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An inpatient alcohol and drug rehab gives clients in recovery the opportunity to have access to full time care and support while living communally with individuals who are also struggling with some type of addiction. Inpatient facilities are either located in a residential type location or a hospital where medical care is available as needed.
Unlike outpatient settings, inpatient facilities allow for full immersion. An individual in inpatient treatment is fully invested in the process of recovery without any distractions or unnecessary stressors which could trigger a relapse. As opposed to their everyday lives outside of treatment, inpatient settings remove negative factors which would typically interfere with treatment and cause a relapse. In such an environment and without access to drugs or alcohol, inpatient treatment makes the likelihood of program completion and success much more realistic. This level of care is ideal for individuals who have failed to complete outpatient treatment or have relapsed after outpatient or lower level treatment programs, such as self-help groups. It is also ideal for individuals who have been identified as needing this level of treatment due to a chronic long-term drug or alcohol problem, who would prefer to apply the right treatment approach the very first time they're in treatment. The level of treatment necessary should always be decided on by someone qualified to make such a decision of course, such as a trained addiction specialist after appropriate assessment.
As stated before, the level of treatment someone requires should ultimately be decided by a treatment professional or trained addiction specialist. Professionals in the field are best equipped to make this unbiased decision and have the addict's best interests at heart. But the individual who needs treatment should understand how treatment professionals come to such a conclusion, so they can better understand why an inpatient alcohol and drug rehab would be recommended.
The first thing someone should ask themselves honestly is how dedicated they would be to the recovery process if they chose outpatient instead of inpatient. When asking this question, the stresses of home life and work, the abundant temptations, the friends and acquaintances who influence one's substance abuse, and any other factors that may impact the course of outpatient treatment should be taken into consideration. Also, whether or not previous attempts have been made in outpatient should be considered, which have likely ended in relapse if someone is considering entering treatment again. Relapse is not a failure, but an opportunity to reevaluate and readjust the course of action. If outpatient didn't work, it's time to give inpatient a try.
One of the main concerns that individuals have when deciding between inpatient and outpatient is the time spent away from one's family and friends, and the lack of emotional support they believe they'll face if they decide upon inpatient treatment. What many individuals find when entering inpatient treatment is that the peer support they receive is essential for their recovery, because the individuals they are receiving treatment alongside know exactly what they are going through. Individuals in treatment can share in their struggles and successes and provide the positive encouragement empathy that can only be provided in this type of circumstance.
The length of inpatient alcohol and drug rehab varies, but you will find programs that advertise as either short or long term. The traditional definition of short term is up to 30 days, and long-term treatment is at least 90 days. Most long-term inpatient facilities provide treatment for about 90-120 days, although there are inpatient programs which treat clients at their own pace and may retain clients for as long as a year in some cases. The National Institute on Drug Abuse states on their website that, "participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes."
When entering inpatient alcohol and drug rehab it can take several weeks to get through detox and learn how to adjust to daily life without having to rely on chemicals to function. You also must consider that individuals have to learn how to get back to normal healthy patterns of eating, sleeping, socializing, and so many other activities that take time to re-adjust to and which can cause stress in the beginning stages of treatment. All the while, individuals experience intense cravings and other emotional and psychological stresses as they readjust and learn how to live sober. This readjustment is not something that can happen overnight and to be realistic it may not happen within just a few short weeks. Long term inpatient alcohol and drug rehab gives individuals the time for this readjustment to occur, but more importantly the time afterwards and with mental clarity to be able to fully address the causes of their addiction.
Nearly 75% of drug and alcohol treatment programs delivering treatment today incorporate some aspect of the 12 Step recovery model into their program. Treatment programs which use the 12 Step model encourage continued participation in 12 Step help groups following treatment. The one-year follow up success rate of 12-Step type programs and groups is about 27% although peer reviewed studies report this figure to be placed more accurately at about 5-10%.
The good news is, there are many alternatives, and there are inpatient alcohol and drug rehab programs which may involve 12 Steps but may also incorporate other practices and modalities which can encourage a higher rate of success for clients. Some inpatient programs use specific evidence based practices known to resolve specific types of addiction, to address the individual and social consequences of substance abuse, and to prevent relapse. One very good example of this is Cognitive Behavioral Therapy (CBT), which is one of the primary psychotherapies in use in evidence based programs today. Through CBT, clients identify behavior patterns that are self-destructive and are encouraged to develop coping skills to handle these situations and stressors differently in the future. Motivational Enhancement Therapy (MET) helps individuals in treatment become more motivated to change and participate in the process of rehabilitation, and consists of several sessions of motivational interviewing. During these sessions clients discuss and analyze their substance abuse and become more internally in change. The Matrix Model, developed specifically for stimulant abuse, uses therapy to build a positive bond and trust to prevent premature departure from treatment and relapse. Clients develop relapse prevention strategies, which could entail participation in self-help groups and programs which are regularly screened for drug use. Family Behavior Therapy (FBT) involves a therapist who helps the client and family member(s) develop proactive strategies to resolve issues in the home which could be triggering or impacting the substance abuse and/or mental health issues being treated. Sessions are goal oriented and usually with rewards for goals attained. Multisystemic Therapy is therapy designed specifically for children and adolescents who are substance abusers who also struggle with severe antisocial behavior, which addresses factors which could influence their destructive behaviors and substance abuse including their family and family life, school, friends and their attitude towards substance abuse.
A dual diagnosis is surprisingly common circumstance when a person is experiencing a drug or alcohol problem and a mental health disorder at the same time. In fact, an estimated 1/3 of persons experiencing symptoms of a mental illness also struggle with a drug or alcohol abuse disorder and 1/3 of individuals who abuse alcohol and half of individuals who abuse drugs report symptoms of a mental health disorder. It would make sense that an inpatient alcohol and drug rehab is the most appropriate place for a client diagnosed with co-occurring disorders, because they are particularly challenged and because an inpatient setting is one which is best equipped to address dual diagnosis. In an inpatient alcohol and drug rehab dual diagnosis patients can be treated professionally with individualized treatment plans to help them recover from addiction and become mentally stable. Treatments commonly used to treat dual diagnosis clients include medication management, therapies and psychotherapies to which may be significantly more involved than someone just treating a drug or alcohol addiction. For this reason, dual diagnosis clients may need to be engaged in treatment significantly longer.
No matter what type of program someone chooses, how long they remain in treatment, and how confident they are about their sobriety, returning to a "normal" life outside of treatment with the intention of remaining permanently abstinent is no small feat. Particularly for individuals who struggle with severe chronic addictions and dual diagnosis clients, confidence about one's sobriety comes and goes and it could be a struggle for many years without a support structure, involvement in self-help, and some type of aftercare plan in place. Following any type of treatment, but particularly inpatient, individuals will be encouraged to engage in self-help groups, continued outpatient treatment, and even residence in a sober living facility or a group home if supportive housing is essential at that time.
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