Trying to navigate the waters of substance abuse treatment may seem rather intimidating and confusing to an outsider who is entering those waters for the first time. It is scary enough because you are either finally facing your own fears and getting yourself help for your own problem, or you are trying to save the life of someone you love. Not only are you tackling an emotionally, mentally and physically exhausting situation but you are entering a whole new world full of unfamiliar concepts and terminology. What is inpatient treatment, and outpatient treatment, and what do all of these letters OP, PHP, and IOP stand for. Most importantly, you may be asking yourself, “which is the best solution for my needs?”
In order to help you chart these new and strange waters, let us first decipher what the three levels of treatment are:
In-Patient treatment, is also known as full hospitalization. Most in-patient facilities have a doctor on staff 24/7, and offer full detox. In-patient facilities are recommended for the most extreme cases, and are the only ones designed to handle dangerous withdrawals such as extreme alcoholism, benzodiazepines, and/or high dose methadone users. These are live in facilities that generally range from 28 days to a few months long, and often transition down to the out-patient treatment phase. While this is the most intense and thorough treatment option, it is also the most expensive.
PHP, stands for partial hospitalization. This is recommended for moderate to severe drug users and alcoholics. PHP consists of offering a day program which lasts for several hours a day. This on site program, serves as a type of daily inpatient setting complete with on site doctors, counseling staff and groups. Patients are either transported from their homes or recovery housing and can either be dropped off on site by treatment provided transportation or by their own methods depending on the facility. They arrive in the morning and return home in the evenings.
Out-Patient treatment, or OP, is for those with a less severe addiction, or alcoholism problem, or those who have extenuating life circumstances that will not allow for them to take a full lapse from society. Out-patient programs can run from Intense Out-Patient (IOP) which consists of several hours of counseling and groups a week coupled with detox, to a regular out-patient which may only consist of a couple hours a week of groups. These are generally the least expensive and least intrusive forms of substance abuse treatment but generally only effective for those with a less severe issue, or work well as a follow up to the more intensive forms of treatment.
Choosing Which Treatment Is Right For Your Situation
When it comes to choosing treatment for yourself or your loved one, there is never a right decision. No form of treatment is guaranteed to work. As the old saying goes, treatment is designed to “lead the horse to the water” but it is up to the client to ultimately drink that water of recovery, and continue to drink it through the course of their life. Treatment will help to detox the client so that they have a clear mind, and grasp on reality, and then give them the tools to live a productive, clean and sober life. Treatment centers of all levels plant the seeds of recovery, but no one can nurture them to life other than the person who is receiving treatment.
Some people get clean and stay recovered after their first treatment center, and some go through treatment multiple times. I have been in recovery myself for eighteen years, but it took my multiple incarcerations and several treatment centers to get recovered. We all have different paths, and different levels of addiction.
So, how do we decide which is best for ourselves or our loved ones? Generally this is something that will be decided along with you and suggested at the intake interview of any treatment facility. The choice between in-patient and PHP may depend on mental health issues, as well as the substances that were being used and the danger of withdrawal. Both forms of treatment have doctors on staff, but only the in-patient centers provide 24/7medical supervision. Both forms of treatment limit access to the outside world. In inpatient treatment there is zero access to the outside world, and in PHP it is extremely limited. Both forms of treatment generally have a two week to 28 day blackout period which entitles limited phone access, and constant supervision.
If these are things that may interfere with taking care of children or a career or schooling then Outpatient treatment may be a better choice. Both IOP and OP offer various treatment/meeting times that can work around a persons job and family schedule. This is more convenient, but is definitely not a good option for the severe addict who will need constant supervision and a removal from all triggers and temptation. Out-patient is also almost always used as a follow up to the more severe forms of treatment in order to sustain the behaviors learned in them, and to reinforce the knowledge and tools gained.
No one form of treatment is better than the other. Just as every single addict/alcoholic is different and needs varying levels of care, so are the forms of treatment. Many choose to start out at the out-patient level and then work their way to the more severe forms of treatment if they aren’t able to sustain sobriety. There is not a “one size fits all” for recovery. Every situation and person is different, and it is ultimately up to you and/or your loved one how serious they want to take this thing. According to a study found in Psychiatry Online, all of the above forms of treatment were found to be equally effective. This again shows that the true measure of change depends upon the individuals willingness to learn and use the tools and knowledge given to them.
Daniel McGhee is an employee of Hopes Horizon, as well as the author of “Chasing A Flawed Sun”, the dynamic true story of addiction and recovery that takes you into the mind, heart, and soul of an addict. At a young age, McGhee became addicted to alcohol and heroin, and was homeless by the age of 18. McGhee lived through multiple overdoses, incarcerations and treatment facilities, and had heart attack at the age of 22. Now sober for 18 years, he is a well-known community activist, speaker and addiction outreach provider in Baltimore. McGhee is the President and Founder of the non-profit Agape Projects, which fights homelessness and hunger, and provides assistance to low income seniors, helps people impacted by natural disasters, and facilitates animal rescue in Haiti and Honduras