There are two categories of treatment settings: outpatient and inpatient. An inpatient setting provides all services in the facility, and clients stay there overnight. Outpatient settings provide some rehab services, and clients do not live at the facility. Often, outpatient is the most convenient option for people with jobs or families because their schedules are more flexible than inpatient. Likewise, 4 out of 5 rehab facilities in the United States are outpatient.
Both inpatient and outpatient facilities treat almost all drug addictions, and they both use similar therapy techniques like Cognitive Behavioral Therapy and Contingency Management. If you want more information about residential inpatient treatment, read our guide to inpatient rehab.
|Duration||Usually 30-90 days, longer for long-term treatment||Usually 3-4 months, longer for support groups|
|Time Commitment||24 hours, 7 days per week||1-9 hours per week|
|Level of Addiction||Moderate to Severe||Mild to Moderate|
|Cost||$5,000-$20,000 per month||Free to $3,000 per month|
|Insurance||Insurance covers treatment but usually not room or board||Insurance covers most services|
|Medication Available||At most facilities||At some facilities|
Regardless of the location, setting, or drug being treated, complete rehabilitation includes the following four stages – stopping after just one or two puts you at a much higher risk for relapse.
Some outpatient programs offer each of the four stages at one facility, while others only include one or two stages. For example, support groups provide aftercare but no other services. You can either mix and match different outpatient programs or choose one that has services for each stage.
To learn more, read our guide on “The Rehabilitation Process”
Each year, the Substance Abuse and Mental Health Services Administration surveys rehab programs to provide a comprehensive picture of what services are being provided and for whom. The 2016 version of the N-SSATS had a 91% response rate from treatment centers in the U.S., including over 14,500 facilities. Of the more than one million individuals in rehab, 90.6% of them are in outpatient treatment. Likewise, the vast majority (82.2%) of all treatment facilities are outpatient. Out of all the outpatient facilities surveyed:
Out of 14,500 facilities (inpatient and outpatient):
On average, outpatient programs have 40 clients in each facility, and those programs vary in the level of care and services they provide. Some only cover one or two stages of the rehab process while others have all the services needed for rehab. With the exception of support groups, outpatient programs all provide assessment and therapy services. However, the availability of different types of behavioral therapy is dependent on the facility and their therapists’ certifications.
One of the biggest differences between outpatient programs is their provision of medical services. The availability of medications is entirely dependent on the facility. The most recent data from 2016 shows that only 11.5% of outpatient facilities offered medication-assisted detox (compared to 30% of inpatient facilities that offer detox medications). While some institutions may offer medication to help with withdrawal symptoms but no medication for detox, relatively few outpatient facilities directly provide any type of medical aid.
Intensive outpatient treatment programs (IOTs) are the most intensive outpatient option, providing each stage of the rehab process. Each IOT program includes the following three stages or goals. These work together with the general rehabilitation process outlined above – the first two stages happen during therapy (step three of the rehabilitation process) and the third stage below typically happens during aftercare (step four of the rehabilitation process).
Core services commonly include:
The availability of medication at IOT programs depends on the size of the facility and if they have medical professionals in the building. Some IOTs are certified as opioid treatment programs that have medication-assisted therapy to help with opiate abuse.
Likewise, some programs offer medication-assisted detox services, but more often than not, they have ambulatory detox services. Ambulatory detox means the program has a plan for people who could be in danger from detox and need more extensive services from entities such as hospitals that have the requisite services.
Occasionally, IOTs have a standalone detox option that solely provides detoxification services and monitoring without the added steps of the rehab process. Read more in our Alcohol and Drug Detox guide.
The duration of each client’s stay varies. A client could be in treatment for anywhere from 30 days to years, but the minimum recommended length is 90 days. Likewise, IOT recommends around 9 hours per week, but it can range from 6 to 30 hours per week depending on each client’s needs.
Because of the extensiveness of services and the greater time commitment from therapists, IOT is more expensive than other outpatient programs. For a 90 day treatment, IOT can cost $3,000 – $10,000 dollars for the entire experience.
Find out more about the Cost of Rehab in our guide on the subject.
Counseling, also referred to as regular outpatient, often occurs in an office building that also provides other social services. The therapists on staff are certified to assess clients, teach clients about drug addiction, and provide individual and group therapy during detox and throughout treatment. The type of therapy used is based on the individual therapist’s training and background. Clients should make sure that their counselor has a history of serving clients struggling with substance abuse.
People with intense addictions often go to regular outpatient for aftercare once they complete a more intensive inpatient or intensive outpatient program.
Many regular outpatient programs provide ancillary services to help clients with other difficulties as well, including:
Regular outpatient programs rarely provide medications of any kind. However, their offices often have agreements with medical providers if the client needs medical support.
Counseling sometimes provides the majority of treatment, but other times it just used for aftercare. Only those with mild addictions typically use regular outpatient for their entire rehab experience.
The therapy frequency and program duration depend on an individual’s level of addiction and needs. For example, therapy could be one hour every other week for a few months or three sessions per week of group and individual therapy.
The average duration is one to two sessions of therapy per week for 45-60 days. At that point, the program may become less-intensive by reducing the frequency of therapy or moving to group therapy and support groups for aftercare services.
Without insurance, therapy usually costs $50-$240 per session. However, insurance will usually cover most of the counseling cost as it is part of many individuals’ treatment plans.
Find out more about the Cost of Rehab in our guide to the subject
Also known as mutual help or self-help groups, support groups provide aftercare to people who are trying to overcome drug addictions. During group meetings, members share their experiences and struggles, offering encouragement to one another. Many 12-step programs are spiritual, but there are also alternative, secular options available.
The National Institute on Drug Abuse estimates that anywhere from 40-60% of people who enter rehab will relapse, but those numbers rise for those who don’t continue with aftercare after their stint in a rehab program. Support groups are an affordable way to reduce the chance of relapse.
Many support groups are led by previous addicts who are providing supportive accountability and an open space to talk. Support groups are not considered “group therapy” because they aren’t typically led by a certified therapist. While these groups are not technically therapy and give no medical assistance, they do provide valuable insight, encouragement, and understanding that previous and current addicts may struggle to find elsewhere.
Because support groups are not led by therapists and are therefore not considered “therapy,” they only complete the final stage of the rehab process: aftercare.
Many support groups meet once or twice per week, and the meetings often last one or more hours depending on the size of the group. Previous and current addicts can freely choose how frequently they attend and how long they want to continue going. However, maintaining regular attendance in support groups is directly correlated with a lower relapse rate.
While donations of any amount are accepted, you won’t be charged any type of fee, which makes them an affordable way to stay accountable to your sobriety goals.
|Intensive Outpatient||Patients receive the extensive services of an inpatient program but return home after. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medical treatment is available to those who qualify.||Hours per Day: 2-4||3-4 months|
|Days per Week: 3|
|Counseling / Regular Outpatient||Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medical treatment is not available.||Hours per Day: 1-2||As long as desired|
|Days per Week: 1-3|
|Support Groups||Self-help groups are recommended to help maintain abstinence after another form of treatment.||Hours per Day: 1-2||As long as desired|
|Days per Week: 1|
The best outpatient program is based on many personal factors, such as your level of addiction and your time and financial constraints. For a full look at all of the considerations, read our guide on “Choosing the Right Rehab.”
|Support Groups||Counseling / Regular Outpatient||Intensive Outpatient|
|Substances with severe physical withdrawal symptoms||✕||✕||✕|
|Patients with potential medical complications||✕||✕||✕|
|Patients with limited budget||✓||✓||✕|
|Stage 1: Assessment||✓||✓||✓|
|Stage 2: Detox Services||✕||✓||✓|
|Stage 3: Therapy||✕||✓||✓|
|Stage 4: Aftercare||✓||✓||✕|
After determining what type of outpatient program is appropriate, you can use our directory to locate rehab programs and facilities around the U.S.
Our directory of rehab programs 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, price, and location.
While the large number of outpatient treatment programs means there’s usually a large selection to choose from, it also means that it can be hard to find the program that may be best for you.If you are looking for a rehab center, read our guide for Choosing the Right Rehab or learn more about what happens during rehab in our guide to the addiction rehabilitation process.
If you aren’t sure that inpatient rehabilitation is right for you, read our guide to inpatient rehabilitation programs to learn more about your other options.