How to Find the Right Outpatient Level of Care

There is an urgent need for addiction treatment in the U.S. More than 14 million people have an alcohol use disorder, while 8.1 million have a drug disorder. Too few of these people seek treatment. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported that in 2015 only about 20% of people with alcohol use disorder sought care.

While it is more important than ever that anyone struggling with addiction seeks care, it is also vital to find the best treatment possible when they do. The decision to attend rehab is personal and includes consideration of the person’s level of addiction, availability, and budget. Outpatient treatment is best for those with a level of addiction that would be considered low to moderate. Costs can vary widely, but outpatient options are typically less expensive than inpatient. Finally, outpatient typically offers a more varied range of time commitments for those who need a flexible schedule because of other commitments in their life.

Levels of Substance Abuse Treatment

According to the American Society of Addiction Medicine (ASAM), there are five primary levels of substance abuse treatment care:

• Level 0.5: Early intervention services
• Level I: Outpatient services
• Level II: Intensive Outpatient/Partial hospitalization services (Level II is subdivided into levels II.1 and II.5)
• Level III: Residential/Inpatient services (Level III is subdivided into levels III.1, III.3, III.5, and III.7)
• Level IV: Medically managed intensive inpatient services

These provide a continuum of care for those with addiction problems. The next step is determining the best outpatient level of care by establishing the individual’s personal needs.

Outpatient Substance Abuse Care

Finding the right outpatient level of care for drug or alcohol abuse starts with an honest assessment of each person’s requirements. The best care is customized because there is no one-size-fits-all solution for addiction treatment.

The first level of care mentioned by the ASAM is outpatient services. This includes:

• medication treatment
• group and individual abstinence counseling
• relapse prevention programming
• drug and alcohol education

Attendees average less than 10 hours a week in this treatment program. Most will take place at a nonresidential care facility and are best suited for individuals with a strong support system. It is also the suggested level of care for those who wish to maintain certain aspects of their life; for instance, continuing to work or care for children and family members.

Intensive Outpatient Treatment

A more intensive outpatient experience, level II: Intensive outpatient/Partial hospitalization services are for those with more complex needs. This may mean they have a co-occurring disorder (also known as a dual diagnosis) or who would be eligible for an intensive outpatient program.

Just as in the first level of outpatient care, individuals can maintain their life and activities outside of treatment with this level of treatment. It is recommended that they engage in the program for a minimum of 90 days for nine or more hours a week. Many of the programs within this level offer more substance use counseling than those at level 1.

What to Ask

A reputable treatment center will need to know certain information to determine the best program fit for someone seeking help. Possible questions that may be asked include:

• How severe the person’s substance use disorder is
• What other physical or mental health conditions do they have
• Whether they have a place to live, transportation, and resources to manage their life

Additionally, the individual should ask the facility specific questions. To start, is the center licensed and accredited? Reputable centers will have accreditation from the nonprofit The Joint Commission or the Commission on Accreditation of Rehabilitation Facilities (CARF®). This ensures the treatment, staff, and facility meet certain standards.

Next, they should ask what the evidence-based treatments used are. Some examples include cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, and medications to help treat certain substance disorders like opioids and alcohol.

Finally, ask about any specialty programming. This includes treatment geared toward specific age groups or genders and help with a dual diagnosis. Other questions to consider include:

• What is the patient-to-counselor ratio?
• How successful is your treatment program?
• Are you in-network with any insurance?
• Do you provide mental health services?
• Do you offer medical detox or other medication-assisted therapies?
• How long does the program last?
• What kind of post-treatment support do you provide?
• Do you offer family support?
• How long have you been providing addiction treatment?

Addiction is a chronic disease that can be managed but not cured. Be wary of any treatment center that professes the ability to cure someone of their substance abuse. The decision to seek help for addiction is brave, and the person should acknowledge that. The path forward may not always be smooth, but asking for help is a significant first step.

Bridges of Hope’s treatment philosophy is based on a comprehensive and integrated approach to addressing all issues related to substance use and mental health disorders. Utilizing therapeutically proven, evidence-based clinical practices, Bridges of Hope provides superior patient care in Indiana through its all-inclusive treatment services.