When you or your loved one is struggling with an alcohol use disorder (AUD), you may be unsure about the various types of treatment options available. You may have heard about inpatient and outpatient treatment programs but aren’t sure which is right for you. Inpatient treatment means 24/7 treatment in a rehab program, whereas, in outpatient treatment, you go home at night after participating in treatment sessions for several hours each week.
While outpatient treatment is a valuable treatment option, it may not always be the most appropriate level of care for certain individuals, such as those with relatively more severe AUD and/or significant acute alcohol withdrawal risks. Undergoing a thorough assessment by a doctor or other substance abuse treatment professional can help you determine if outpatient treatment is right for you.
What is Outpatient Treatment?
Outpatient treatment is a form of treatment for drug and alcohol use disorders in which a person regularly attends treatment at an outpatient center but is able to return to their home or other outside living arrangements outside of program hours.1 Several types of outpatient programs are available, with a varying number of treatment hours per week and intensity of oversight.2 Some programs offer daily sessions and others only meet 1 to 3 times per week.3
Some outpatient programs are relatively time-intensive and structured and are known as either partial hospitalization programs (PHPs) or intensive outpatient programs (IOPs). Both provide a full range of assessment, ongoing support, and linkages to more intensive levels of care if needed.2
Successful outpatient program participation is contingent upon a person’s home environment being alcohol/drug-free and further benefits from the presence of a safe support system. These types of programs are also sometimes utilized after completion of an inpatient program (i.e., step-down treatment after residential rehab) as a way of easing the transition back to an individual’s everyday life. However, this isn’t always the case, as all types of outpatient programs may serve as a person’s initial point of rehabilitation care, when appropriate.
What Therapies Are Used?
Many outpatient programs will utilize a combination of medical and behavioral treatment interventions, though these approaches may vary from one program to the next as well as based on the type of substance use disorder being treated. Some of the more commonly used therapeutic interventions include:
- Cognitive-behavioral therapy (CBT): This approach teaches people to identify certain types of maladaptive thoughts so that they can adjust the resultant behaviors associated with them, such as using and/or abusing alcohol. The underlying idea is that thoughts and behaviors are learned, and thus can be unlearned.4 CBT teaches people to cope with triggers that lead to drinking and to learn new ways to cope and avoid relapse.4
- The Matrix Model: This approach was developed to treat people who used stimulants, though variations of the original treatment protocol have been used to help people with substance use issues involving opioids and alcohol. The Matrix Model incorporates numerous approaches and treats the whole person, including relationships, behavior, and emotions. 4 This approach emphasizes the counselor-client relationship and teaches patients how to structure and manage their daily schedules and free time.4
- Contingency management: This approach is based on the idea that individual recovery may be promoted when some of the rewarding aspects of using drugs or alcohol are replaced with other types of rewards to encourage abstinence. Clients are often given vouchers for submitting negative urine drug screens, for example, or attending certain groups. These vouchers can be traded for a variety of items.4
- Motivational interviewing: This approach focuses on meeting a client where they are and not forcing a person to see that he or she has a problem with drugs or alcohol. Instead, the therapist works on “rolling with resistance,” an approach in which the counselor helps the person determine his or her own definition of the problem, as well as the solution, which minimizes power struggles and resistance, as the person isn’t being told what to do. Other techniques are designed to motivate change.5
- 12-step facilitation: Patients are introduced to the concept of 12-step groups for recovery and relapse prevention. The principles of 12-step groups are used as a foundation of the program and attendance at 12-step groups, such as AA is encouraged and promoted as a tool for aftercare.4
- Family therapy: Family therapy incorporates the family into treatment by including them in sessions and encourages members to set up family rules that reinforce abstinence and discourage substance use. This approach includes contracting for positive behaviors and sometimes incorporates elements of contingency management.6
- Medication-assisted treatment (MAT): This type of treatment involves FDA-approved medications, in combination with counseling and behavioral therapies, to treat certain types of substance use disorders.7 Often used in treating opioid use disorders, certain types of MAT can help people control cravings and decrease continued drug use. Some drugs are also used to treat people with an AUD, as discussed in the following section.
Are Medications Used in Outpatient Settings?
Numerous medications may be used in outpatient treatment to aid with withdrawal management and help prevent relapse. These medications are used in conjunction with counseling. The long-term use of drugs such as methadone and buprenorphine is often incorporated into treatment to aid in managing symptoms of withdrawal from opioids and in controlling cravings and preventing relapse.8
The following 3 medications are most commonly used to treat an AUD:8
- Disulfiram is given only after a person has undergone detoxification and is abstinent from alcohol. Disulfiram’s side effects may include nausea, vomiting, chest pains, and headaches if even a small amount of alcohol is ingested.
- Acamprosate does not prevent withdrawal symptoms, but aids in helping a person continue in abstinence from alcohol once they’ve stopped drinking. It is typically started on the 5th day of abstinence from alcohol.
- Naltrexone prevents a person from feeling some of the rewarding euphoria associated with alcohol use, thereby facilitating a decrease in ongoing drinking behavior. Naltrexone can be given by injection, including formulas that work for several weeks at a time. Naltrexone can be administered even if a person is actively drinking. Naltrexone also controls cravings for opioids, which is helpful if a person struggles with opioid misuse in addition to alcohol issues.
Again, it is important to note that medication is only one element of AUD treatment. Comprehensive rehabilitation efforts combine medications with counseling and behavioral therapies.8
Several factors are involved in determining whether a patient is a candidate for MAT. These factors include:9
- The person’s motivation to stop drinking.
- The person’s readiness to change his or her drinking.
- Underlying psychiatric or medical issues.
- Ability to tolerate the medication.
- Potential for relapse.
- Whether or not the person is pregnant.
How Effective is Outpatient Treatment?
Outpatient treatment has been demonstrated to be effective for an AUD; however, some people tend to do better overall in this type of setting than others. People who respond less favorably to outpatient treatment include:10
- People with prior treatment attempts.
- Participants who attempted suicide.
- People with co-occurring disorders.
- People who relapsed while in treatment.
- People with more lengthy durations of relapse prior to returning for additional treatment.
- People who have dropped out of treatment.
Although people in these groups may not do as well as others overall, many participants in these groups still benefit from outpatient treatment. A recent study indicated that outpatient treatment may be just as effective as inpatient treatment for treating AUDs.11
Other studies show that 50%-70% of people who attended an IOP were abstinent from alcohol during follow-ups.12 Another review of numerous research studies show that overall, outpatient treatment was just as effective as inpatient treatment for the majority of participants.12
Outpatient Treatment With American Addiction Centers
Alcohol.org is a subsidiary of American Addiction Centers (AAC), a nationwide provider of addiction treatment facilities. Outpatient treatment with AAC is uniquely tailored to meet every patient’s specific needs; we know there’s no one-size-fits-all approach to treatment.
We offer a complete continuum of care starting with detox and continuing through aftercare, which is a form of ongoing support once you’ve completed formal treatment to help prevent relapse. Our facilities offer treatment for co-occurring disorders (also referred to as a dual diagnosis) to address both the addiction and the mental health condition.
At AAC, we know that it’s important to begin the treatment process as soon as possible. Our screening process begins within 24 hours of your arrival at one of our facilities, when you will meet with a psychiatrist, case manager, therapist, and nurse for a comprehensive evaluation that will help to determine the appropriate level of care for you.
Not only will we look at the addiction, but a physician or other treatment professional will also examine your mental health and assess your medical condition. A urinalysis and complete physical will be conducted to help ensure that we are addressing all of your needs. We also use a wide range of medical technologies, such as pharmacogenetic testing, to help us learn more about how you react to specific drugs.
Information collected from our various assessments will be used to customize your treatment. Your treatment plan may involve a psychiatric consult, medication-assisted treatment, group therapy, individual therapy, a consultation with a registered dietician, and attendance at 12-step groups or SMART Recovery (a non-12-step support group). We’ll also connect you with different specialists as needed.
Our specialized tracks include:
- The Salute to Recovery program is geared toward veterans and first responders who are struggling not only with addiction but co-occurring mental health issues like PTSD.
- We created a unique LGBTQ+ track to offer a safe and welcoming place to work toward recovery for those within this population.
- Our faith-based alcoholism treatment program involves a comprehensive curriculum that focuses on Biblical principles and evidenced-based alcoholism treatment.
- Our personalized and therapeutic healing (PATH) alcohol treatment program offers dedicated care for individuals who struggle with addiction and chronic mental illness.
- Our alcoholism treatment program for impaired professionals helps licensed healthcare professionals overcome struggles with substance abuse and return to their careers.
We also offer aftercare planning and an alumni support system to help you once you’ve completed formal treatment. Aftercare plans are designed with recommendations from your counselor, psychiatrist, and/or physician as needed. We will ensure that you have a comprehensive aftercare plan in place to help you successfully reintegrate into home life, employment, and the community at large.
Your aftercare plan may include sober living housing (alcohol- and drug-free residences designed to support you during the first phase of recovery after treatment), 12-step groups, individual counseling, or other forms of care.
Check Your Insurance Benefits
If you’re ready to seek treatment for alcoholism with AAC, fill out the form below to see if your insurance covers treatment within our facilities. Or call our hotline to speak with an admissions navigator who can answer any questions you may have about treatment and your options. All calls are 100% confidential.
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2015). Detoxification and substance abuse treatment.
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2014). What is substance abuse treatment? A Booklet for families.
. Substance Abuse and Mental Health Services Administration. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Treatment Improvement Protocol (TIP) Series, No. 47. Chapter 3. Intensive Outpatient Treatment and the Continuum of Care.
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2013). Substance abuse: Clinical issues in intensive outpatient treatment.
. Department of Mental Health. (n.d.). A definition of motivational interviewing.
. National Institute on Drug Abuse. (2020). Family behavior therapy.
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2020). Medication-Assisted Treatment (MAT).
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2020). Medication and counseling treatment.
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2006). Substance abuse. Clinical issues in intensive outpatient treatment. Treatment entry and engagement.
. Substance Abuse and Mental Health Services Administration. (SAMHSA). (2015). Medication for the Treatment of Alcohol Use Disorder: A Brief Guide.
. Soyka, M., & Schmidt, P. (2009). Outpatient alcoholism treatment–24-month outcome and predictors of outcome. Substance Abuse Treatment, Prevention, and Policy, 4(1), 15.
. López-Goñi, J. J., Fernández-Montalvo, J., Arteaga, A., & Esarte, S. (2017). Searching objective criteria for patient assignment in addiction treatment. Journal of Substance Abuse Treatment, 76, 28-35.
. McCarty, D. et al. (2014). Substance abuse intensive outpatient programs: Assessing the evidence. Psychiatric Services, 65(6), 718-726.