Treatment for substance use disorders comes in many different models and has varying lengths. Each person has unique situations and needs and one size definitely does not fit all. There are recommended levels of care based on severity of substance use and associated conditions or symptoms, and then the accepted course of treatment is to continue to follow the continuum of care on through to eventually have no more treatment, but instead people and systems for support.
Longer Treatment Engagement Periods are Recommended
There was a time when people thought that in order to recover, someone needed to go away for 3 to 12 months in a residential treatment program, but today there is a lot of research supporting that after initial stabilization periods, that longer term engagement can come in the form of outpatient care.
Transitioning from detox to residential and down through day treatment (PHP), intensive outpatient and regular outpatient over the course of several months allows for extended treatment engagement periods while helping individuals become more acclimated to their daily struggles in their new sober life. Without this, relapse rates are often higher because they don’t have the help, support and accountability they need to deal with routine challenges.
An example of an good year of treatment may include 7 days of detox, 30 days of residential treatment (consecutive), 15 days of partial hospitalization/day treatment (weekdays), 45 days of intensive outpatient (3 half-days per week for a total of 15 weeks) and then 60 days of regular outpatient treatment (one or two 90-minute group or individual sessions per week). Through this, a person in recovery gets the acute care early on in a structured inpatient setting to stabilized and lay a solid foundation, then continues treatment upon returning home in various intervals. This can take someone a full year to complete and hopefully have sufficient time.
Additional help they can receive during this time include attending recovery support group meetings, having an aftercare case manager, a sponsor, a peer support specialist, a sober living provider, a recovery coach or other assistance.
Insurance Often Dictates Length of Stay
While it is wonderful that more people have been able to access treatment by mandated behavioral health coverage through their health insurance plans, one of the results has been for insurance companies to start to reduce the amount of covered days for the higher levels of care. The upside is that with support systems in place there is often enough covered intensive outpatient and regular outpatient days to put together an adequate long term treatment plan.
