“My son/daughter needs help.” “I can’t keep doing this… it’s time to get right.” Either of these sound familiar? For most families and people who struggle with addiction, the need for rehab seems glaringly straightforward. And it is. After all, admitting helplessness over addiction is what brings us all to the table in the beginning. So many people become confused when the first question out of a treatment counselor’s mouth is about what level of care they’re seeking. “Level of care? What? I just need help!” As arbitrary as this question might seem at first, levels of care in rehab actually affect whether or not a specific rehab can accommodate you or your loved one. So which level of care is right for you?

Levels of Care in Rehab

Medical Model of Recovery

Each individual’s recovery journey contains unique stories. Drugs of choice vary, living situations are different, family dynamics and trauma history are all over the map. But overall, most people recovering from substance abuse follow a general trajectory once they choose to get clean and sober. These evolving needs equate to different levels of care in rehab. Think about it: it doesn’t make sense to group someone suffering from their first day of dope sickness with someone who has been clean for two months. They bring different needs to the table depending on the state of their physiology and withdrawal symptoms. And they benefit most from being with others in the same stage of recovery. In order to treat people effectively, treatment staff distinguish these levels of care upon admission. And individual case managers work to move them through each level of care at an appropriate pace.

Not everyone admits to rehab at the same level of care. Especially if this is not their first time in treatment. That said, we’ll start with the most intensive level of rehab.

Inpatient Detox

Who’s it for?        Active daily users who have established a chemical tolerance and need to taper into sobriety in a controlled clinical setting. It is not safe to detox at home, so please seek medical help if you or a loved one is seeking to get clean and sober.

How long?           7-10 days (more for high doses of methadone/suboxone)

What is it?          Inpatient clinical setting where users are monitored 24/7 by trained staff. The goal of detox is to wean users off completely in a safe and controlled environment. Tapered detox medication, typically buprenorphine, is administered according to each individual’s needs on a titration schedule. Usually includes daily individual and group therapy. Detox is medically required for getting off high doses of alcohol and benzodiazepines, as the withdrawal symptoms can be fatal without it. It’s also done for opiate withdrawal because dope sickness is physically excruciating.

Residential Care

Who’s it for?        Freshly sober people at high risk for relapse who are not stable enough to live independently. They may or may not have had prior rehab experience. Treatment centers recommend this phase after a person completes detox.

How long?           30-90 days

What is it?          Inpatient clinical setting. No detox medication. Daily individual and group therapy. AA meetings usually required. Residential care teaches the tools of recovery to high risk populations so they can transition to independence. Many centers who offer detox also offer residential care, as they require similar levels of facility/staff resources.

Intensive Outpatient Program (IOP)

Who’s it for?        Person has some sobriety under their belt, but they need a therapeutic program to address their addiction. Individuals go home in between sessions and voluntarily submit to random drug screenings.

How long?           3-6 months

What is it?         Outpatient therapy program. No detox medication. Typically includes both individual and group therapy. AA meetings required. IOP builds more recovery skills like daily sobriety maintenance and crisis planning. It’s the most structured level of independence available for rehab. Therapy schedules vary, but it usually starts at 5 hours a day/6 days a week and tapers down over the course of several months. IOP prepares people to integrate back into independent society with a new sober and functional lifestyle.

Sober Living

Who’s it for?        Person has achieved enough sobriety to function in an independent environment, but still benefits from program accountability to avoid relapse.

How long?           Indefinite

What is it?         Sober living homes usually consist of 6+ beds in a residential house. Most reputable houses will only accept men OR women (not both) who have at least 30 days of sobriety. These prerequisites establish safe boundaries and a stable environment. Each room contains multiple beds (usually 2-3) by design to discourage isolation among housemates. Weekly AA meeting quotas required, and most houses host at least one AA meeting a week on site. Some people who choose to stay in sober living for many years eventually accept positions as house managers.

Levels of Care in Rehab: Which is Right for Me?

So back to the question all treatment admission counselors ask, “What level of care in rehab are you seeking?” The answer to this depends on your individual circumstances. Treatment is not one-size-fits-all. Each person chooses to get help at a specific stage of their addiction, and rock bottom looks different for everyone.

Many programs specialize in one or two levels of care in rehab in order to provide the most effective environment for recovery. In order to determine which level of care in rehab is right for you or your loved one, there are a few questions to ask as a pre-assessment.

Pre-Assessment Questions
Determine Levels of Care in Rehab

This assessment can only be made by a treatment professional. If you’re seeking one, ours are always available at 855-737-7363. But if you’re just looking for information, here’s what you can expect an admissions counselor to ask before admitting someone to a rehab:

  • What is their drug of choice, and how much are they currently using a day?
  • Has this person been sober before? How long?
  • What is their previous treatment history, if any?
  • Any medical problems and/or current prescriptions?
  • Any diagnosed or suspected mental, mood, or thought disorders?
  • Are they employed, and if so, have they encountered problems at work related to their substance abuse?

This is just an overview of the standard procedure, and you can expect more questions about psychiatric issues, family history, and more. Most pre-assessments take about 20 minutes if the person is lucid. 

The answers to these question will determine the correct level of care. If you or a loved one is seeking help for a substance abuse problem, our treatment counselors are available 24/7 for free case assessments: 855-737-7363