Educational content only. This article summarizes publicly available information and is not medical advice. If you or someone you love is struggling with substance use, call SAMHSA's free, confidential helpline: 1-800-662-HELP (4357).
In brief: Addiction treatment levels, from most to least intensive, are medically supervised detox, hospital inpatient or residential care, partial hospitalization, intensive outpatient, standard outpatient, and recovery housing. A clinical assessment matches a person to a level, and people often step down over time. Most people need at least 3 months of treatment in total.
Addiction treatment comes in levels, from most to least intensive. They run from supervised detox, to 24-hour hospital or residential care, to day programs and outpatient visits, and then to recovery housing (FindTreatment.gov; NIAAA). Everyone entering treatment gets a clinical assessment to find the best fit, and most people need at least 3 months of treatment to cut back or stop their drug use (FindTreatment.gov; NIDA).
Do not stop heavy drinking suddenly on your own. Stopping after long, heavy drinking can cause a painful or even life-threatening withdrawal, with symptoms like a racing heart or seizures (NIAAA). Withdrawal can sometimes be so severe that people hallucinate or have convulsions (FindTreatment.gov). Seek medical help to plan a safe way to stop (NIAAA), and call 911 for a seizure or any other emergency.
What are the levels of addiction treatment care?
There are six common levels: detox, inpatient or residential care, partial hospitalization (PHP), intensive outpatient (IOP), standard outpatient, and recovery housing. Treatment approaches keep changing, and many programs do not fit neatly into one type (NIDA). The table below shows how they usually compare.
| Level | Hours or intensity | Who it usually fits | Where you live |
|---|---|---|---|
| Withdrawal management (detox) | Supervised withdrawal, often with medication, for several days to a week or more (FindTreatment.gov) | People withdrawing after using large amounts of alcohol or drugs (FindTreatment.gov) | A hospital ward, an inpatient detox unit, or at home with close medical supervision as an outpatient (FindTreatment.gov) |
| Hospital inpatient | 24/7 care connected to a hospital, lasting days or weeks (FindTreatment.gov) | People with serious mental or medical concerns along with a substance use disorder (FindTreatment.gov) | In the hospital or clinic (FindTreatment.gov) |
| Residential | Care 24 hours a day, generally in a non-hospital setting (NIDA) | People without stable living or work situations, or with little family support (FindTreatment.gov) | At the program (live-in care) (FindTreatment.gov) |
| Partial hospitalization (PHP) | At least 20 hours a week of structured programming (SAMHSA TIP 47) | People who need coordinated outpatient care for complex needs (NIAAA) | At home, since it is an outpatient service (NIAAA; FindTreatment.gov) |
| Intensive outpatient (IOP) | Traditionally at least 9 hours a week, often three 3-hour sessions (SAMHSA TIP 47) | People who can make changes while living at home (SAMHSA TIP 47) | At home (SAMHSA TIP 47) |
| Standard outpatient | Varies by program; some meet daily, others one to three times a week (FindTreatment.gov) | People with a stable home, reliable transportation, and supportive family or friends (FindTreatment.gov) | At home, on your own (FindTreatment.gov) |
| Recovery housing (sober living) | A recovery support service, not treatment; houses range from peer run to clinically focused (SAMHSA) | People during or after outpatient treatment, or moving on from an intensive setting (SAMHSA; FindTreatment.gov) | In a shared alcohol- and drug-free home (SAMHSA) |
Detox is a first step, not treatment by itself (FindTreatment.gov). It should be followed by a formal assessment and referral to addiction treatment (NIDA). Compare settings in medical detox vs. home detox.
What is the difference between IOP and inpatient rehab, and which fits whom?
The main difference is where you sleep: inpatient and residential programs provide care around the clock, while IOP lets you live at home and attend sessions (NIDA; SAMHSA TIP 47). A typical IOP schedules 3 hours of treatment on 3 days or evenings each week (SAMHSA TIP 47).
Outpatient care costs less than residential or inpatient care, and it is often better for people with jobs or strong social support (NIDA). Residential care is best for people without stable living or work situations, and for people with very serious disorders who could not stay sober in other treatment (FindTreatment.gov). Hospital inpatient care is most likely for people with serious mental or medical concerns (FindTreatment.gov).
| If this sounds like you | Level that may fit |
|---|---|
| Serious medical or mental health problems as well as addiction | Hospital inpatient (FindTreatment.gov) |
| No stable home or job, little family support, or past treatment did not work | Residential (FindTreatment.gov) |
| A job and supportive people at home | Outpatient or IOP (NIDA) |
SAMHSA’s expert panel says the real question is not which level is better, but which level is more appropriate for each person at a given time (SAMHSA TIP 47). Some intensive outpatient models can match residential programs in services and effectiveness, depending on the person (NIDA). Read more about the benefits of residential treatment.
What is a partial hospitalization program (PHP)?
A PHP, also called day treatment, is a structured outpatient program of at least 20 hours a week (SAMHSA TIP 47). SAMHSA’s expert panel says a program that meets daily for 6 hours a day should be considered partial hospitalization (SAMHSA TIP 47).
NIAAA groups PHP with IOP as coordinated outpatient care for complex needs (NIAAA). People with mild withdrawal from alcohol, sedatives, opioids, or stimulants can sometimes go through detox in a PHP (SAMHSA TIP 47). Staff must first decide whether detox can be done safely that way (SAMHSA TIP 47).
How does sober living or recovery housing work?
Recovery housing is a safe, family-like home free of alcohol and drugs that supports people in recovery (SAMHSA). It is a recovery support service rather than treatment, and all homes center on peer support and connection to services (SAMHSA). For details on rules, costs, and moving in, see how sober living works.
Homes range across four levels: peer-run houses, homes, supervised housing, and residential treatment housing (SAMHSA). Many homes expect residents to work, go to school, or volunteer (SAMHSA). SAMHSA says homes should give each new resident written rules and expectations (SAMHSA).
Many residents live in recovery housing during or after outpatient treatment (SAMHSA). SAMHSA recommends that homes put no barriers on residents’ use of prescribed medications, including buprenorphine, methadone, and naltrexone (SAMHSA). Before moving in, ask whether the house supports medication for substance use disorder (SAMHSA).
How is the right level of care chosen?
A clinical assessment decides the level. Everyone entering treatment receives one, and it continues throughout treatment (FindTreatment.gov). Be honest during it, because the counselor needs a full picture to plan the most effective treatment (FindTreatment.gov).
Many programs use The ASAM Criteria, the most widely used set of standards for placing patients with addiction (ASAM). Its assessment looks at a person’s biomedical, psychological, and social needs, across six dimensions or life areas (ASAM). The goal is the least intensive care that is still safe and effective (ASAM).
No single treatment is right for everyone, and matching the setting to the person’s needs is critical (NIDA). The treatment plan should be checked often and changed as needs change (NIDA). After intensive treatment, the provider should help the person move to less intensive continuing care (NIDA).
Can you take medication (MOUD or MAUD) at any level of care?
Yes. SAMHSA says medications for opioid use disorder should be available in all settings and at all levels of care (SAMHSA TIP 63). This includes outpatient counseling, intensive outpatient, inpatient, and long-term therapeutic communities (SAMHSA TIP 63).
Buprenorphine, methadone, and naltrexone are the most common FDA-approved medicines for opioid use disorder (MOUD) (SAMHSA). Acamprosate, disulfiram, and naltrexone are the most common for alcohol use disorder (MAUD) (SAMHSA). Medicines work best combined with counseling and other behavioral therapies (NIDA).
Methadone can be given only at licensed opioid treatment programs, so you need a way to get to the clinic (FindTreatment.gov). Learn more about medication-assisted treatment.
How long does treatment last at each level?
Most people need at least 3 months in treatment to greatly reduce or stop drug use, and longer treatment brings the best results (NIDA). For residential or outpatient treatment, less than 90 days is of limited effectiveness (NIDA). That total often spans more than one level, and there is no set length for any one person (NIDA).
| Level | Typical length the source gives |
|---|---|
| Detox | Several days to a week or more (FindTreatment.gov) |
| Hospital inpatient | Days or weeks (FindTreatment.gov) |
| Residential | A few months to a year (FindTreatment.gov) |
| Outpatient | About two months to one year (FindTreatment.gov) |
| Recovery housing | Residents choose how long; often several months to years (SAMHSA) |
| Methadone treatment | 12 months is considered the minimum (NIDA) |
Recovery often takes more than one round of treatment, and a relapse is a sign to restart or adjust treatment (NIDA). See how long rehab for alcohol lasts and how aftercare programs support the time after formal treatment.
How do you find a program at the right level?
Start with FindTreatment.gov, SAMHSA’s confidential and anonymous search tool for treatment in the United States (FindTreatment.gov). All facilities listed there offer assessment services (FindTreatment.gov). If a facility can’t see you within 48 hours, try another one (FindTreatment.gov).
You can also call the SAMHSA National Helpline at 1-800-662-4357. It is free, confidential, and open 24/7, 365 days a year, in English and Spanish (SAMHSA). It refers callers to local treatment facilities, support groups, and community organizations, and can point people without insurance to state-funded programs (SAMHSA).
For alcohol, the NIAAA Alcohol Treatment Navigator helps you find the right treatment near you (NIAAA). A primary care provider is a good first step too, since they can make referrals and prescribe medicines (NIAAA). When you call a program, ask what medications you can take during treatment (FindTreatment.gov).
Sources
- Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), National Institute on Drug Abuse, 2018
- What To Expect: Treatment Options, FindTreatment.gov, Substance Abuse and Mental Health Services Administration
- FindTreatment.gov, Substance Abuse and Mental Health Services Administration
- Treatment for Alcohol Problems: Finding and Getting Help, National Institute on Alcohol Abuse and Alcoholism
- TIP 47: Substance Abuse: Clinical Issues in Intensive Outpatient Treatment, Substance Abuse and Mental Health Services Administration, 2006
- Best Practices for Recovery Housing, Substance Abuse and Mental Health Services Administration, 2023
- TIP 63: Medications for Opioid Use Disorder, Substance Abuse and Mental Health Services Administration, 2021
- Treatment Options for Substance Use Disorder, Substance Abuse and Mental Health Services Administration
- SAMHSA’s National Helpline, Substance Abuse and Mental Health Services Administration
- About The ASAM Criteria, American Society of Addiction Medicine
Frequently asked questions
Is detox the same as rehab?
No. Detox is not treatment by itself; it is a first step that can prepare a person for treatment (FindTreatment.gov).
How many hours a week is IOP?
IOP has traditionally been at least 9 hours a week, but some programs offer as few as 6 hours and others more (SAMHSA TIP 47).
Is PHP more intensive than IOP?
Yes. PHP involves at least 20 hours of structured programming a week, compared with at least 9 for IOP (SAMHSA TIP 47).
Is sober living the same as treatment?
No. Recovery housing is a recovery support service, and many residents attend outpatient treatment while they live there (SAMHSA).
Can I keep taking buprenorphine or methadone in rehab or sober living?
You should be able to. SAMHSA says medications for opioid use disorder should be available at all levels of care, and recovery homes should not restrict prescribed medications (SAMHSA TIP 63; SAMHSA).
About this article
This article is an educational summary written by the Drug Detox and Rehab editorial team. It is not medical advice. The information above was researched from the listed references.