Length Is Not One Fixed Number
Many individuals require several rounds of treatment, but they eventually develop strategies for relapse prevention and learn coping skills to stay sober.
Long-term or continuing care is important because it provides patients with ongoing support and therapy for the duration of their recovery. It also helps address underlying issues such as trauma or mental illness. Long-term care may include a sober living home, aftercare, peer-support groups, counseling, medication management, outpatient programs, individual psychotherapy sessions, family therapy, 12-step groups, and more.
Aftercare programs provide support, skills training, and assistance with relapse prevention for people who are trying to live sober lives.
Participation under ninety days in residential or outpatient treatment has been shown to be of limited effectiveness. Treatment lasting significantly longer than this period (e.g., 90 days) has been associated with better outcomes.
Patients who remain in treatment significantly longer have better chances at maintaining abstinence and leading a healthy life without drugs or alcohol. The majority of addicts require multiple courses of treatment to achieve sustained recovery.
Treatment that is conducted for less than 90 days is much more likely to result in relapse than extended treatment lasting 3 months or longer.
Individuals are often encouraged to continue treatment after a course of care. Aftercare includes ongoing recovery support through participation in Alcoholics Anonymous, other twelve-step programs, and continuing individual or group therapy.
The course of treatment should be tailored to address the needs of each individual client. There are no hard-and-fast rules as to when or how long treatment is appropriate; every person’s needs for care are different.
How Long Detox Usually Runs
Alcohol withdrawal timing often begins within eight hours after your last drink. But sometimes it can take days before you feel the effects of stopping alcohol use, especially if you’ve used for an extended period of time.
The symptoms of alcohol withdrawal may peak between 24 and 72 hours after the last drink. Withdrawal symptoms usually go away in a few weeks, but sometimes they can persist for months after you stop using alcohol.
The symptoms of alcohol withdrawal include:
- Anxiety, nervousness, irritability
- Fatigue
- Mood swings or depression
- Nausea and vomiting
- Headache
- Insomnia
Mild to moderate alcohol withdrawal can often be managed on an outpatient basis, but it’s important to have someone stay with you during this time. Depending on how severe your symptoms are, you might need to make daily visits to a healthcare provider until the symptoms subside.
You will likely be closely monitored for signs of hallucinations and delirium tremens (DTs).
A person who drinks heavily on a daily basis and suddenly stops is at risk of developing alcohol withdrawal syndrome, which can lead to delirium tremens (DTs), a potentially fatal condition characterized by hallucinations and confusion. If you have DTs, your doctor may recommend hospitalization for observation.
Shorter Residential Stays
Short-term residential alcohol programs provide intensive and supportive care while also helping patients begin the transition back to their home environments and daily lives.
Brief residential alcohol programs provide intensive support for recovery. Some people choose to attend a short-term residential program after completing inpatient care or an outpatient detoxification treatment program.
Others provide short-term residential alcohol treatment with an extended outpatient program to follow. Shorter-term inpatient facilities are sometimes used as transitional care when stepping down from a longer-term program, such as a therapeutic community.
After residential stays for alcohol addiction, it’s crucial to continue with outpatient care.
Short-term residential alcohol programs provide intensive 24-hour care.
The earlier short-term residential pattern paired hospital-based treatment with 12-step support groups.
Short-term residential stay programs may be used as an initial phase of care before entering long-term or outpatient treatment.
Continuing care may include an aftercare or discharge plan. These plans should recommend ongoing services and activities to support recovery as well as a clear relapse prevention strategy.
Some people choose outpatient treatment while recovering from alcohol addiction, but others opt for partial hospitalization or short-term residential stays first. Then they move on to sober living or other forms of continuing care after their residential stay is complete.
After the brief hospital residential phase people often continue living at home during outpatient therapy. Patients may receive individualized treatment plans or group counseling sessions as part of an outpatient program.
Longer Residential Stays
Therapeutic community stays are planned for 6 months to a year depending on patients' needs and progress. The treatment staff provides the structure and support that promote ongoing behavior change while in treatment. In the TC model, group counseling is used as a primary mode of intervention.
A therapeutic community is based on the principle that ongoing feedback, group participation, and modeling provide a powerful component of substance abuse and mental health treatment. Clients actively participate in the community as they learn to live without substances by gaining or re-gaining skills and strategies for living.
Residential treatment centers use many different approaches and programs. They often combine elements of other types of care with 12-step or non-12-step models. These programs also address any underlying mental health issues, such as anxiety or depression.
Therapeutic communities plan multi-month stays in non-hospital settings. The length of stay is based upon the persons need for long-term therapy to establish new patterns of behavior and support recovery from addiction. Residents are expected to engage in community programs and services.
Therapeutic communities help individuals develop new skills and values, replace bad habits, and learn to master challenges without resorting to alcohol or drugs.
Outpatient Timelines
Outpatient and intensive outpatient schedules unfold over months, or even years. You can receive a combination of medication and counseling at the same time.
There are no hard and fast rules about the length of time that outpatient treatment takes. The length of treatment is usually decided based on how well you respond to counseling sessions or medication alone, or a combination of both.
Outpatient alcohol care continues while people live at home, hold jobs, or attend school. Other outpatient programs offer more intensive services including counseling and medication support in the doctor's office, regular group therapy sessions, and 12-step meetings. People who benefit from these types of care are able to stay on track with treatment at home while they receive intense counseling and support during specific parts of the week.
The duration of outpatient care depends on many factors. Generally, if you need more than one form of treatment for a long time, your course of outpatient treatment will be longer than someone who only needs individual counseling sessions. The level of care you need also affects how long you'll be in outpatient treatment. If you only need medication management or short-term counseling, your treatment may take weeks or months.
Outpatient treatment generally consists of individual counseling, group therapy, self-help meetings, and/or family education and support.
Outpatient episodes also follow the three-month research-backed guideline for effectiveness.
Some patients do well in just one episode, while others benefit from multiple episodes of care.
What Shapes Length of Stay
Matching settings and services to a person's needs makes it possible for them to make the most of their treatment and be successful upon release from residential care. Matching an individual's needs with a particular setting is important because treatment that does not address all of a person's needs has little chance of producing long-term recovery.
Matching settings and services to a patient's needs requires accurate assessment and diagnosis that reflects the range of needs and problems associated with drug abuse. The length of stay is tailored to each patient's individualized treatment plan, which depends on the individual's needs, circumstances, and availability of needed resources. Patients are typically treated in residential (inpatient) or outpatient programs for 3 months or more.
Problem type and treatment needs shape how long someone stays in treatment. The length of stay is usually based on:
- A patient's current problems
- How severe their condition is
- What they need to change
- Their risk level
Research has shown that longer stays in treatment are linked with positive outcomes for patients. More than 90 days of care is often needed for significant recovery.
People who stay in residential treatment for at least 3 months experience greater success at long-term sobriety.
Treatment settings are determined based on an assessment of the individual's needs. The assessment can be performed at the point-of-entry into a program or during the course of treatment.
Why Completing the Planned Episode Matters
Completing the planned episode of care for alcohol problems is an important step to becoming or staying sober. However, the completion of a particular episode of treatment does not mean that your journey through recovery has ended. You may need additional support after you complete the episode of care. For example, there are self-help groups that help people avoid drinking.
Completing your entire program allows you to have the greatest possible chance of staying sober in the long term.
Staying through the planned course of drug abuse treatment or mental health care is extremely important. If you leave early without completing the recommended number of days, weeks, months, or years of care, you are more likely to relapse or suffer a setback in your recovery. Completing the full amount of time you were scheduled to spend in treatment greatly increases your chances for long-term success.
- It allows you to receive full benefit from the program.
- You'll be less likely to experience a relapse if you stay through your planned treatment episode.
- Leaving before completing your course of care can lead you to return to unhealthy alcohol use and other substance use. You'll also lose your motivation for treatment, as well as opportunities for recovery.
- People who do not stay in treatment for the full duration may have a higher probability of returning to treatment in the future.
Staying through enough weeks of residential or outpatient treatment programs has been shown to improve outcomes and help patients achieve sobriety. Patients who complete fewer than 90 days in a program have poorer outcomes than those who complete longer episodes.
After completing a planned episode, it is important for individuals to stay involved with support groups and counseling sessions so they can maintain their sobriety.
A person's progress through drug addiction treatment is often slower than expected and may involve multiple episodes of treatment.
After the initial episode of treatment ends, the plan for ongoing support during continuing care (also called aftercare or discharge planning) is an important step toward recovery.
A single episode of treatment is often not enough to get you on the road to sobriety.
Completing an episode of residential or outpatient alcohol treatment also prepares you for additional episodes after discharge.