Key takeaways:
There are many options for people who seek alternatives to traditional inpatient, outpatient, or residential rehabilitation.
Treatment options include talk therapy or counseling, medication-assisted treatment (MAT), and other evidence-based interventions.
Health insurance may cover traditional rehab alternatives such as treatment via telehealth.
Millions of people — including preteens, adolescents, adults, and seniors — deal with addiction — also known as substance use disorder. According to the 2020 National Survey on Drug Use and Health, 40 million people age 12 or older, or 14.5% of the U.S. population, had a substance use disorder in the last year. Those substances include alcohol, prescription medications, and illegal drugs. About the same number needed substance use treatment in the last year, according to the survey.
What is considered ‘traditional’ rehab for addiction?
Traditional rehabilitation for addiction, or substance use disorder, is often defined by the treatment setting. Generally, there are three traditional options:
Inpatient: This treatment is often provided in a hospital or clinic for people who have a mental disorder or serious medical concerns combined with a substance use disorder. This usually includes detoxification, or detox.
Outpatient: This category can include day treatment or partial hospitalization as well as a treatment program at a hospital, clinic, or other site. Participants usually live at home.
Residential: Treatment is provided in a living environment, such as a therapeutic community, from one month to a year or longer.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the components of traditional rehab may include:
Assessment
Medical care
Treatment plan
Group and individual counseling
Individual assignments
Education about substance use disorders
Life-skills training
Alcohol and substance use testing
Relapse-prevention training
Why would you go to traditional rehab?
Many people are trying to recover from long-term addiction. Often, they would go through traditional inpatient or residential programs. Those treatment options remove you from distractions and temptations that can trigger substance abuse issues. An inpatient program also can benefit someone who has relapsed after completing an outpatient program or who is living around others who have substance abuse issues.
Who would be a good candidate for alternative addiction treatment services?
There are many substance use disorder symptoms. The severity of your substance use disorder — a diagnosis ranging from mild to severe — will be determined by the number of symptoms. People with milder diagnoses who don’t need 24-hour care at an inpatient or residential facility may be good candidates for alternative addiction-treatment services.
Alternative treatment services for drug addiction and other substance use disorders
Telehealth: Telehealth, also known as telemedicine, became an increasingly available option during the COVID-19 pandemic. This mode of treatment includes virtual visits with your providers as well as therapy sessions with groups — and even your family.
Digital tools: Recovery apps can track sobriety, provide information, and complement 12-step programs, among many other uses. This is often considered an aspect of telehealth.
Talk therapy: Talk therapy with medication is often used to treat substance use disorder. Many different kinds of talk therapy — also called psychotherapy or counseling — are considered “evidence-based,” which means they are backed by science. Generally, cognitive behavior therapy (CBT) is considered the most effective for substance use disorders. Talk therapy can be delivered via telehealth.
Medication: As mentioned above, talk therapy is often paired with medication that helps you recover from substance use. The National Institute of Drug Abuse reports that prescription medications such as buprenorphine and methadone help with opioid cravings and withdrawal symptoms. Some medication-assisted therapy can be delivered via telehealth.
Sober-living homes: Sometimes called “recovery residences,” this living situation can offer the care and support needed between inpatient and outpatient care.
How much do alternative rehabilitation services cost?
The COVID-19 pandemic made more telehealth services available. For substance use disorders, those include virtual 12-step meetings, online psychotherapy, and remotely prescribed medication-assisted treatment. These services can range in cost and are sometimes more affordable. Savings include the money that is not spent on transportation costs. Virtual-visit options with a psychiatrist can be accessed through the GoodRx Telehealth Marketplace.
If you have insurance, these services can be billed as equal to in-person treatment. If you are uninsured or underinsured, there are several affordable treatment options.
SAMHSA research shows that one year of methadone maintenance treatment is about $4,700 per patient. SAMHSA offers a National Helpline at 800-662-4357, in English and Spanish, for people facing mental health and substance use disorders.
Does health insurance, including Medicare, cover alternative rehab services?
Your insurance may cover all or most treatment costs. U.S. law requires mental health parity, which means insurers can’t offer a lower level of coverage or higher copayments or coinsurance for mental health care — such as psychotherapy — than for physical or medical care. Most insurers will want to see a treatment plan to determine what they will pay.
Medicare coverage for substance use disorders includes alternative services such as telehealth and specific virtual treatment options for opioid use disorder. Medicare Advantage plans also may cover alternative substance use disorder treatments.
The bottom line
Substance use recovery often happens in inpatient, outpatient, and residential treatment settings, but there are other options. Alternatives include talk therapy, medication, digital tools, and sober-living homes. Often, this treatment can be delivered via telehealth. Check with your provider and your insurance health plan to determine if any of these treatment options are right for your recovery.
Why trust our experts?
References
Centers for Medicare & Medicaid Services. (n.d.). The Mental Health Parity and Addiction Equity Act (MHPAEA).
David, D., et al. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry.
Medicare.gov. (n.d.). Opioid use disorder treatment services.
Medicare.gov. (n.d.). Telehealth.
National Institute on Drug Abuse. (n.d.). Home.
National Institute on Drug Abuse. (2014). Addiction medications.
National Institute on Drug Abuse. (2018). Is drug addiction treatment worth its cost?
Substance Abuse and Mental Health Services Administration. (n.d.). Home.
Substance Abuse and Mental Health Services Administration. (2014). What is substance abuse treatment? A booklet for families.
Substance Abuse and Mental Health Services Administration. (2021). 2020 NSDUH annual national report.
Substance Abuse and Mental Health Services Administration. (2022). SAMHSA’s National Helpline.
Telehealth.HHS.gov. (2021). What is telehealth?
