When it comes to addiction treatment, one of the first decisions families face is the question of level of care: should your loved one go into residential (inpatient) treatment, or can they be treated through an outpatient programme while living at home? Understanding the difference between these approaches — and what each is actually appropriate for — helps families make better decisions and avoid paying for more intensive care than is needed or settling for less than is required.

What Is Inpatient (Residential) Rehab?

Inpatient treatment means the person lives at the treatment facility for the duration of the programme — typically 28 days, though 60 and 90-day programmes exist and produce significantly better outcomes. During residential treatment, they receive:

• 24/7 support and supervision
• Medical management of withdrawal where required
• Individual and group therapy — typically multiple hours daily
• Complete removal from the environment, people, and situations associated with their addiction
• Peer community of others in early recovery
• Structured days that eliminate the time and opportunity for use

What Is Outpatient Treatment?

Outpatient treatment allows the person to continue living at home and meeting other obligations (work, family, school) while attending treatment sessions on a scheduled basis. Outpatient ranges significantly in intensity:

• Standard outpatient (OP): 1–2 sessions per week of therapy or counselling
• Intensive Outpatient Programme (IOP): 3–4 days per week, 3 hours per session — a substantial commitment that provides significant treatment without residential removal
• Partial Hospitalisation Programme (PHP): 5 days per week, 4–6 hours per day — the most intensive outpatient option, approaching residential in terms of time commitment

When Inpatient Is the Right Choice

Residential treatment is typically recommended when:

• The addiction is severe — daily use, high volume, or significant physical dependence
• Previous outpatient attempts have not been successful
• The home environment is chaotic, enables use, or does not support recovery
• There are co-occurring mental health conditions that require intensive management
• Medical detox is required and will be followed by a residential programme
• The person’s social network is primarily composed of people who use
• There is significant risk of harm to themselves or others

When Outpatient May Be Sufficient

Outpatient treatment is appropriate when:

• The addiction is less severe — not daily use, not significant physical dependence, no history of serious withdrawal
• The home environment is stable, supportive, and substance-free
• The person has significant work or family obligations that residential treatment would seriously compromise
• They have already completed a residential programme and are transitioning to lower levels of care
• Motivated individuals who have not previously attempted treatment

The ASAM Criteria: How Professionals Assess Level of Care

The American Society of Addiction Medicine (ASAM) criteria are the professional standard for determining the appropriate level of care. They assess six dimensions: acute intoxication and withdrawal potential; biomedical conditions; emotional and cognitive conditions; readiness to change; relapse potential; recovery environment. Proper assessment across all six dimensions produces a recommendation — rather than the person or family simply choosing a level of care based on cost or convenience.

Cost Considerations

Residential treatment is significantly more expensive than outpatient — often $5,000–$50,000+ for a 28–30 day programme, compared to $1,000–$10,000 for a 90-day IOP. Insurance coverage varies considerably. See our guide: Does Insurance Cover Rehab? →