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Substance Abuse Outpatient Programs: Same Difference?

Substance Abuse Outpatient Programs: Same Difference?

Drug addiction is a serious, chronic brain disease characterized by an insatiable, compulsive need to seek drugs and abuse them, despite known consequences. Underlying the addiction are often co-occurring emotional or mental disorders. Thus, it is critical to know that mental health and substance abuse disorders do not vanish on their own without some form of intervention. The good news is that you do not have to suffer alone — a rehabilitation program can help you jumpstart your recovery.

The problem of addiction is extremely pervasive. Between 2006 and 2010, excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost in the United States. On average, alcohol shortened the lives of these people by 30 years. Additionally, data reveal that excessive drinking was responsible for 10% of all deaths among working-age adults aged 20-64 years.

deaths working age

With respect to drugs, the Centers for Disease Control (CDC) estimates that 78 people die each day because of drugs, while thousands of others arrive at hospital emergency rooms for treatment. Approximately 10.2% of people age 12 and older reported using some form of illicit drug within the past month.

The United States is undeniably in the midst of an opioid overdose epidemic. Opioids and heroin were responsible for more than 28,000 deaths in 2014 alone, more than any year on record. At least half of all opioid overdose deaths involve a prescription opioid.

Meanwhile, the latest National Survey on Drug Use and Health administered by Substance Abuse and Mental Health Services Administration’s (SAMSHA) revealed that 8.5% of the United States population (22.5 million total people) aged 12 and older needed treatment for some form of illegal substance or alcohol issue in 2014. Of that population, just 18.5% (4.2 million total people) actually received any treatment for their substance abuse issues.

These sobering statistics demonstrate the fact that the hardest step is undoubtedly the first one: committing to recovery. Although the first step requires an extremely high amount of courage, admission is truly the only way to open the door for a long-term solution. You have to be able to see a clean life in your mind before you can make it happen.

clean life

When you think of rehab, your mind may automatically go to a residential inpatient unit, were you’re completely cut off from the rest of your world. While inpatient programs can be extremely effective and even necessary for certain people, it’s important to know that not everyone needs the wide array of intensive services offered by these treatment facilities. Outpatient treatment options are available, and evidence suggests that success rates are just as high as those of inpatient treatment facilities when properly adhered to. Nevertheless, the different types of outpatient programs have their own nuances that you should consider before deciding which might be best for you.

Intensive Outpatient Programs (IOP)

Intensive Outpatient treatment is a primary treatment program best suited for individuals that do not need medically supervised detox. The primary focus of an IOP is relapse prevention. Relapse is a hallmark symptom of addiction. This is especially true if you suffer from a dual-diagnosis. People with a co-occurring mental health disorder, such as depression or anxiety, unfortunately have a greater chance of reverting back to substance abuse to veil the challenges that may arise after treatment.

Criteria for IOP candidacy can vary from person to person based on an individual’s treatment needs. Professionals often employ a multidimensional assessment devised by the American Society of Addiction Medicine (ASAM) to devise a holistic, biopsychosocial assessment for a person and determine appropriate service planning and treatment across all services and levels of care. There are 6 dimensions to this assessment:

Dimension 1: Acute Intoxication and/or Withdrawal Potential.
In this stage, your historical and current experiences of substance abuse and withdrawal are taken into account to determine your relapse risk.

Dimension 2: Biomedical Conditions and Complications
Your health records and current physical condition are reviewed to determine your overall health status and the presence of any comorbidities.

Dimension 3: Emotional, Behavioral or Cognitive Conditions and ComplicationsAn assessor will evaluate your thoughts, emotions and state of mental health to determine whether there are complicating factors that could undermine treatment efforts. At this stage, a dual-diagnosis may be uncovered.

Dimension 4: Readiness to Change
An assessor will evaluate your willingness, interest and readiness to change. Your chances of success in any program that you aren’t fully committed drops exponentially. If this is the case, outpatient programs are likely not the ideal strategy for you.

Dimension 5: Relapse, Continued Use or Potential for Continued Problems

Everyone who struggles with addiction has a unique relationship with relapse, continued use or complications. The appropriateness of an outpatient program for you largely depends on your likelihood to relapse.

This multidimensional assessment is part of ASAM’s larger National Practice Guideline — which serves to make recommendations on:

  • The clinical assessment and, ultimately, the diagnosis of opioid use disorder
  • How to choose the most appropriate available treatment options for certain individuals
  • Opioid withdrawal treatment
  • Proper use of methadone, buprenorphine and naltrexone in opioid addiction treatment
  • Psychosocial treatment options, if appropriate
  • The use of naloxone in treating opioid overdose

Meanwhile, the frequency and intensity of treatment are adjusted according to treatment requirements. For the right person, there are several distinct benefits for intensive outpatient programs:

  • Longer treatment duration, which is associated with optimized outcomes.
  • You can keep your regular life routine because the services and flexible and accessible.
  • The cost of an intensive outpatient program is generally much lower than inpatient residential treatment facilities.
  • The retention rate is much higher than that of low-intensity outpatient care services.
  • Each day is an opportunity to apply learned coping skills in real life situations.
  • You are more responsible for maintain your own care, which creates accountability.

Importantly, IOPs enable people in recovery to schedule treatment and therapy sessions on a part-time — yet still intensive — schedule. This helps to accommodate a healthy work and family life balance.

 Intensive Outpatient: What to Expect

Individual counseling plays an undeniably important, supportive role in addiction treatment, but group therapy formats form the crux of IOPs and are the primary treatment method. With respect to relapse prevention training, a group format is as effective as one-on-one counseling. Group counseling also helps programs reduce costs by eliminating otherwise unnecessary one on one counseling. In a group format, you would receive support from:

  • Having the opportunity to develop communication and social interaction skills. In particular, this benefit is especially helpful for people whose socializing and interaction previously relied primarily on drugs or alcohol.
  • Participating in a safe environment where people are willing to help you, support you and tell you when your actions are wrong, to foster your growth.
  • Experience the structure and discipline that was likely missing during your time of addiction.
  • Surrounding yourself with recovering addicts at every stage. Those who may be further along than you in the process can tell what they’ve learned through their journey and what did and did not work for them.
  • Learning in a venue where group leaders can communicate new information, teach new skills and serve as guides you while you practice better behaviors.

Intensive outpatient program group treatments can take several district formats, including psychoeducational groups, skills development groups, process-oriented recovery groups and interpersonal process groups. Each type of group treatment focuses on the different areas of relapse prevention and life rebuilding.

Psychoeducation groups feature a supportive environment where you can learn about dependence and its consequences. These groups are often initiated at the outset of treatment, and they are low key and less emotionally intense than groups for inpatient care. Goals of treatment in these groups include acquiring rational problem solving mechanisms and letting go of dysfunctional thinking patterns.

Meanwhile, skills-development groups focus on practicing learned behaviors in the safety of the treatment setting. These skills trainings usually include:

  • Drug and alcohol refusal techniques
  • Relapse prevention training
  • Assertiveness training
  • Stress management strategy

Normally initiated in the middle to late stage of addiction treatment, process-oriented recovery groups include people who are at the same stage of recovery. All participants are ordinarily dealing with similar problems. They focus on:

  • Pragmatic strategies to alter negative thinking, emotions and behavior patterns.
  • Learning and attempting new ways to relate to other people without substances.
  • Conflict resolution strategies that don’t involve the use of violence or substances.
  • Pointing out how group members’’ actions affect the others in the room.

Outpatient  Programs

In many instances, outpatient treatment programs are treated as the next step after either a partial hospitalization program, full blown inpatient stay or IOP. After finishing the intensive portion of your treatment, you can transition to regular outpatient treatment. Such programs meet fewer times per week and for fewer hours to help sustain recovery.

inpatient rehabilitation

Many of the best outpatient rehabs offer many of the same services provided through inpatient rehabilitation programs, including:

  • Group and Individual Counseling: When you enter outpatient drug treatment at most facilities, you receive counseling in both one-on-one and group formats. Counseling is extremely effective, and these services are intended to help you meet several goals. First, you should be able to understand more about your addiction to drugs or alcohol. Second, therapy should help assist you in planning your life beyond addiction. Third, counselors will help you acquire the crucial coping skills and tools necessary to reduce your chances of relapsing during recovery.
  • Educational Sessions: Understanding the ins and outs of drug addiction can help you better understand and support your own recovery process. Most rehab facilities offer educational sessions to discuss essential topics that range from dual diagnosis challenges to communicable diseases that often result from habitual drug use.
  • Family Support: You need to realize and come to terms with the fact that your addiction does not just affect you. It also greatly affects each person in your family and your circle of close friends. There are even instances in which these people in your life are suffering from addictions of their own. A combination of family counseling and family experiential therapy can help you support communication, honesty and compassion during your recovery.
  • Case Management: Case management is critical because it allows your counselors, and the facility at large, to give you the best drug rehab treatment possible in an outpatient format. Staff members want to get to know the whole you. This helps them to assist you in beating your drug addiction from a holistic, comprehensive perspective. Case management allows us to achieve this goal.

flexibility freedom

The major benefit of an outpatient program is the increased flexibility and freedom. You can go home and be with your family and loved ones every night. Importantly, the majority of individuals who embark on an outpatient treatment program are able to continue some level of employment and normalcy.

Ideal Candidates for Outpatient Programs

ASAM advocates for the idea that people should receive treatment at the lowest intensity from which they’d still benefit. This normally translates to a presumption of outpatient treatment. According to ASAM criteria, outpatient care is best suited for individuals that:

  • Do not have comorbid medical or mental health issues. During detox, these individuals likely need a higher level of care and attention for safety reasons.
  • Have expressed some degree of motivation and willingness to take the detox process seriously. The lower amount of oversight could create treatment gaps if you haven’t fully committed to the idea of recovery.
  • Are able to remain completely abstinent during the entire treatment process. Outpatient treatment can’t possibly work if you use outside of program — even once.
  • Have a strong enough support network and life structure to ensure a health recovery environment at home.

outpatient tacticsOutpatient programs often involve several key behavioral therapy tactics:

  • Cognitive-behavioral Therapy (CBT): Cognitive-behavioral therapy can provide you with instruction on how to manage thoughts, feelings and your body’s physical response. This can help you effectively manage any addictive compulsions. The guiding ethos of CBT is that people have a say in their own experiences, rather than just responding to the outside environment and experiences.
  • Multidimensional Family Therapy: This therapy, developed for adolescents with drug abuse problems as well as their families, addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning.
  • Motivational Interviewing: This therapy style helps you explore and resolve any ambivalence you may have about treatment. The intended outcome is to enhance your self-motivation to change and ultimately recover from addiction.
  • Motivational Incentives: This therapy involves offering you small, tangible rewards to reinforce positive behaviors such as abstinence. Sometimes this may come in the form of a voucher or a small prize.

Outpatient or Intensive Outpatient: What’s the Key Difference?

The major difference between the two types of outpatient program formats is that one may be more appropriate than another based on your circumstances and progress into recovery.

In general, you’ll need IOP treatment prior to regular outpatient treatment if you require more structure and support from treatment. Treatment sessions may increase in frequency to three times per week or more when compared with regular outpatient programs.

Going back to ASAM dimensions, any barriers that may signal the need for a higher level of care usually exist within the realm of the in the last three dimensions: motivation or readiness, potential for relapse or continued use and recovery environment. Normally in this scenario, the individual is strongly resistant to the idea of treatment, is deemed unlikely to remain abstinent or is under pressure from to recover in non-friendly recovery environment.

Both outpatient and intensive outpatient programs place a large emphasis on the importance of therapy.

rehab therapy

No matter which you choose, the overarching goals of addiction treatment are generally the same. All forms must be able to help you do the following:

  • Stop abusing drugs
  • Stay the course in your recovery
  • Function as a productive member of your family, at work and in society.

Keep in mind that these programs are not for everyone. After some critical reflection and professional evaluation, it’s possible that you’ll realize that your issues spread beyond addiction. Comorbid mental health problems may be compounding your addiction problems. In many of these cases, people begin abusing drugs or alcohol as a means of self-medicating these conditions in the first place. In cases of dual-diagnosis, a medically managed or monitored inpatient program is likely the most appropriate treatment strategy.

Common co-occurring mental health disorders implicated in a dual diagnosis include:

One meta-analysis published in the journal of the American Psychiatric Association found that between 50% and 70% of individuals who received treatment in either setting reported abstinence at their follow-up appointments. The findings of a majority of studies substantiated this observation. “IOPs are an important part of the continuum of care for substance use disorders,” the authors concluded. “They are as effective as inpatient treatment for most individuals.”

What’s Next?

You may wonder if you can handle the adjustments or if you really have what it takes to recover. It’s of paramount importance for you to know that with commitment, motivation and the right support, you can complete the journey to recovery.

rehab importance

Successful recovery requires integrative support. Professional mental health and substance abuse treatment equips you with proven tools to live a happy and successful life in recovery. When considering all of your different treatment options, you should remember that treatment should address more than substance abuse. Many genetic and psychological factors contribute to a propensity for addiction. Any addiction treatment center worth your time will be sure to address co-occurring disorders.

A magic formula for addiction recovery doesn’t exist. Everyone’s recovery needs are truly different, and your addiction treatment should be tailored to address your unique challenges and situation. JourneyPure Emerald Coast utilizes professional therapists, counselors and health professionals to work with each client privately and individually to ensure the best treatment possible.

unique rehab needs

Following-through is the key to maintaining success. Once you’ve truly committed to a life of recovery, it’s important to follow through on that pledge. You’ll need to have a game plan for each day, and coaches and teammates to help you devise that plan will make it more likely that you can execute it.

recovery success

The treatments at JourneyPure Emerald Coast’s center can be very intense, although importantly the degree of intensity is mostly dependent on the severity of the drug addiction. Our outpatient treatments are fully comprehensive and individualized. We design treatment plans specially with your goals, challenges and interests in mind.

Many of JourneyPure Emerald Coast’s IOP services mirror those provided to the clients in inpatient, including:

Outpatient drug rehab centers are a safe and effective way to deal with a drug addiction. At JourneyPure Emerald Coast, you have a host of treatment options, including group support, education classes and other treatment strategies. If you or someone you know is struggling with drug addiction, our outpatient drug rehab is an excellent option that may even provide life-saving help and support. Contact us now to get started on your personalized treatment plan.