Treatment Type Comparison | Find the Right Care

📊 Continuum of care

Treatment intensity decreases from left to right. Most people move through several levels over the course of recovery. Click a level to jump to its details.

🏥 Medical Detox

🏠 Residential (Inpatient)

🌅 PHP (Partial Hospitalisation)

🌤️ IOP (Intensive Outpatient)

🌿 Outpatient

💊 MAT (Medication)

🤝 Peer Support

🏥 Medical Detoxification

The process of safely managing the physical symptoms of withdrawal under medical supervision. Detox is the first step for many people, but it's not treatment. It clears the body while treatment addresses the mind.

What it involves

24/7 medical monitoring during acute withdrawal
Medication to manage withdrawal symptoms safely
Duration: 3-10 days depending on substance and severity
Hospital or dedicated detox facility settings
Transition planning to next level of care

Who it's for

Anyone withdrawing from alcohol or benzodiazepines (medically necessary)
Heavy opioid users wanting a safe, managed withdrawal
Anyone at medical risk during withdrawal
First step before residential or PHP treatment

Cost indicator

High cost. Most insurance covers medically necessary detox. SAMHSA can help find funded options.

Important notes

Detox alone rarely produces sustained recovery, it must be followed by treatment
Tolerance resets during detox, relapse risk is extremely high immediately after
Discuss MAT options with the detox team before discharge

Non-negotiable: Alcohol and benzodiazepine detox must be medically supervised. Attempting these withdrawals without medical support can be fatal. Call SAMHSA at 1-800-662-4357 to find a medically supervised detox facility near you.

🏠 Residential (Inpatient) Treatment

Live-in treatment providing intensive therapy, structure, and 24-hour support in a therapeutic environment. The gold standard for severe addiction, early recovery, and people needing removal from a triggering home environment.

What it involves

Residential living in a treatment facility
Structured daily schedule: therapy, groups, activities
Individual and group therapy sessions daily
Duration: 28 days (short-term), 60-90 days, 6-12 months (long-term therapeutic communities)
Medical staff on-site or available

Who it's for

Severe addiction requiring removal from home environment
Co-occurring mental health conditions needing intensive support
Multiple prior treatment attempts with outpatient
Unstable or unsafe home environment
High relapse risk with less intensive care

Cost indicator

Highest cost. Insurance covers many programmes. State-funded options exist. SAMHSA helpline for funded placements.

What the research shows

Longer residential stays (90+ days) produce better outcomes
Treatment quality varies enormously, ask about therapy types, staff credentials
Transition planning is critical, discharge without a step-down plan dramatically increases relapse risk

🌅 Partial Hospitalisation Programme (PHP)

The bridge between residential and outpatient. PHP provides hospital-level intensive treatment during the day (5-7 days per week, 5-8 hours per day) while allowing you to sleep at home or in sober living. High intensity, high flexibility.

What it involves

5-7 days per week attendance, 5-8 hours per day
Group therapy, individual therapy, psychiatric services
Medical monitoring available during programme hours
Duration: typically 2-6 weeks
Step-down from residential or step-up from IOP

Who it's for

People leaving residential who need a structured transition
People requiring intensive treatment who can't leave home (work, family)
Co-occurring mental health conditions needing psychiatric oversight
When IOP hasn't been sufficient

Cost indicator

Moderate-high cost. Most insurance covers PHP. Often significantly less expensive than residential.

Key considerations

You return to your home environment each evening, requires a safe, sober home situation
Evening support structure (sober living, family support) significantly improves PHP outcomes
Transportation to and from programme needs planning

🌤️ Intensive Outpatient Programme (IOP)

The most common treatment level for people who can't or don't need residential care. IOP provides structured group and individual therapy 3-5 days per week while you maintain work, school, and family commitments.

What it involves

3-5 days per week, 3-4 hours per session
Group therapy as the primary modality
Individual therapy sessions (weekly or biweekly)
Substance use monitoring (urine screens)
Duration: 8-16 weeks typically

Who it's for

People who can't attend PHP due to work or family obligations
Step-down from PHP or residential
Moderate addiction severity with stable home environment
First formal treatment for people with good social support

Cost indicator

Moderate cost. Insurance typically covers IOP. Significantly more accessible than higher levels of care.

What works best in IOP

Attendance at all scheduled sessions, dropout is the main predictor of poor outcomes
Supplementing with peer support meetings on non-programme days
Having a sponsor or recovery coach alongside formal treatment
Sober home environment during IOP attendance

🌿 Standard Outpatient Treatment

Individual and/or group therapy sessions 1-2 times per week. The maintenance level of care for people in stable recovery, or the appropriate first step for mild addiction severity with strong support systems.

What it involves

Weekly or biweekly individual therapy sessions
Group therapy options (once or twice weekly)
Medication management if on MAT
May include drug testing
Duration: ongoing, typically 6-12 months minimum

Who it's for

Step-down from IOP as recovery stabilises
Mild addiction severity with strong social support
Ongoing maintenance therapy for people in stable recovery
People on MAT who need regular monitoring and support

Cost indicator

Lowest formal treatment cost. Widely covered by insurance. Sliding-scale options available at community mental health centres.

When to step back up

Relapse or near-relapse
Significant increase in relapse risk score
Major life stressor or crisis
Feeling like outpatient alone isn't providing enough support

💊 Medication-Assisted Treatment (MAT)

FDA-approved medications combined with counselling and support. The most effective treatment available for opioid use disorder, reducing overdose mortality by 50-60%. Not a standalone, MAT works best alongside therapy and peer support.

Available medications

Buprenorphine (Suboxone), opioids, office-based prescribing
Methadone, opioids, OTP clinics
Naltrexone (Vivitrol), opioids and alcohol
Acamprosate, alcohol
Disulfiram, alcohol (deterrent)
Varenicline / NRT, nicotine

Who it's for

Anyone with opioid use disorder, first-line treatment
People with alcohol use disorder seeking pharmacological support
People at high overdose risk
Can be combined with any other level of care

Cost indicator

Low to moderate. Medicaid covers most MAT. Generic buprenorphine is inexpensive. SAMHSA helpline for funded options.

Access

Any GP can now prescribe buprenorphine (no waiver since 2023)
Telehealth MAT prescribing widely available
findtreatment.gov for MAT providers near you
SAMHSA: 1-800-662-4357

For comprehensive MAT information including myths, facts, and specific medication details, see the MAT Information Tool.

🤝 Peer Support & Mutual Aid

Free, community-based recovery support from people with lived experience. 12-step programmes, SMART Recovery, recovery coaching, and peer specialists. Peer support is not treatment, but research shows it dramatically improves treatment outcomes when combined with formal care.

Types available

AA, NA, CA and other 12-step fellowships
SMART Recovery (science-based, non-12-step)
Celebrate Recovery (faith-based)
Certified peer recovery specialists / coaches
Recovery community organisations (RCOs)
Online communities and recovery forums

What the evidence shows

AA produces comparable outcomes to CBT at lower cost (Cochrane 2020)
Peer support specialists reduce hospitalisation rates
Sponsor relationships are among the strongest predictors of long-term sobriety
Community belonging is a resilience factor against relapse

Cost indicator

Typically free. 12-step, SMART, and most peer support is no-cost. Recovery coaching and peer specialists may have modest fees.

Access

Find meetings at the Meeting Finder
Online meetings available 24/7
SAMHSA peer support specialist directory
Build your network with the Sober Network Builder

📊 Side-by-side comparison

Treatment type	Intensity	Duration	Cost	Best for	Main limitation
Medical Detox	Very high	3-10 days	High	Managing acute withdrawal safely	Not treatment, must be followed by care
Residential (28 day)	Very high	28-90 days	Very high	Severe addiction, unsafe home environment	Cost, access, disruption to life
PHP	High	2-6 weeks	Moderate-high	Post-residential transition, need intensive care with home return	Requires safe home environment
IOP	Moderate	8-16 weeks	Moderate	Working adults, moderate severity, step-down	Less intensive, not enough for severe cases
Outpatient	Low	6-12+ months	Low	Stable recovery maintenance, mild severity	Minimal structure, requires high motivation
MAT	Variable	Ongoing	Low-moderate	Opioid and alcohol use disorder, any severity	Requires prescribing access, ongoing commitment
Peer Support	Low	Ongoing	Free	Any stage, complements all formal treatment	Not a substitute for clinical treatment

🎯 How to choose the right level

🏥Choose medical detox if: You use alcohol or benzodiazepines heavily (medically necessary), or you want medical support through any withdrawal.

🏠Choose residential if: You have severe addiction, an unsafe or triggering home environment, multiple prior outpatient failures, or significant co-occurring mental health needs.

🌅Choose PHP if: You need intensive treatment but can return home each evening to a safe environment, or you're stepping down from residential.

🌤️Choose IOP if: You need structured treatment but can't leave work or family, you have a stable home, or you're stepping down from PHP.

🌿Choose outpatient if: You're in stable recovery maintaining therapy, or you have mild severity with strong support systems.

💊Add MAT if: You have opioid use disorder (strongly recommended) or alcohol use disorder and want pharmacological support, at any level of care.

🤝Add peer support always: Peer support improves outcomes at every level of care. Use the Meeting Finder and Accountability Partner Tracker alongside formal treatment.

📞 SAMHSA: 1-800-662-4357

The most important thing about levels of care

The right level of care is the one that provides enough structure and support to hold you through early recovery, but not more than is necessary. Under-treating addiction (insufficient care intensity for the severity) produces relapse. But over-treating creates unnecessary disruption to life, career, and family while not producing better outcomes than matched treatment.

The American Society of Addiction Medicine (ASAM) criteria provide a standardised framework for matching people to appropriate levels of care based on 6 dimensions: intoxication and withdrawal potential, biomedical conditions, emotional and cognitive conditions, readiness to change, relapse potential, and recovery environment. A good addiction assessment will use these criteria. Ask your assessor specifically about their ASAM criteria assessment.

Stepping up and stepping down

Treatment is not linear. Most people move up and down the continuum based on how they're doing. A relapse during outpatient care might indicate a need to step back up to IOP or PHP. Sustained stability in residential might allow a step-down to PHP while still in the 28-day programme. This flexibility is clinically appropriate and shouldn't be experienced as failure. Recovery is not a straight line, and treatment flexibility reflects that reality.

Track your recovery status with the Relapse Risk Calculator weekly. Consistently elevated scores, especially in the emotional and social domains, are a signal that your current level of care may not be sufficient. Bring this data to your treatment provider and have the conversation about whether stepping up is appropriate.

To find treatment: SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7). Online locator at findtreatment.gov. For MAT specifically, any primary care physician can now prescribe buprenorphine, or use the MAT Information Tool for more options.