There are several types of addiction treatment, ranging from inpatient hospitalization and medical detox to outpatient programs like Partial Hospitalization (PHP) and Intensive Outpatient Programs (IOP). Treatment also includes individual counseling, group therapy, and addiction medicine, often guided by the ASAM Criteria to match care to individual needs.
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Understanding Addiction Treatment Through ASAM Criteria
When it comes to addiction treatment, not all care is created equal — and that’s intentional. The ASAM Criteria, developed by the American Society of Addiction Medicine, is the gold standard framework that clinicians use to match people with the right type and intensity of care. Think of it like a treatment roadmap that helps providers recommend the right level of support based on someone’s medical needs, mental health, living situation, and substance use history.
What Is the ASAM Criteria?
In simple terms, the ASAM Criteria is a set of guidelines used by treatment providers to evaluate six key areas of someone’s life and health:
- Acute Intoxication and Withdrawal Risk – How physically dependent someone is and what withdrawal might look like.
- Biomedical Conditions and Complications – Any medical conditions that need attention alongside addiction treatment.
- Emotional, Behavioral, or Cognitive Conditions – Co-occurring mental health challenges like anxiety, depression, or trauma.
- Readiness to Change – How motivated someone feels about entering or staying in treatment.
- Relapse or Continued Use Potential – The risk of returning to use without structured support.
- Recovery and Living Environment – The stability of someone’s home, work, and community life.
Why Does the ASAM Criteria Matter?
If you or someone you care about is navigating treatment options, knowing about ASAM Criteria can help you understand why a provider might suggest detox first instead of jumping into outpatient counseling, or why someone might need a higher level of care after a relapse. It’s not about labeling someone as “worse off” — it’s about making sure care fits the actual need, rather than under-treating or over-treating the situation.
Addiction Treatment Levels of Care
It should be a given, but its not (we’ll get back to that below). Quality substance use treatment should try to match someone to the level of care that fits their substance use severity. One of the best tools for that is that ASAM Criteria…even if it’s boring and not that exciting to read through.
Once a provider uses the ASAM Criteria to assess your needs, the next step is determining where treatment should happen and how much structure is necessary. This is where the idea of levels of care comes in. Instead of thinking about addiction treatment as one single program, it’s more helpful to imagine a continuum — ranging from the most intensive care to the least.
At one end, you have inpatient hospitalization, where medical teams monitor your health around the clock. At the other end, you have outpatient counseling, which might look like weekly therapy sessions while you continue living at home. In between, there are options like medical detox, Inpatient Treatment, Partial Hospitalization Programs (PHP), and Intensive Outpatient Programs (IOP) — each offering different blends of medical care, therapy, and support.
Medical Detox for Addiction Treatment
Medical detox is the process of clearing drugs or alcohol from the body under the supervision of medical professionals. For many people entering addiction treatment, detox is the first necessary step before they can engage in therapy or counseling. The goal of detox is to manage withdrawal symptoms safely and help the body begin to function without substances.
What Happens During Medical Detox?
During detox, you are monitored by a medical team that can manage withdrawal symptoms, provide medications to reduce discomfort, and address any complications that arise. This is especially important for substances like alcohol, benzodiazepines, and opioids, where withdrawal can be physically dangerous or extremely uncomfortable.
Medical detox typically takes place in a specialized detox center, inpatient facility, or hospital. While the focus is on physical stabilization, some detox programs also offer brief counseling or support groups to help people begin thinking about their recovery plan.
How Long Does Detox Take?
The length of detox varies depending on the substance, how long you’ve been using, and your overall health. In general, detox can last anywhere from 3 to 7 days, though longer stays are sometimes necessary for certain substances or more complex cases.
Do You Always Need Detox Before Treatment?
Not everyone needs formal detox before starting addiction treatment. Detox is usually necessary when:
- You are physically dependent on substances known to cause severe withdrawal (alcohol, benzodiazepines, opioids).
- You’ve experienced withdrawal complications in the past.
- You have co-occurring medical issues that could make withdrawal riskier.
- Your substance use is heavy and long-term.
For substances like cannabis or stimulants (cocaine, methamphetamine), withdrawal symptoms are typically more psychological than physical, meaning detox may not be required. An assessment using the ASAM Criteria helps determine if detox is necessary before moving into the next level of care.
For some people, this may be sufficient…but usually its not. If someone gets to the place that they need medical detox, they have typically built a lot of habits around their use that can make it really tough to just quit after detox.
Ever tried to lose weight? If so, you probably went on some diet. You had a period of time where you removed all the “junk food” from your life and started feeling better. You probably felt great and proud of yourself and thought “this will be easy!” Then after a few stressful days, you don’t feel like cooking those healthy meals you’ve been cooking, you order takeout, and now you’re off to the races and back to eating unhealthy again. Detox is sort of like this process. It can get you stable and set up for success, but it takes time for new habits to form.
Inpatient Addiction Treatment
Inpatient addiction treatment provides round-the-clock care in a structured, residential setting. It’s designed for people who need intensive support to begin their recovery — either because withdrawal symptoms are severe, home isn’t a safe or supportive place to recover, or previous treatment attempts haven’t been successful.
What is Inpatient Addiction Treatment?
During inpatient treatment, you live at the treatment facility full-time. Each day follows a structured schedule that combines individual therapy, group counseling, educational sessions, and recreational activities. Many programs also offer psychiatric care and medication management, especially if you have co-occurring mental health conditions like depression, anxiety, or trauma.
The goal of inpatient care is twofold: first, to stabilize you physically and emotionally, and second, to help you build a strong foundation of coping skills, self-awareness, and relapse prevention strategies that you can carry into the next stages of recovery.
How Long Does Inpatient Treatment Last?
The length of inpatient treatment varies. Short-term programs often last 28 to 30 days, while long-term programs can run 60, 90, or even 120 days. The right length for you depends on factors like:
- Severity and duration of substance use
- Presence of co-occurring mental health conditions
- Past treatment history and risk of relapse
- Personal responsibilities and financial considerations
Who Needs Inpatient Treatment?
Inpatient addiction treatment is typically recommended for people who:
- Need a safe, substance-free environment to begin recovery
- Have experienced multiple relapses after trying outpatient care
- Need medical supervision due to withdrawal risks or health complications
- Have co-occurring disorders that require integrated psychiatric care
Inpatient care offers a fully immersive experience, which can be critical for people whose home environments or social circles are tied closely to substance use. By stepping out of everyday life and into a dedicated treatment environment, you can focus entirely on your recovery without distraction.
Partial Hospitalization Program (PHP) for Substance Use
A Partial Hospitalization Program, or PHP, is a structured treatment program that offers intensive care during the day, but allows you to return home (or to a sober living environment) in the evenings. PHP is often a step down from inpatient care or detox, but it can also be the first point of entry for someone who doesn’t need 24/7 medical monitoring.
What is a Partial Hospitalization Program (PHP) for Substance Use?
In a PHP, you attend treatment for several hours a day, typically five days a week. This treatment includes a mix of individual therapy, group counseling, education on addiction and coping skills, and sometimes medication management if needed. The goal is to provide high-level support while helping you begin to practice real-world recovery skills in your daily life.
Some people call PHP day treatment because it functions almost like a full-time job — you’re actively engaged in treatment most of the day, but you have time in the evenings to manage personal responsibilities, rebuild relationships, or attend community support meetings.
Who Is a Good Fit for PHP?
PHP is ideal for people who:
- Have completed inpatient or detox and need continued structure
- Need significant support but are medically stable enough to live outside of a facility
- Are motivated to participate in treatment and work on recovery skills
- Have a relatively stable home or sober living environment
It’s also a strong option for people who have relapsed and need a reset without starting over at the most intensive levels of care.
What Are the Benefits of PHP?
One of the biggest advantages of PHP is that it balances intensive care with independence. You get access to a clinical team, regular therapy, and peer support — but you also have opportunities to test what you’re learning in the real world. This blend can help people build confidence while still having a safety net in place.
Intensive Outpatient Program (IOP) for Substance Use
An Intensive Outpatient Program, or IOP, offers structured addiction treatment without requiring you to live at a facility. It is often used as a step down from inpatient or partial hospitalization programs, but some people enter treatment directly at the IOP level if they do not need 24/7 supervision. IOP is designed to provide a strong level of support while still allowing you to maintain parts of your regular life, like work, school, or family responsibilities.
What is an IOP for Substance Use?
In an IOP, you typically attend treatment sessions three to five days per week for a few hours each day. These sessions include a mix of individual therapy, group counseling, and educational workshops focused on topics like relapse prevention, coping skills, and understanding addiction. Many IOPs also offer medication management if needed, especially for people with co-occurring mental health conditions.
IOP is sometimes called structured outpatient care because it bridges the gap between intensive treatment and fully independent outpatient counseling. It allows you to stay engaged in your daily life while still getting consistent professional support.
Who Is a Good Fit for IOP?
IOP works well for people who:
- Have completed a higher level of care, like inpatient treatment or detox
- Need a structured treatment plan but can safely live at home or in a sober living environment
- Are motivated to participate in treatment and apply what they are learning outside of sessions
- Have a supportive environment that encourages recovery
It can also be a helpful option for people who have experienced a relapse but do not need to start over in a residential or hospital setting.
What Are the Benefits of IOP?
One of the biggest benefits of IOP is flexibility. You get regular access to therapy, peer support, and education while still being able to work, go to school, or care for family. This combination helps people learn how to apply recovery skills in real-life situations, rather than in the bubble of a residential program.
At the same time, you still have accountability and connection to a treatment team, which can make a big difference in the early stages of recovery when the risk of relapse is highest.
Substance Abuse Counseling
Not everyone needs inpatient or intensive treatment to address addiction. For many people, the core of long-term recovery happens in regular counseling sessions and through the support of addiction medicine. These two approaches — therapy and medication — often work best when combined, especially for people with long-term substance use or co-occurring mental health concerns.
What Happens in Substance Abuse Counseling?
Substance abuse counseling can take many forms, but it usually involves regular sessions with a licensed therapist, counselor, or addiction specialist. Counseling might be one-on-one, in a group, or a mix of both. The goal is to help you understand the root causes of your substance use, develop healthier coping mechanisms, and build a life that supports long-term recovery.
Some of the approaches used in substance abuse counseling include:
- Cognitive Behavioral Therapy (CBT) to identify and change unhelpful thinking patterns
- Motivational Interviewing (MI) to help strengthen your internal motivation for change
- Relapse prevention planning to help you anticipate triggers and develop strategies to stay sober
- Family counseling to address how addiction has affected relationships and how to rebuild trust and support
Counseling is also where a lot of the real work of recovery happens — learning how to manage stress, repair relationships, and create meaning and purpose outside of substance use.
Addiction Medicine
Addiction medicine focuses on the medical aspects of substance use disorders, including the use of medications to reduce cravings, manage withdrawal symptoms, and support long-term recovery. This is sometimes referred to as medication-assisted treatment, or MAT.
Common medications used in addiction medicine include:
- Buprenorphine or methadone for opioid use disorder
- Naltrexone for alcohol or opioid dependence
- Antabuse (disulfiram) to discourage alcohol use by creating unpleasant side effects if you drink
- Medications to manage co-occurring conditions like depression, anxiety, or sleep disorders
Addiction medicine works best when it is part of a larger treatment plan that includes counseling and support. Medication can help stabilize things a little, making it easier to focus on therapy and rebuilding your life.
Why Combining Counseling and Medicine Works Best
Research consistently shows that people have better outcomes when they use a combination of therapy and medication, especially for opioid or alcohol use disorders. Medication helps manage cravings and physical symptoms, while counseling helps you rebuild the psychological and social pieces of your life that support recovery.
Some people start with more intensive care, like inpatient treatment or PHP, and then transition to outpatient counseling and medication management as their recovery stabilizes. Others begin with counseling and medication right away, especially if they have mild to moderate substance use concerns.
No matter where you begin, the key is finding a plan that meets your needs — and being willing to adjust that plan over time as your recovery evolves.
Take a Systems Approach
Addiction is a chronic condition, which means even when things get better, they’re not necessarily over. It moves through cycles — sometimes stable, sometimes struggling — much like other long-term health issues. That’s why you’ll often hear people in recovery say, relapse is part of the process.
This matters because if you think of treatment as a one-time fix, you’re setting up unrealistic expectations. Effective addiction care works best when it treats the whole system — not just the moment someone seeks help. That system includes physical health, mental health, family support, housing, work, and purpose. Recovery happens when all of those pieces align, not just because someone made it through detox.
That’s why AIM takes a systems approach. Instead of treating addiction as a single episode, we focus on creating an ecosystem where someone can move up or down levels of care based on what they need at the time — from psychiatry and therapy to intensive outpatient and case management. The goal isn’t just sobriety; it’s long-term recovery that actually works in real life.
If you’re interested in learning more or getting some guidance on how to address your or someone else’s substance use, reach out to us. We’re happy to play guides and help you figure out what is the best fit for you.
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