Substance Abuse FAQs

Medically reviewed by:
Dr. Baran Erdik, M.D.

How is Substance Abuse Treated?

Substance abuse is treated by a team of medical doctors, therapists, and other addiction recovery specialists trained to help individuals with substance use disorders put an end to compulsive drug and alcohol seeking and use, and to avoid relapse. Patients at professional rehab programs go through detox, counseling, and other therapies that provide the necessary tools for building a life that allows them to thrive without substance use.

What is a Drug Detox?

A drug or alcohol detox is when an individual quits drinking or using, and the body detoxifies and adjusts to functioning without addictive chemicals. Although some people may quit using before they attend a rehab program, it is usually safest to experience detox with the supervision of addiction treatment professionals. These professionals can provide medications and treatments that can make withdrawal symptoms less painful, and can treat or help patients avoid dangerous health complications that can sometimes arise during the detoxification process. Once the individual has fully detoxed and is stabilized, they will be able to obtain the full benefit from the other services provided in addiction treatment.

What Is Addiction Treatment Like?

Addiction treatment programs come in different formats and degrees of intensity. An individual usually chooses the most intensive level required to treat their unique circumstances, and then “steps down” to programs and services that require less time and offer more flexibility as their condition improves.

• Inpatient or residential programs provide 24-hour care to patients in a controlled environment. This is usually beneficial to those with more severe addictions or additional issues. Inpatient programs are in a medical facility with the supervision of doctors and nurses who can oversee a safe detox for individuals likely to experience a difficult withdrawal syndrome. In residential treatment, the patient still lives in a controlled environment, but without the same medical oversight.
• Partial hospitalization programs (PHPs) usually offer intensive day treatment, such as six hours of different therapies a day, five days a week, while the patient lives at home. This is a good option for people with a stable home environment, and/or people who want a gentler transition from inpatient treatment to outpatient treatment.
• Outpatient and intensive outpatient treatment programs provide many of the same therapies as inpatient care, but patients are able to return home after their sessions. Intensive outpatient treatment usually requires several hours of treatment for several days a week, while outpatient may only require a few hours of therapy once or twice a week.

Rehab for addiction is usually highly structured with treatments occurring at the same times every day. Patients may be admitted either voluntarily or involuntarily and decide with their doctor which treatment options will best benefit their situation. Although there is a widespread belief that someone must “hit bottom” and then choose treatment in order for it to be effective, this is not true. The earlier someone gets treatment, the easier their recovery will be, and even someone forced to get treatment by an employer or a judge’s sentence can have their perspective changed by treatment, and achieve a successful recovery.

Who Should Receive Inpatient Addiction Treatment?

Inpatient addiction treatment is the right choice for patients who may be a danger to themselves or others—for example, patients with especially severe addictions who may be at risk of a fatal overdose, or someone with multiple DUIs who puts others at risk by constantly driving while inebriated.

Inpatient treatment would also be recommended for patients with possible psychiatric or medical safety issues, such as patients with health complications from substance abuse, who may require additional medical services along with addiction treatment. Individuals with intensive psychiatric needs fare better in inpatient care, where they can receive more in-depth therapies for co-occurring mental disorders like depression, anxiety, or schizophrenia, in addition to their addiction care.

Individuals likely to suffer from dangerous withdrawal symptoms during detox should seek treatment at an inpatient facility with 24/7 medical oversight. This would include people who have been seriously addicted for a long time, and people addicted to alcohol, benzodiazepines, or more than one drug (known as a poly-drug addiction), as they are more likely to suffer from dangerous withdrawal syndromes. People without a strong social support system also often require inpatient care in order to safely recover. In this case, the doctors, nurses, therapists, and other patients in the facility become the individual’s support as they help the patient learn how to create a support system in their lives outside of treatment.

Anyone with an unsafe or unstable home environment would benefit from inpatient treatment. Many inpatient rehab programs provide supportive services that can help patients work through issues they may have at home and find safer housing to move into after completing their treatment program.

Finally, there may be therapeutic choices made by the recovery team that necessitate inpatient treatment. For example, a patient to be started on long-acting injectable naltrexone for opioid abuse needs a 10-day opioid-free washout after detox, and would therefore require inpatient supervision.

Who Should Receive Outpatient Addiction Treatment?

Outpatient treatment would be recommended for patients with a support system in place, sufficient motivation, and no ability to take time off work. Some questions to ask before opting for outpatient treatment include:

• Does the patient have access to reliable transport to get to and from the treatment center?
• Do they have a stable home environment and the necessary support system?
• Are they likely to resume or keep using and drop out of treatment?
• Are they physically and emotionally stable enough to not need 24-hour supervision/monitoring to keep them safe and substance-free?
• Do the problems associated with temporarily leaving behind outside responsibilities outweigh the benefits of inpatient treatment?

All in all, outpatient treatment would be recommended for patients that are likely to be committed to their program, are no risk to themselves or others, and have responsibilities at home that make inpatient treatment impossible If an individual can handle outpatient treatment, they have the advantage of integrating the treatment experience into their daily life from the start, so that they can stay employed and close to friends and family, while never having to feel disconnected from society.

How Long Does Rehab Take?

The time it takes to go through rehab treatment and recover from addiction is different for everyone, but most programs require at least a 30-day stay, as this is considered the bare minimum necessary for recovery. Most experts agree that at least 90 total days of inpatient and/or outpatient treatment will give patients their best chance of a successful recovery, especially anyone with a long-term or serious addiction, and/or with any co-occurring mental health issues.

Some rehab facilities offer even longer treatment programs, as some individuals may require treatment of 6 months to a year or more. This treatment should be provided in step down levels that gradually lessen the intensity of therapy and increase the level of independence for the patient. In this way the patient has both a long-term, in-depth treatment experience, and a gradual transition into the experience of coping with the challenges of day to day life outside of a rehab facility.

What About Patients with Co-occurring Disorders?

Patients with co-occurring disorders, such as depression or schizophrenia or any other mental health issue, need to receive specialized care and support in addition to addiction treatment. Doctors and treatment professionals should assess the needs of each patient and work with the individual to build a program based on these needs. While some treatment approaches, such as cognitive behavioral therapy, are effective for almost all mental health issues as well as for addiction, other approaches, such as trauma therapy, may be necessary for the complete recovery of individuals with co-occurring disorders.

What is Cognitive Behavioral Therapy (CBT)?

CBT, or cognitive behavioral therapy, is a form of behavioral therapy that takes a practical approach to recovery by working to change a patient’s negative patterns of thought and behavior, replacing them with new perspectives and more productive and healthier coping mechanisms. In this way, a positive, substance-free lifestyle starts to become habitual to the individual, so that recovery becomes easier and more natural over time.

What is Addiction Aftercare Treatment?

Many rehab centers offer aftercare treatment options to support patients who have completed a rehab program. Aftercare services provide the benefits of longer treatment in a more relaxed and flexible format. These options prolong the support of treatment and help keep patients on track and involved in a recovery community.

There are many different types of aftercare options available to individuals in recovery from substance use disorders, including:

• Booster sessions: By allowing visits to the rehab center after the treatment program ends, these sessions are like refresher courses that remind people of what they learned in rehab, and renew their commitment to a life free of substance abuse.
• Sober living houses: These facilities allow residents to come and go for work, attend meetings or outpatient care, and pay an affordable rent while staying in a drug- and alcohol-free space. It is a great option for people without a stable home environment, or who feel they need to transition more gradually into independent living in order to avoid relapse.
• Support groups: 12-step groups like Narcotics Anonymous or non-12-step groups like SMART Recovery allow members to practice social support and help one another through recovery. Almost all of these kinds of meetings are free, and they are readily available in most areas, sometimes even seven days a week, providing a source of support for anyone who needs it. While there are addiction-specific groups, these meetings can be helpful to anyone. For example, someone recovering from cocaine addiction may feel the need to attend a meeting, but the only one available at that time is an Alcoholics Anonymous meeting. They can get many of the same benefits from attending that AA meeting as they would from Cocaine Anonymous.

If I Relapse, Does that Mean My Treatment Failed?

Many people believe that relapse equals failure, or that their relapse is their fault, but this simply isn’t true. It is important to understand the nature of substance abuse and why so many people relapse even after attending treatment. As addiction is a chronically relapsing disease, it is difficult for many individuals––even those who haven’t used in a long time––to avoid relapse. When relapse does occur, people should not look at it as a failure, but as a sign that their recovery currently requires more focused attention.

• If you do relapse back to substance abuse after or during your addiction treatment, make sure you tell someone immediately.
• Consider why you returned to your substance abuse: was there a specific trigger that made you want to use?
• If you are not currently in treatment, you may want to consider returning to a rehab program or another type of option (such as a support group or individual counseling). This can help you get back on track with your recovery.
• Make sure that you remain in treatment for as long as you need. Sometimes a relapse occurs when someone leaves the treatment environment before they are ready.

How Much Does Rehab Cost?

There is a wide range of costs when it comes to addiction treatment, but many rehab costs can be covered by government programs, and non-profit organizations. Most rehab centers accept insurance as well, although some programs will only accept specific options, so it is important to investigate this in advance.

In some cases, addiction treatment may even be free or very low cost to patients who could not otherwise afford to attend rehab, due to assistance from available programs, or to the sliding scale fees many facilities offer based on a patient’s ability to pay.

You can normally find a rehab program with a cost that suits your budget, but it is also important to consider the cost of continued substance abuse versus the cost of treatment. In most cases, those who continue to use drugs may think recovery and professional care is too expensive, but issues like legal battles, losing one’s job, and homelessness are all common among addicts, not to mention the consistent need to obtain and use more drugs. In the long run, rehab is the cheaper option as well as the healthier one.

How Much of My Treatment Will My Insurance Plan Cover?

Usually, insurance plans will cover at least some, if not all, of a person’s treatment costs for addiction rehab. This allows many individuals who otherwise wouldn’t be able to seek care for their addictions to be able to do so. However, it is important to be aware of when your insurance plan will not cover the entirety of your costs.

If you do choose a rehab center or treatment program where your plan is only covering part of the cost, you can finance the rest of your treatment expenses. This allows you to pay a certain amount up front and then to make payments over time, ensuring you do not have to pay more than you can afford at any one time.

How Do I Find a Rehab Program that Will Take My Insurance?

You will want to make sure the rehab program you choose will accept your insurance before committing to stay or receive treatment there. Every rehab center does not accept every insurance plan, so keep this in mind when choosing the program that is best for your needs. Search the SAMHSA directory for more treatment options, sorted by state, or contact your insurance provider directly for a list of approved facilities.

How Can I Help My Loved One Recover from Substance Abuse?

The best way to help your loved one is to encourage them to attend professional rehab. Having friends and family members involved in a person’s recovery can help strengthen and extend the benefits the patient gains through treatment. In addition, your support will be essential to their strong recovery, so make sure to let them know you’ll be by their side every step of the way.

How Can I Find Safe, Reliable Care?

The best way to find a treatment option that will be effective for you is to consider all of your needs, even those that may not directly affect your addiction. You may want to talk about this with trusted friends and family, a counselor or doctor, or an addiction treatment professional, to get advice on the sort of rehab that will help you most.

Still, whether or not you know what you require from a rehab program, if you are ready to get addiction treatment, a resource like SAMHSA, the Substance Abuse and Mental Health Services Administration, can help you search for the best option for your location and situation. The most important thing is for you to start making an effort to get the help you need as soon as possible.