Outpatient versus Inpatient Addiction Treatment


“Drug use is on the rise in this country and 23.5 million Americans are addicted to alcohol and drugs. That’s approximately 1 in every 10 Americans over the age of 12 – roughly equal to the entire population of Texas.”

~Dr. Kima Joy Taylor, director of the Closing the Addiction Treatment Gap Initiative

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over 24 million Americans aged 12 years or older have used an illicit drug within the last 30 days. That number represents almost 10% of the US population, and even more alarmingly, it indicates an increase in drug use of over 8% within the last 10 years.

The numbers are much higher when it comes to alcohol. As reported by the National Institute on Alcohol Abuse and Alcoholism, almost 87% of American adults say they have drank alcohol in their life, with over 56% reporting that they have drank in the last month. Over 16 million American adults and nearly 700,000 American adolescents have an Alcohol Use Disorder (AUD).

Horrifying Costs

The costs of addiction are staggering, both financially and in human terms:

  • Substance abuse costs society $484 BILLION a year in the United States.
  • Substance abuse costs society more money annually than diabetes and cancer combined.
  • Approximately 570,000 people die each year because of drug use.
  • 440,000 people die annually due to diseases related or linked to tobacco use.
  • 85,000 people die annually because of alcohol.
  • 20,000 people die annually because of illegal drugs.
  • 20,000 people die annually because of prescription medication abuse.
  • Roughly 100 Americans die every single day specifically because of drug overdoses.
  • Drug overdoses are the leading cause of accidental death in the US – accounting for more fatalities than suicides, gun homicides, and even traffic fatalities.

Everybody Knows Somebody Who’s Got a Problem

As stated above, an estimated one out of every 10 Americans over the age of 12 are addicted to drugs or alcohol. That seems like a high number, but let’s really put that in perspective.

According to a survey published in the New York Times, the average American knows about 600 people. Doing the math, that means that the average American knows 60 people who are addicted to alcohol or drugs.

Let that sink in for a moment.

You’re an American. Think about all of the people you know. Does it boggle your mind that you know 60 addicts and alcoholics?

Hold on a minute,” you say. “Most of those are just acquaintances. That doesn’t really count.”

Fair enough. The same survey estimates that most Americans only know 10-25 people well enough to trust them. Those are your “real friends”.

Do the math again.

That means in your close circle of friends – people you trust and probably loveyou know two or three people who have a problem with substance abuse.

This is the point – it can be anyone. The drug addict or alcoholic in your life can be your parent, your sibling, your spouse, your child, your partner, your best friend, your coworker, or anyone else that you care about.

It can even be you.

So Someone Needs Help. What Do You Do?

When you or someone you know have a substance abuse problem – illegal drugs, alcohol, or prescription drugs – the first step is to get professional help. Addiction is a problem that most people can’t handle by themselves. Only trained and experienced counselors, addiction specialists, and medical personnel know how to properly deal with the multitude of issues that come along with substance abuse.

You will find that when it comes to addiction treatment, the choices of rehabilitation facilities are divided into two categories – inpatient and outpatient. Each category has its own benefits and advantages as well as its own drawbacks and disadvantages.

Both types of facilities are dedicated to helping people overcome their addiction and return to a clean and sober life of peace and serenity. The variable in the equation is the individual needing help – their type of addiction, the severity of their addiction, the needs and obligations present in their life, and their budget – both financial and availability.

In order to properly choose the type of facility that is right for you or your loved one, you should carefully consider all the factors involved.

Let’s take a closer look.

What is inpatient rehab?

An inpatient drug rehabilitation property is a full-time addiction recovery facility in a residential setting. Incoming patients check in and are expected to live there for the complete length of the recovery program.

An inpatient facility is staffed 24 hour a day by support staff and medical personnel trained in addiction treatment. Counselors, nurses, aides, psychiatrists, and medical doctors are there to make sure that the mental and physical health of their inpatient charges is closely and safely monitored. Support staff is there to make sure that all of the patients’ practical needs are met – meals, clean lodging, and even healthy recreational activities.

Inpatient drug rehabilitation is not typically held in a hospital. It is usually in a more remote location that is secluded enough to provide the quiet and peace that is most conducive to recovery. Typically, every effort is made to create a serene, comforting, and welcoming environment.

The focus is on recovery

That is the key benefit of inpatient treatment. Patients are removed from the obligations and stresses of their normal lives so they can fully focus on their own recovery, without outside distraction.

This lack of “outside distraction” also is responsible for the other main benefit of inpatient treatment. Because they are in an extremely-controlled environment, residential patients in attendance have absolutely no contact with alcohol or drugs of abuse.

Inpatient drug rehabilitation is considered to be the most comprehensive type of treatment, because each day’s activities are prescribed – individual counseling, group therapy, 12-step meetings, medication, meals, recreation, exercise, personal time, and even outings. Almost every hour is accounted for with a positive objective. This gives recovering addicts/alcoholics the structure that their lives in the outside world most likely lacked.

Because of this immersive structure and the sheer amount of time that is spent solely focused on activities directly related to recovery, inpatient rehabilitation is considered to be much more intensive than outpatient therapy.

Intensive inpatient treatment is often the best choice for individuals who have tried drug rehab before without success or who are suffering a significant relapse.

How long does inpatient drug rehabilitation take?

The length of a patient’s day at an inpatient facility depends upon a number of factors – the substance abused, the severity of the addiction, the length of the addiction, the patient’s progress, and their ability to pay. Typically, these issues are addressed and the determination as to the length of stay will be primarily discussed during an intake interview. After this preliminary assessment, adjustments can be made based upon an individual patient’s progress.

Statistics have shown that the most beneficial programs last a minimum of 90 days. However, this treatment length is not an absolute that is set in stone. For those recovering addicts/alcoholics whose personal circumstances warrant a different approach, there are programs of shorter durations of 30 or 60 days. For individuals with severe need, there is also an extended-length option that has no set duration. Although uncommon, it is not unheard-of for an individual to be in a program for as long as 18 months.

What is outpatient addiction treatment?

The biggest difference between inpatient and outpatient drug rehabilitation is the structure and the length.

Over time, the same sort of treatment programs and classes are offered – individual and group counseling, 12-step meetings, relapse prevention, etc.

However, the client is able to attend on a schedule that is much more flexible and crafted around their existing obligations – work, school, family obligations, etc. Except where possibly directed by the Court, there is no minimum level of mandatory attendance.

Recovery on their own terms

This flexibility affords a number of advantages to the person in recovery:

  • they are still able to live at home or a sober living facility
  • they can continue working at their same job
  • they can attend school
  • they can work on their recovery while still receiving support from their friends and family
  • they can go to recovery classes, meetings, and counseling sessions as often or as infrequently as fits their individual needs

There is one factor about the more relaxed schedule in outpatient therapy that needs to be taken into consideration. Because attendance is not as frequent or intensive, the overall length of treatment can be much longer than in an inpatient setting. Whereas a six-month or year-long stay at an inpatient facility is rare, it is not at all uncommon for someone to continue outpatient treatment for those durations.

Conversely, however, most people who have need of outpatient treatment of longer than a year are usually better served if they attend an inpatient facility. The reason for this is that individuals who have a need great enough to necessitate extended rehab are also usually at significant daily risk of a dangerous relapse if they remain in an unstructured environment.

How do the costs compare between the two?

There is a huge variance in the cost of different inpatient drug/alcohol rehabilitation centers. A low-end option might cost $7000 to $8000 a month, while a resort-like luxury facility can cost well over $100,000 per month. Most mid-range inpatient rehabs will be between $20000 and $30000 per month.

For many, the expense of checking into an inpatient drug rehabilitation facility might seem prohibitive. On an individual basis, that may be true, but there are a couple of things to consider that will put that cost in its proper perspective.

First, most insurance plans offer coverage for substance abuse rehabilitation. If an individual has the proper coverage, rehab costs can be a lot more manageable.

Second, when you are considering a rehab facility but the cost seems too expensive, consider this – the drug or alcohol addiction for which treatment is being sought also carries with it a huge financial burden – the cost of the drug itself, missed days at work, criminal and civil fines, attorney’s fees, and medical bills.

Lastly, there are state, federal, and charity programs that can help with the cost of rehab. Many rehab facilities extend payment plans as a convenience.

Because outpatient drug rehab is not as intensive as the inpatient option, the cost incurred is a fraction of residential care. The average cost for a 10-week intensive outpatient treatment program is only about $7000, roughly $135 per day.

It’s gets even better –

  • More than a third of all outpatient programs offer free treatment for selected clients and a sliding cost scale.
  • One out of every seven programs offers their services free to at least some clients.
  • 76% offer payment assistance.


So which one is best?

The short answer is this – they both are.

Either program could be the perfect fit for you, depending upon your personal situation.

If you are able to leave your family in good hands, can put school and your job on hold, and if you can afford it, then an inpatient facility would work best for you. Remember; the longer someone stays in an immersive rehab facility, the better their chances of sobriety are.

If, on the other hand, your work, school, and family obligations make it impossible for you to get away for weeks or months at a time,  or if money is an insurmountable barrier, then an outpatient facility can meet your needs while you recover at your own pace.


The fact that you are searching for a rehab facility for yourself or your loved one is an excellent start. This means that you have already admitted that you need help. That is always the first, most difficult step on the road to recovery.

As long as you pick a facility that meets all of your needs – inpatient or outpatient – you will begin making progress, and that is to be celebrated and commended. At the end of the day, it does not matter the route that you take to long term-sobriety. It only matters that you get on your way as fast as possible.