Inpatient rehab programs provide consistent daily structure based on the needs of those in residence. The schedule is designed to help you focus on behavioral change and to provide social support, healthy meals, and a safe place to stay.
The National Institute on Drug Abuse (NIDA) states there are two foundational pillars for drug addiction treatment: detox and rehabilitation. The process of detox involves medically supervised withdrawal, which can be in an inpatient or outpatient program.
Once you have safely detoxed, you will transition to rehabilitation, which focuses on behavioral changes through counseling.
Rehabilitation offers a range of both inpatient and outpatient approaches to treatment. Your specific needs will be measured when you begin the process during your clinical assessment. You will be assessed again after you complete detox, and this assessment can help transition you to the appropriate form of rehabilitation.
Outpatient rehabilitation is becoming the more common approach to managing behavioral therapy, but inpatient treatment still holds an important place for many people.
If you have a hard time staying away from drugs or alcohol, have a history of relapses, or do not have the social support needed to stay sober when you complete detox, you should consider spending 90 days (three months) in a residential, or inpatient, treatment program.
These programs work well for people who have co-occurring mental health and substance use disorders, and those who have serious chronic health conditions that require treatment alongside addiction treatment.
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Residential or inpatient treatment programs are best for those who have little to no support from friends and family, especially when it comes to staying sober. They also work well for those who have unstable housing situations, serious medical conditions that require 24/7 medical supervision, or who cannot stay away from substances without restriction.
After completing detox, you will spend your very first day at your rehabilitation program being assessed.
This ensures all your medical, residential, and counseling needs are met. Then, you will develop a treatment plan with a case manager, social worker, therapist, or doctor who supervises your treatment for the next several weeks.
This will include creating a daily schedule, which you will adhere to unless you reassess the plan with your case manager and determine that some components need to be changed.
Below are some of the core components of a schedule at an inpatient rehab program:
Often, people who have abused drugs or alcohol for months or years struggle with malnutrition. For example, people who abuse stimulants may have lost a lot of weight very quickly because they do not feel hungry. People who abuse crystal meth in particular develop a craving for sweets, and they may eat candy to the exclusion of anything else. People who abuse alcohol are more likely to have thiamine (B12) deficiencies.
Eating regular meals — breakfast, lunch, and dinner — creates a sound structure for the individual to schedule other parts of their life around. These meals provide healthy food so that clients no longer struggle with vitamin and mineral deficiencies, which can otherwise make them feel worse.
This is the core component of many treatment programs, both inpatient and outpatient. Most addiction treatment uses group therapy as the foundation of their programs, so clients are expected to participate in group sessions at least once per day. These will be led by a counselor trained in cognitive behavioral therapy.
Inpatient programs often offer individual and family therapy as well. Many people entering inpatient treatment struggle with co-occurring mental health problems that require other approaches to management.
Art therapy, music therapy, meditation or mindfulness, exercise therapy, animal therapy such as equine-assisted therapy, expressive therapies, and journaling are all important parts of inpatient treatment. While none of these approaches to therapy should be used alone to change compulsive behaviors around substances, they are all effective when combined with traditional therapy.
While many people use medication-assisted treatment (MAT) during the detox process, people who struggle with opioid addiction increasingly use MAT during rehabilitation. This is because tapering the body off long-term opioid abuse, especially for potent drugs like heroin or OxyContin, requires months. In some instances, it can even take years to complete safely and successfully.
The focus of MAT is to physically stabilize the individual so that they can begin to change their behaviors around opioids. However, not every inpatient treatment program allows prescription drugs, including MAT, in the building due to the risks to other clients. If you are using buprenorphine or methadone and want to attend inpatient treatment, ask for referrals to programs that allow these medications. Once you are in an inpatient program, nurses and doctors will manage the tapering process, which includes dispensing your medicine.
While personal time may be structured around certain activities, like journaling, you are likely to have some hours of the day for your own activities.
Addiction changes how the brain functions, including related to sleep, and withdrawal symptoms often include insomnia. If you are in rehabilitation, you may not have had a regular, healthy sleep schedule for months or years. Inpatient treatment will require everyone residing in the facility to turn off their dormitory lights at a certain time of night, which is usually around 10 p.m. or 11 p.m. You will be expected to wake up around the same time as everyone the next morning.
The program determines a healthy amount of sleep. While it may take you a few days to adjust to this schedule, getting regular, consistent sleep will help your brain heal.
To understand how the components of inpatient rehabilitation work over a day, here is a sample schedule:
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