(lowest to highest)

Entering treatment for substance abuse is difficult whether it's by personal choice, or if it's being recommended or required by an outside source such as the court system, family, or employer. The first step in establishing a treatment plan for a substance abuse issue disorder is a full evaluation. The evaluation typically includes:

• Complete assessment of the person's current use
• Previous substance abuse and treatment history
• Physical history
• Social situation
• Identification of treatment goals

After this evaluation, a substance abuse professional will recommend a type of treatment based off of safety concerns and medical necessity. The recommended treatment will occur on either an inpatient or outpatient basis, referred to as a level of care (LOC).

Outpatient Care

12-Step Programs (Community-based and free)

Includes programs such as Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, or Ala-Teen

• Typically very useful for patients trying to achieve recovery, and for family members affected by
• substance abuse
• Allows opportunity for contact with individuals with many years of recovery
• Offers support and strategies for a successful recovery
• Research suggests that commitment to these types of programs is what makes the difference in long-term sobriety

Routine Outpatient Care (ROC)

• Includes individual counseling with a therapist who has training/experience with substance abuse
• May also include a Psychiatrist or Addictionologist to determine if medication would be helpful to achieve and maintain sobriety
• Does not include the medical treatment of complicated withdrawal symptoms

Substance Abuse Intensive Outpatient Program (IOP)^*

Structured treatment that teaches about the concepts of addiction and recovery
Usually encourages participation with 12-step programs
Typically consists of 3-5 days per week and an average of 3-4 hours of treatment per day for a set number of sessions or period of time
Many programs are structured so individuals may continue to live and work in their community

*NOTE: Sober housing is not covered by Cigna

Substance Abuse Partial Hospitalization^*

• Structured treatment sometimes recommended for those who have been unsuccessful in maintaining sobriety despite active treatment at a lower level of care
• Typically consists of 5-7 days per week for 6-8 hours each day
• May offer an arrangement for sober housing while attending the program

Ambulatory Detox^*

• Provided on an outpatient basis for those that are highly motivated for recovery but need medical treatment for complicated withdrawal symptoms
• Appropriate when the individual can be seen by medical professionals often enough to be safely monitored and detoxified

Inpatient Care

Inpatient Detox^*

• Recommended for individuals that require 24-hour intensive medical care to ensure their safety
• Sometimes recommended when the individual is dependent on alcohol, sedatives, and some opiate-based drugs such as narcotic painkillers or heroin
• Typically intended for people whose situations are medically-complicated (Because withdrawal symptoms are common when stopping the regular use of most substances, this type of treatment may not be recommended for most people)

Inpatient Acute Care^*

• May be recommended following inpatient detox after withdrawal symptoms have decreased, but medical or psychiatric symptoms that require 24-hour care and daily doctor visits are needed for continued stabilization
• Treatment is typically short-term

Inpatient Residential^*

• Usually considered after multiple attempts at other levels of care have failed
• Intended for people who do not need medical supervision
• May last 28 days or more
• Not appropriate for people who are unmotivated for change and recovery
• This type of treatment has not been found to be any more effective in predicting long-term sobriety than any other level of care
• Should include weekly family therapy

Find our level of care guidelines.

^{*Authorization requires a face-to-face assessment by facility staff who will contact us with clinical information and a request for authorization. We will then make a determination regarding the appropriate level of care to authorize based on medical necessity guidelines.}

Expectations Of Treatment

People often ask, "What is the success rate of each level of care?" There is no simple answer to this question. Addiction is a chronic and progressive disease, much like diabetes. If a diabetic takes his medication but does not watch his diet or exercise, the medication will not be very effective.

Substance abusers are most likely to have a successful recovery if they:

• learn about their addiction,
• manage conflict in a healthy way,
• take care of their physical and emotional health,
• follow the direction of their health care professionals,
• develop a sober support group, and
• make changes to the parts of their life that support drinking/using

Recovery takes heroic effort every day. Most people that achieve quality recovery feel that it is worth it. Experiencing relapse is common during the recovery process. Relapse doesn't mean that the person or treatment program has failed. It's often a sign that the treatment program may need to be re-examined or changed.

Extra support is needed during this time. If the person is put down for having a relapse, they may be less likely to return to recovery or treatment.

Family Dynamics

It's common for family and loved ones of people with a substance abuse addiction to try to cope with the situation in unhealthy ways. These behaviors may have developed over years and sometimes are a result of childhood experiences. In most cases, these patterns of behavior are accompanied by the best of intentions, as loved ones want to help the person.

The loved one is usually concerned for the person's safety and wants them to be in protective environment where they know they are safe.

It's a common myth that certain types of treatment will guarantee that the person will be "fixed". Often loved ones hope there is a "cause" for the behavior and that as soon as this can be identified, the addictive behavior will stop.

Loved ones may also resent the amount of time and energy the person must dedicate to recovery, and urge them to turn their focus away from recovery and more on the needs of the family. As the person recovers, they may resent the lifestyle changes necessary for long-term change, as well as their loss of the role of the "healthy one" in the family. For the healthiest recovery, all family members must work on their own "recovery" and learn new ways of operating within the new family.

When to Consider a Higher Level of Care

A higher level of care should be considered in the following situations. When the person: Has been attending treatment consistently and following recommendations of the treatment team, but still drinks/uses, is struggling with medical complications, and/or shows a decrease in level of functioning.

What Do I Need to Know and What Can I Do to Help?

If you or someone you love is abusing alcohol or other drugs, you need to first have a clear understanding of the situation before you can determine what treatment options are available. It's important to remember that substance abuse is an illness that can't just go away. As with other serious illnesses, it may require medical attention and the availability of a caring, sober support system of friends and family.

Each substance abuser is different, and will have different needs and responses. They will also have different reasons for drinking/using. Knowing about the person's unique qualities and their way of life puts you in a good position to help them. By understanding the signs and effects of substance abuse, you should be in an even better position to consider a strategy for helping.