.

12-step recovery groups are the single most important resource for the recovering addict. These groups convene at various times throughout the day and in thousands of locations.

You may be stunned when you realize just how many recovery meetings are happening in your area. If you live in a metropolitan area, it’s likely that you can even find a meeting within walking distance.

While the recovering addict may choose to pick a Narcotics Anonymous group as his or her ‘homegroup’, it is important to remember that there is no big difference between an AA, NA, CA, or MA meeting.

The unity of experience and universal unmanageability of addiction give each meeting the ability to provide support to the addict. Do not be deterred from attending an AA meeting (the most commonly held meeting) because you don’t believe drug addicts are welcome.

While some meetings may require you to use the word “alcohol” when sharing, most groups aren’t hung up on the details. A desire to remain clean and sober is the only requirement for attending.

Because staying clean also requires you to also abstain from alcohol, you’ll soon realize the similarity of experience. Just as you’ll also soon find that you’ll be hard pressed to find an alcoholic who hasn’t used or abused drugs before recovery.

While your story may not be exactly the same as those shared in AA, look for the similarities and not the differences. You’ll be sure to identify with the unmanageable nature of alcoholism and see the parallels it shares with your own addiction.

For the Friends and Family of Alcoholics

While your friend or loved one is beginning their recovery journey, it’s important to find levels of care for yourself, as well.

Addiction can cause havoc within families and loving relationships. It is important to have an outlet for the resentment, anger, and hurt you have experienced. Fortunately, regular meetings of Al-Anon are likely all around you.

Al-anon meetings are comprised of the friends and family of the alcoholic or addict and provide support and recovery to those who have shouldered the burden of caring for an addict.

These groups can help you set the boundaries you’ll need moving forward as the addict returns from rehab and you transition back into life together.

Burning Desire: More Obstacles to Recovery

Co-occurring disorders are not uncommon in those who develop alcohol or drug dependence. This often because addicts began their addiction by been self-medicating to control symptoms of another disorder.

These disorders can include but are not limited to bipolar disorder, depression, PTSD, eating disorders, grief or anxiety. Inpatient rehabs typically have professionals on staff that can detect, treat, and provide supportive medication management services. If the addict does not choose to go to an inpatient facility, these disorders may go overlooked.

Finding a therapist to help the addict handle the stresses involved with a new way of life can be wise. These sessions will not take the place of 12-step recovery. They can be helpful when unpacking difficult memories, new responsibilities, and the detection of co-occurring disorders.

Like traditional treatment options, these therapists are available via self-pay or through insurance. If financial concerns common in early sobriety are a concern, consider looking for a low or no-cost facility.

These low-cost facilities often house therapists who have recently graduated. They are there to be of service while fulfilling requirements to start their own practice. They may not have the same experience as someone who has spent 30 years specializing in the treatment of addiction.

It’s important to remember, though that these therapists do not come without their own list of advantages. With a sincere interest in their patient’s care and the most recent science fresh in their minds, these therapists can help support the recovery of the newly clean and sober addict.

Moving Forward

As the addict transitions back into life clean, there are bound to be obstacles. Feelings that have been muted by drugs are likely to bubble to the surface and stressors and temptation abound.

Staying committed to recovery means using all the resources available to you. Lean on a reliable support system and the levels of care need to stay clean.

Over time these needs will stabilize. 12 step groups will become a place for fellowship and service and not a daily necessity for sobriety.

Addicts who choose to get clean and pursue a bigger life beyond addiction haven’t chosen an easy road. No one can convince an addict to get clean and stay clean (though many an Al-Anon has tried over the years).

Living clean and sober is a decision the addict must make for themselves. With the proper levels of care and the willingness needed, recovery is possible.

For more information on substance abuse treatment, visit our blog for more. We’re here to help and you’re not alone.

Article Reviewed by Dr. Keerthy Sunder, MD, DFAPA

Dr. Keerthy Sunder, MD, DFAPADr. Keerthy Sunder, MD is an accomplished and internationally recognized expert in the field of addiction. He has earned diplomates from the American Board of Psychiatry and Neurology, the American Board of Addiction Medicine, and the Royal College of Obstetricians and Gynecologists.