Medically Reviewed by Dr. David Hu, MD
It’s not easy for someone to admit they are struggling with a substance use disorder. It takes a lot of courage to ask for help. Deciding to enter a treatment program for help takes tremendous strength. One of the most difficult challenges in the entire addiction recovery journey is taking that first step.
But what happens next? How does a person start the path to recovery and achieve a sober, happy, healthy lifestyle?
While it may seem like a substance abuse treatment plan would be the same for everyone, the truth is that everyone requires a specific, customized treatment plan. There are several treatment levels, and it’s essential to know what each addiction treatment service consists of so an individual can decide what makes sense for their life.
How Does a Treatment Center Determine the Levels of Care for Substance Abuse Recovery?
The level of care for drug and alcohol recovery is typically determined during the pre-assessment process. During the assessment, specialists gather information that helps understand your substance use disorder to make an informed decision about a treatment plan. Questions you may be asked during the assessment include:
- Have you taken part in a treatment program before?
- How often are you using? How much are you using?
- Do you have an official mental health diagnosis?
- Does your family have a history of mental health issues?
- Do you have any medical issues?
- Do you take any medications?
The above questions are only asked as a reference to help guide your treatment plan. Even though a pre-assessment is comprehensive, there are various factors that ultimately influence treatment recommendations.
Once the treatment center completes your assessment, it’s time to start the process of helping you learn the tools to achieve a sober life.
Levels of Care for Substance Abuse Recovery
The goal of care levels is to ensure each person receives the appropriate care immediately upon admission and can smoothly transition to the next levels in the treatment process. It is important to note that an individual may be moved to a higher or lower level of care dependent on how they meet the specific goals they’ve created with the help of their treatment provider.
The first step on the path to recovery is to make that initial phone call and set up an appointment with a substance use treatment center. After treatment center staff complete an evaluation, together you will decide your optimal level of care.
The American Society of Addiction Medicine (ASAM) created a specific continuum of care that aims to guide a person through the recovery process as smoothly and successfully as possible. The five core levels of care include:
- Level 0.5: Early Intervention Services
- Level 1: Outpatient Services
- Level 2: Intensive Outpatient/Partial Hospitalization Services
- Level 3: Residential/Inpatient Services
- Level 4: Medically Managed Intensive Inpatient Services
Level 0.5: Early Intervention Services
This first level in the continuum of care focuses on intervention by targeting individuals at risk of developing a substance dependence. In addition, Level 0.5 aims to assist those who show symptoms and signs of a substance addiction but may not meet the specific criteria to diagnose.
Early intervention identifies specific risk factors that may lead to a substance use disorder. The following are the most common risk factors to look out for:
- Minimal to no parental supervision
- Poor social supports and relationships
- Aggressive childhood behavior
- Access to substances such as drugs or alcohol
Early intervention can prevent a full-blown addiction from developing later down the road. For more information, call Zinnia Healing at (855) 430-9439.
Level 1: Outpatient Services
When a person struggling with drug or alcohol use can maintain their day-to-day lives but still require treatment, outpatient rehab may best suit their needs.
Outpatient services typically require 9 hours of treatment per week (6 hours per week for adolescents). This includes meeting regularly with addiction professionals and doctors for recovery treatment. A person can attend therapy, receive medication, and engage in additional addiction treatment programs. Outpatient rehab provides treatment at one of the lowest levels of intensity.
Sometimes, patients who can hold down a job or keep their family together need more help than they realize. They often suffer in silence because they can convince those around them that they are fine. Taking the first step to get help takes courage.
Level 2: Intensive Outpatient/Partial Hospitalization Services
Intensive outpatient programs and partial hospitalization programs (PHP) offer more intensive services than other outpatient programs. Often one will spend more time in a therapeutic setting. With more intense treatment and additional resources available, IOP and PHP are a better option for individuals who need a higher level of treatment yet choose to live at home. Level 2 treatment is further divided into sublevels 2.1 and 2.5.
Level 3: Residential/Inpatient Services
Residential addiction treatment programs or inpatient addiction treatment programs provide around-the-clock treatment at an inpatient facility. A person will typically live on-site or very close to the treatment facility. Within Level 3, there are additional sublevels including:
- Level 3.1: Clinically Managed Low-Intensity Residential Services. Recovery skills are the primary focus of Level 3.1, including managing emotions and relapse prevention skills. At this level, a treatment center will provide at least five hours of clinical services each week. Some of the most common treatment services in Level 3.1 include a structured atmosphere, 24/7 staff availability, outpatient services, life-skills building, and house meetings.
- Level 3.3: Clinically Managed Population-Specific High-Intensity Residential Services. The Level 3.3 treatment program is also referred to as long-term care or extended care and offers a structured atmosphere with medium-intensity clinical services. This type of recovery treatment is for individuals with substance or alcohol use disorders whose lives have been severely impacted by substance abuse. Level 3.3 offers treatment at a slower pace, focusing on repetition to guide a person back into a healthier, drug, and alcohol-free lifestyle. This level offers ongoing case management, housing, transportation, vocational needs, and access to self-help meetings.
- Level 3.5: Clinically Managed High-Intensity Residential Services. The Level 3.5 treatment program for individuals with multiple needs such as a severe functional impairment, co-occurring disorders, or are struggling to adjust to a healthy routine.
- Level 3.7: Medically Monitored Intensive Inpatient Services. The Level 3.7 treatment program is the highest intensity Level 3 service. This recovery treatment is for people with substance use disorders and medical and/or emotional issues, or withdrawal risks that serve as roadblocks in their recovery progression.
Level 4: Medically Managed Intensive Inpatient Services
Level 4 is the most comprehensive and highest treatment level, incorporating 24-hour medical care, treatment, and evaluation, including meeting with a doctor daily. Typically, facilities that offer Level 4 treatment may be psychiatric hospitals, which all provide substance abuse treatment and co-occurring disorders treatment. This stage of the continuum focuses on ensuring a person will be ready to enter a less intensive care level in their journey toward recovery.
PHP or IOP—Which is better for your recovery journey?
Once your Levels of Care for Substance Abuse Recovery are determined, you’ll either be placed in a Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), or another level of care. If you have questions, call Zinnia Healing at (855) 430-9439.
Partial Hospitalization Program (PHP)
PHP, sometimes known as day treatment, has an intensive level of treatment that provides a solid foundation for your recovery. You will be able to live at home or in specified housing through the treatment center. A PHP program can be a good next step when someone leaves a residential program. It’s also a good option for people who can keep up with their day-to-day life but are still struggling. Partial Hospitalization Programs provide access to top-notch medical staff in a safe environment while allowing you to retain your independence. The program also reinforces skill sets and strategies for helping patients deal with real-world scenarios during recovery.
Intensive Outpatient Program (IOP)
An intensive outpatient program is a good option for anyone who still requires treatment but also has familial, professional, and financial obligations to uphold. The IOP helps you build a sense of accountability with education and therapy. There is a focus on teaching and reinforcing the necessary skills to avoid relapse and how to recognize and cope with triggers.
Continuum of Care for Individuals with Substance Use Disorders
The continuum of care is a guideline for recovery treatment to help address that neither addiction nor recovery is linear, meaning they don’t follow a straight line. It helps caregivers decide the best treatment for each individual. It allows the focus to be on a person’s changing needs, which is vital to creating a path to recovery. With evidence-based treatment, addiction professionals can utilize proven treatment methods and thus improve long-term recovery chances.
To learn more, call Zinnia Healing at (855) 430-9439.