The Addiction Rehabilitation Process

Inpatient assessments are designed to transition a patient into the treatment center

For inpatient facilities, the assessment phase is the “intake process,” which serves to transition the patient in from the outside world and to build a treatment plan specifically designed for the individual.

Throughout this process, the treatment center or medical facility is evaluating whether you are a good fit for the program, and you should be evaluating whether the facility is a good fit for you. Sometimes, an individual is referred to another facility (such as a hospital) if it’s determined that the treatment center isn’t equipped to handle the unique challenges of the patient in question.

Outpatient assessments focus on developing a treatment plan

Those pursuing outpatient treatment may opt to get a standalone assessment. The assessment process for outpatient facilities tends to focus on determining the nature and severity of the addiction, and on developing a treatment plan based on the individual’s needs. The “intake portion” of the assessment process may not be needed for these types of assessments.

You will be asked to provide basic personal information

Whether you drop in, call ahead, or correspond via email, the assessment process starts as soon as you contact the treatment center. At that point, they will begin to collect your basic personal information, such as name, date-of-birth, and the like.

You will make payment arrangements

Depending on the institution, this is usually one of the first steps in the assessment process. The goal is to verify that you can afford the treatment or that you have insurance that will cover all or some of the services. If not, some treatment centers may offer payment plans, or they may be able to help you find payment assistance.

The cost of substance abuse treatment can be one of the biggest obstacles to overcoming addiction, but there are many ways to find free or low-cost care. For more information, read our guide on The Cost of Rehab.

You will be asked to provide your medical and mental health history

Many treatment centers will want access to your complete medical history, while others may simply have you fill out several forms. They will specifically want to know if you have any diagnosed medical conditions or diagnosed mental health problems. The primary reason for these questions is to ensure your safety (especially during detox).

Medical conditions and mental health problems can be a large part of the underlying cause of addiction, so centers that will also be providing treatment (not just detox) will use this information to build your treatment plan.

You may be required to complete a drug and alcohol test

Some treatment centers require incoming patients to complete a drug and alcohol test to verify which substances are present, and whether the individual needs to be sent to detox, or if they can go right to treatment. This step can vary from facility to facility.

You may be interviewed about your history with addiction

• When was the first time you used (or abused in the case of alcohol) a substance?
• What events led to your substance abuse problem?
• What circumstances or challenges are there that are contributing to your struggle with addiction?
• Do you have ongoing relationship problems with family or friends?
• What kind of substances do you use?
• How often and in what quantity do you use them?
• Why are you here and what do you hope to gain?

Note: It’s universally recommended that individuals be open and honest about their addiction severity and usage habits. Some patients may be tempted to downplay or lie about their addiction habits due to shame or embarrassment. It’s crucial to obtain an accurate picture of each person’s addiction and usage habits so that the right treatment plan can be developed.

It’s wise to seek professional assistance with the detoxification process

The first decision you will have to make is to decide if you will seek professional help, or attempt to detox on your own if you opt for outpatient treatment. Detoxing on your own can be very dangerous for those with severe addiction or medical complications. If you don’t seek professional help, you could risk serious medical consequences, even including death.

The main advantage of detoxing in a professional environment is that withdrawal symptoms (both physical and emotional) are managed. Depending on the length and severity of your substance usage, withdrawal symptoms can be quite severe. A professional treatment center will monitor your mental and physical well-being, and take appropriate action to ensure your safety.

Detoxing in a full-service rehab center provides an easy transition to further treatment

The next decision you will need to make is whether to rehab in a stand-alone facility (such as a hospital) or a full-service treatment center. While there are quite a few other factors that go into choosing the right place to detox, the transition from detox to treatment may be smoother at a full-service facility.

Clinically administered medications can lessen the symptoms of withdrawal

While the care you receive at any facility should always be focusing on providing safe detoxification, choosing a rehab center that utilizes medication to ease the body’s transition from dependence on drugs or alcohol can go a long way to making your detox experience easier.

For more information, read our guide on “Alcohol and Drug Detox Centers”

Your experience with therapy varies drastically between inpatient and outpatient service settings

As the term “residential” implies, inpatient programs require you to put all of your other obligations on hold (including family, work, and friends). You will be eating, sleeping, and spending your waking hours at the rehab facility. This allows you to focus on rehabilitation full-time, and it reduces or eliminates the chance of relapse during rehab.

If you choose an outpatient program, you will be attending therapy 4-6 hours per day, 3-5 days per week during this phase of treatment. The cost of outpatient programs tends to be lower, and you don’t have to completely abandon your family, friends, and job responsibilities. However, the chance of relapse during treatment is greater since you may be exposed to stress and triggers in your former environments that contribute to your cycle of addiction.

For more information, read our guides on “Inpatient Rehabilitation Programs” and “Outpatient Rehabilitation Programs”

There are four basic rehab lengths

The overall time it can take to complete this step in the rehabilitation process depends on the length of the program you signed up for. Studies show that, for those with medium to severe addiction problems, the longer you spend in rehab, the better chance of a favorable outcome. Keep in mind that shorter programs tend to be more intensive, as they have to consolidate more treatment into a shorter timeframe. Longer programs allow for a more relaxed schedule and gradual approach. The typical lengths available are:

• 30 days (short-term rehab)
• 60 days (long-term rehab)
• 90 days (long-term rehab)
• 120 days+ (long-term rehab)

Therapy starts to deal with the reasons behind the addiction

Once patients’ bodies are free from their physical dependence on substances, the work can begin to free them from their mental and emotional dependence on the substances. Additionally, skills and behaviors are taught that help recovering addicts avoid “triggers” that can cause a relapse. Triggers are circumstances or challenges that make the addict want to return to substance abuse. The underlying causes of addiction and triggers can include things like:

• Medical Issues: People often become addicted to opiates after medical procedures or ongoing conditions. At first, they are taking the prescriptions as directed by their doctor, but later become addicted. At that point, they start self-medicating to cope with pain, or simply because of their increasing dependence on the substance.

• Mental Health Problems: Many people use drugs and alcohol to self-medicate for problems like depression, anxiety, and Post Traumatic Stress Disorder (PTSD). Many times, the substances they take temporarily numb the pain, but they make the problems worse in the long run, causing addicts to get trapped in the cycle of abuse.

• Family & Relationship Problems: Drugs and alcohol are used by many people to escape the pain caused by family and relationship problems. Divorce, abuse, neglect, and many other issues can entice people to try and escape their problems by abusing substances.

• Peer Pressure: Sometimes all it takes is becoming friends with the wrong crowd who supply pressure to take illegal substances or engage in binge drinking. The “party lifestyle” can quickly turn into a cycle of addiction and substance abuse.

• Proximity: Substance abuse can simply result from proximity – whether it’s a parent, spouse, boyfriend, or sibling, just being around substance abuse leads to a higher chance that the individual will struggle with addiction themselves.

Therapy mainly consists of group and individual counseling sessions

One-on-one therapy is designed to help you work through your issues and problems in an intimate setting with a trained counselor, while group therapy allows you to build healthy relationships with other addicts and increases your communication skills. Additionally, some programs include alternative forms of treatment like massages and team-building activities.

Psychotherapy is the primary type of treatment used

Psychotherapy is a collaborative effort between you and the therapist to change the thought and behavior patterns that contribute to your addiction. During this process, past issues and current challenges that may be contributing to your addiction are addressed. While you will spend a good deal of time talking in a non-judgemental, open environment, there will also be tasks and projects that may be introduced.

Evidence-based treatments present the best chance for long-term recovery

While there are a plethora of treatment options that are used in this phase, there are well-researched, evidence-based approaches that have been shown to be effective in helping people overcome addiction. Here are some of the most widely used types of treatment that have been shown to be effective:

• Cognitive-Behavioral Therapy (CBT): CBT focuses on solving problems and making behavioral changes. This type of psychotherapy encourages patients to develop strategies for coping with cravings and avoiding high-risk situations.

• Contingency Management: This type of therapy involves giving patients tangible rewards when they demonstrate positive behaviors (such as a clean urine test), which helps to keep them engaged and promotes continued abstinence from drugs and alcohol.

• Motivational Enhancement Therapy (MET): MET is similar to Motivational Interviewing (a precursor to MET), and is an approach that essentially encourages the participant to “care.” It’s widely used to help ambivalent addicts with their desire to change – not by using external forces, but by helping the individual to find the motivation within themselves.

• The Matrix Model: This type of treatment is a specially designed program for those addicted to stimulants (like meth and cocaine). It draws on many different therapeutic styles, and it’s highly structured. It’s intended to last for 16 weeks and is typically used in the intensive outpatient setting.

• Family Behavior Therapy (FBT): FBT engages families with contingency management techniques to address substance abuse and other co-occurring issues. Some of the problems that are addressed include unemployment, conflict within the family, and child mistreatment.

Additional treatment is necessary for those with a dual-diagnosis

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that 39% of all those with a substance abuse disorder also have a mental health disorder. Those facing this challenge need to undergo unique therapies specifically designed for their mental health disorder, in addition to therapy designed to overcome substance addictions. There are certain rehab facilities that specialize in treating those with co-occurring disorders.

For more information, read our guide on “Dual Diagnosis Rehabs”

Sober living homes provide a sober environment to facilitate further recovery

Sober living homes (also referred to as recovery residences) are group homes that help recovering addicts transition from treatment facilities to living on their own, while maintaining sobriety. They are especially helpful for those who don’t have a supportive and positive environment to live in after rehab.

Residents can stay for a couple months of for years, as long as they follow the rules and don’t relapse (most homes have a zero tolerance policy for using substances). Other rules usually include completing chores, attending mutual support groups regularly, and paying an equal share of the cost of renting the home.

Some halfway houses are listed in our database, and you can find them by using the appropriate filter in our tool above. Otherwise, head to our guide on sober living homes to learn more about sober living homes, and to find a certified recovery residence near you.

Outpatient treatment may be necessary for those transitioning out of inpatient rehab

Those who take the inpatient approach to rehab but can’t (or don’t want to) transition in a sober living home can participate in decreasingly intensive outpatient treatment. This aftercare option involves follow-up visits for continuing therapy. At first, visits are usually four to five days a week, then decreasing to several days a week, and finally subsiding to monthly checkups or stopping altogether. At that point, recovering addicts can transition to a cheaper, less-intensive form of aftercare.

12-step programs are a cheap, effective approach to aftercare

Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are the two most popular types of 12-step programs, and they use the power of group dynamics to provide support and encourage addicts along in the recovery process. The 12-step process was originally designed for alcoholics, but has been adapted to include those struggling with drug addictions as well.

Click your state listed below to find AA or NA meetings near you

To find Alcoholics or Narcotics Anonymous meetings near you, click on your state from the list below. From there you will be able to find the local organization that coordinates the meetings. They will be able to provide the most up-to-date information about the time and location of meetings, as well as the contact information for group leaders.

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Click your state from the list below, then input your zip code to find rehabs near you

If you or a loved one needs help, you can use our directory which includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, payment options, and location.

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For more questions about rehab, read our Rehab FAQ