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Inpatient vs. Outpatient Alcohol Rehab: Which Is Right For You?

By Manjari Bansal
If you’re having trouble stopping or controlling your drinking, you may be considering different treatment programs. Here's everything you need to know.

If you have been trying but are unable to quit alcohol, your doctor may recommend alcohol addiction treatment. Alcohol treatment can be broadly divided into inpatient and outpatient programs. The type of treatment program that's right for you will be determined based on a number of factors such as the severity and intensity of your alcohol dependence and withdrawal symptoms, as well as your overall health and any co-occuring disorders that may be present. Read on to understand the difference between inpatient and outpatient alcohol rehab and how each type of program typically works. 

Beginning Your Recovery Journey

Many addiction treatment programs–both inpatient and outpatient–begin with detoxification, which clears alcohol from your body under professional supervision. Detox is therefore the first step toward long-term recovery. If you’ve become dependent on alcohol, you may have symptoms of withdrawal when you stop drinking. That’s why it’s important to ask your doctor to help you detox safely. You may need hospital care to avoid dangerous health complications.

Removing alcohol from your body is a crucial initial step toward recovery. Chronic alcohol use can rewire your brain to want alcohol, “so getting into treatment and into some sort of support system that will allow the person to continue to stay sober over time is critical,” Margie Skeer, ScD, an associate professor of public health and community medicine at Tufts University School of Medicine, tells WebMD Connect to Care. 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that you see a trained healthcare professional for an evaluation. That way, they can suggest a treatment plan that’s right for you.

Inpatient Alcohol Rehab: How It Works

If your doctor determines that you have a severe alcohol use disorder, limited social support, unstable living situation, or other health conditions, they may recommend an inpatient rehabilitation program, the NIAAA says. 

These residential programs provide highly structured 24-hour care and are usually run by licensed alcohol and drug counselors and mental health professionals. Short-term programs can last 3 to 6 weeks, followed by outpatient treatment. Long-term programs can last 6 to 12 months. 

Inpatient treatment typically includes: 

  • Medically managed detox 
  • Individual therapy 
  • Support groups 
  • Skill-building sessions 
  • Medication management 
  • Follow-up treatment and aftercare planning

How Long is Inpatient Alcohol Rehab?

“Inpatient alcohol rehabilitation typically lasts a couple of weeks to multiple months,” Zach Ludwig, LPC-S, NCC, VP of Clinical Services & Accreditation at Bradford Health Services, tells WebMD Connect to Care.

However, “how much time someone needs inpatient rehabilitation will vary by the person and the severity of their alcohol use disorder. The initial phase of inpatient treatment is detoxification and stabilization which usually takes a few days but can extend for 7-10 days depending on any complications. After stabilization, treatment duration will be based on clinical and medical progress,” Ludwig says. 

Aaron Sternlicht, LMHC, CASAC, a Therapist and Co-Founder of Family Addiction Specialist in New York, tells WebMD Connect to Care that the length of stay for inpatient rehabilitation for alcohol is determined on a case-by-case basis depending on the number of factors including but not limited to:

  • History of alcohol abuse including duration, frequency, and quantity of use.
  • Past attempts at abstinence including any history of inpatient or outpatient treatment.
  • Physical health and mental health factors.

“Generally, after residential treatment, an individual will either return home and continue with outpatient treatment, or they may enter an extended care program or sober living home and continue with outpatient treatment from there,” Sternlicht says. “In all cases, continuation with some form of treatment after residential treatment is imperative for long-term success.”

What is the Goal of Inpatient Rehab?

Ultimately, tour goals should be tailored to the specifics of your case, health, and life, but there are some general goals that you can keep in mind. 

“The goal of inpatient rehab is to provide patients with the resources and support they need to recover from addiction,” Clare Waismann, RAS, SUDCC, Founder and Director of Waismann Method® Opioid Treatment Center and Domus Retreat in California, tells WebMD Connect to Care. “Inpatient rehab centers offer a safe, structured environment where patients can begin the process of recovery. In addition to providing a safe and sober environment for people struggling with addiction, rehab facilities also offer the opportunity to begin the therapy process. This is crucial, as many people who misuse substances are actually self-medicating for underlying mental health issues.”

Inpatient treatment starts with detoxification but “alcohol rehabilitation is not just about addressing the detoxification process,” James Pratty, MD, a Psychiatrist and Medical Director at Behavioral Health for Brand New Day, tells WebMD Connect to Care. “Of greatest importance is to allow the patient to learn stress coping skills and anxiety management skills that in the past would drive them to return to alcohol to address these issues.”

“In order to successfully achieve sobriety, it is essential to identify the root issue and develop a treatment plan. The therapists at rehab facilities are trained to help patients do just that. By working together, they can create a customized plan that addresses the unique needs of each individual. In this way, therapy can play an essential role in sustaining sobriety in the long term,” Waismann adds.

Outpatient Alcohol Rehab: How It Works

If your doctor determines that you have a less-severe alcohol use disorder, a social support system, a stable living environment, and good physical health, they might recommend an outpatient treatment program, the NIAAA says. 

These programs vary in length and intensity, but they generally allow you to keep up your normal routine. 

Outpatient treatment can involve therapy, group counseling, or a 12-step program. These sessions typically focus on substance abuse education, relapse prevention, stress management, communication skills, and goal setting. Some people also transition to outpatient care after completing an inpatient episode. This step-down in care balances independence with support and accountability.

How Long is Outpatient Alcohol Treatment?

“Outpatient treatment for alcohol varies in length and intensity on an individual case basis,” Sternlicht says. “The duration of treatment will often last for 3 to 12 months. During that time an individual may begin with an intensive daily program and reduce their frequency of attendance over time as they progress in their recovery.”

“Intensive outpatient treatment generally consists of a minimum of 3-hours of treatment per day 5-days per week, while standard outpatient treatment may consist of 1-hour per day anywhere from 1- to 5-days per week,” Sternlicht adds. 

Sternlicht tells WebMD Connect to Care that, the factors that determine how long an individual is in outpatient treatment are determined by their progress and response to treatment, including but not limited to:

  • Length of abstinence
  • Stabilization of physical and mental health issues 
  • Having a stable and supportive living environment
  • Acquiring a sober support system
  • Attainment of vocational, educational, or career goals
  • Relapse prevention tools acquired

Who Offers Outpatient Treatment for Alcohol and Other Drug Abuse?

“Outpatient treatment for alcohol and other drug abuse is provided by a variety of licensed mental health professionals and settings,” Sternlicht says. “Licensed mental health professionals who specialize in treating substance abuse will vary by state but will commonly include licensed clinical social workers, licensed mental health counselors, psychologists, and psychiatrists.”

“Outpatient treatment settings may include addiction treatment centers, mental health clinics, community health clinics, private offices, or hospitals. In addition to formal outpatient treatment many individuals may benefit from working with a recovery coach as well as attending mutual help meetings such as Alcoholics Anonymous, SMART Recovery, or Refuge Recovery,” Sternlicht adds.

Inpatient vs. Outpatient Alcohol Rehab Success Rates

The data on this issue is not robust. However, “One of the few studies that compared inpatient to outpatient treatment success showed that a typical 30-day inpatient rehab was equivalent to twelve outpatient visits (or twelve hours),” Daniel Hochman, MD, a Psychiatrist and Founder of SelfRecovery.org, tells WebMD Connect to Care. “Highly individualized care in an outpatient setting goes a long way and also has the added benefit of easily continuing as necessary without changes to the setting or treatment team.”

It's also important to examine kneejerk reactions that may assume that inpatient treatment is the only successful route. “While inpatient treatment is often thought of as the holy grail, it can sometimes simply delay tricky issues until discharge. It still leaves people with a tough landing when they return home and are left to navigate their previous challenges (like unhealthy relationships and life struggles) without the temporary protection of an inpatient setting. It can also be hard to find follow-up, and hard to open up again and start the process over right away,”  Hochman explains.

It's therefore important to not only do your research about the success rates of the various techniques and facilities you're considering, but also to discuss your treatment options and the specifics of your health with a trusted professional. 

“Comorbidity is a significant issue in alcohol rehabilitation,” Pratty says. “Patients with alcohol use disorders have a higher likelihood of having comorbid depression, anxiety, and panic disorders. The reverse is also true, in that individuals with depression, anxiety, and panic disorders have a higher likelihood of having comorbid substance use disorders. It is important for both the inpatient and outpatient rehabilitation program to address these issues and if necessary prescribed medications that are not addictive to bring about a stabilization of these behavioral health problems.”

Get Help Now

If you’re struggling with alcohol, talk to your doctor and loved ones about it as soon as possible. Early treatment makes you less likely to develop a serious an alcohol use disorder, Skeer says. 

And if you’re already in the early stages of a disorder,  treatment can keep it from getting worse.  Untreated alcohol dependence can interfere with school, work, and relationships. It can also have serious short- and long-term effects, including liver disease, cancer, heart disease, high blood pressure, and stroke. 

Life After Alcohol Addiction Treatment