Overview

If you have substance use disorder, your doctor may suggest treatment at an inpatient or outpatient facility. At inpatient facilities, you stay overnight. At outpatient facilities, you come only during the day. How long you stay varies among programs.

Inpatient and outpatient treatment programs both usually involve the use of a support group. Some support groups are secularly based, such as SMART Recovery or LifeRing, and some encourage the belief in a higher power, such as the 12-step program used by Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Treatment may include group therapy, one-on-one counselling, drug and alcohol education, medical care, and family therapy.

Your doctor or counsellor will help you decide whether you should have inpatient or outpatient treatment. The choice may depend on:

• How severe the substance use disorder is.
• Your mental health.
• Your family support.
• Your living situation.
• How the treatment will be paid for.

Inpatient treatment

Inpatient treatment may be part of a hospital program or found in special clinics. You'll sleep at the facility and get therapy in the day or evening.

Inpatient treatment may be a good option if:

• You've tried outpatient treatment, but it didn't work.
• You have other physical or mental health problems.
• Your home situation makes it hard to stay away from drugs or alcohol.
• You don't live near an outpatient treatment clinic.

You may stay for 1 to 6 weeks, depending on how your recovery is going. After inpatient treatment, you should go to outpatient treatment for more counselling and group therapy. Inpatient treatment also may be residential, which means you stay at the facility for months.

Outpatient treatment

Outpatient treatment happens in mental health clinics, counsellors' offices, hospital clinics, or local health unit offices. Unlike inpatient treatment, you don't stay overnight.

Outpatient programs can be a challenge because you may continue to face problems at work and home. But it will help you build the skills you need to handle everyday problems.

In standard outpatient treatment, you may have 1 or 2 group therapy sessions a week. Treatment may go on for a year or more. Sessions may be in the evening or on weekends so you can go to work.

Outpatient treatment may be a good option if:

• You can't or don't want to quit work or take a leave of absence.
• You want to be close to loved ones.
• You can stay away from drugs or alcohol where you live.
• Inpatient treatment is too expensive.

For outpatient treatment to work well for you, it's important to go to your sessions regularly and also get other support, such as Alcoholics Anonymous or Narcotics Anonymous meetings. Having support from loved ones, good transportation, and a stable place to live also are important.

Whether you get inpatient or outpatient treatment, it's important to stay committed to a drug-free or sober lifestyle. With treatment, you can make healthy changes and keep drugs or alcohol out of your life.

Questions to ask

When visiting a treatment centre to see whether the program offered there meets your and your family member's needs, ask the following questions.

• Are the counsellors certified addiction counsellors? Counsellors who are certified have special training in counselling people who have substance use problems.
• Are any medical doctors associated with the program? If so, are they certified by the Canadian Society of Addiction Medicine (CSAM)? Doctors who are certified have special training in dealing with people who have substance use problems.
• What treatment therapies are used in the program? Is it a peer support program (12-step programs, SMART Recovery, LifeRing) alone or does the program contain cognitive therapy and/or medicine therapy?
• How much time do you spend in the program a day, and how many weeks or months does the program last? Does the program have aftercare?
• What has been the success rate for people going through the program? How has success been evaluated (number completing the program, years not drinking)?
• Does the treatment program offer special services to meet women's needs, such as female therapists, female-only groups, or assistance with child care?
• Does the treatment program address any special concerns that a person from a particular culture or religious background (such as LBGTQ2S+, Indigenous peoples, or Catholics) might have?
• Does the program evaluate and treat people who also have other conditions such as depression, attention deficit hyperactivity disorder (ADHD), or long-term pain disorders?
• Are family members involved in the program? In what ways are they involved?