An intensive outpatient program (IOP) is a rehabilitation program that requires patients to visit a treatment center several times per week for a few hours per day to receive treatment. It’s an important continuum of care that combines the components of inpatient treatment with the flexibility for patients to return home at the end of the day. Intensive outpatient services typically operate in the morning or evening on weekdays, with most services lasting for about 90 days. IOPs are more rigorous than standard outpatient rehab programs and offer comprehensive treatment and care to people who do not need around-the-clock supervision.
IOPs treat various mental health conditions such as depression, PTSD, and bipolar disorder, as well as substance use disorders, such as alcohol use disorder (AUD) and opioid use disorders (OUDs).
Alcohol Use Disorder (AUD)
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), AUD is a brain disease characterized by an inability to control alcohol use despite the various occupational, social, and health consequences. It encompasses the conditions widely known as alcohol abuse, alcohol dependence, alcohol addiction, and alcoholism. AUD occurs as a result of the brain changes caused due to chronic alcohol use. It ranges from mild to severe and is believed to be influenced by certain biological, psychological, and social factors, such as genetics, exposure to trauma or stress during childhood, and drinking at an early age.
Some of the symptoms of an AUD are:
- Consuming alcohol more frequently or in more quantities than intended.
- Finding it difficult to quit or cut back on alcohol use despite many attempts.
- Having strong cravings for alcohol.
- Failing to fulfill important commitments at school, home, or work due to alcohol use.
- Continuing to consume alcohol despite the recurring physical or psychological problems related to its use.
- Developing a tolerance to alcohol (the need to consume more quantities of alcohol to achieve the desired effects).
- Developing withdrawal symptoms when trying to quit or reduce alcohol use.
Opioid Use Disorder (OUD)
According to the American Psychiatric Association (APA), opioid use disorder is a chronic, lifelong disorder capable of causing potential consequences such as disabilities, relapses, and death. It refers to the problematic use of opioids such as heroin, morphine, and prescription painkillers, characterized by a strong, compulsive urge to continue the drug use despite adverse consequences. Even though OUDs are similar to other substance use disorders (SUDs) in many aspects, the highly addictive nature of opioids can lead to physical dependence in as little as 4-8 weeks compared to other SUDs, even if the opioids are taken as prescribed.
Some of the symptoms of an OUD are:
- Taking larger doses of the drug over a longer period than intended.
- Spending a considerable amount of time in obtaining, using, and recovering from the drug.
- Having strong cravings for the drug.
- Finding it difficult to quit or control opioid use.
- Giving up on activities that were of interest before due to drug use.
- Developing a tolerance for opioids.
- Experiencing withdrawals when trying to quit or reduce drug use.
IOP Treatment Services Provided for SUDs
IOP treatment for substance abuse can vary from facility to facility. However, it typically includes 10-12 hours of group and individual therapy a week and engagement in 12-step programs.
Some of the therapies provided by IOPs are:
- Cognitive-behavioral therapy (CBT)
- Contingency management
- The matrix model
- Dialectical behavioral therapy (DBT)
- Motivational interviewing (MI)
Intensive outpatient treatment also includes withdrawal management, relapse prevention training, and educational workshops. In addition, group outings, meditation, exercise classes, career and life training, and other activities can also be provided by certain IOPs as supplemental activities. The treatment sessions are often held on-site at a therapeutic or medical facility. However, certain alternatives, such as online services, are being introduced to help people living in remote areas or towns without access to rehab treatment. This move is especially important during Covid-19 lockdowns as more and more individuals find themselves in need of such services.
How Does IOP Help SUD Patients?
An addiction to alcohol or opioid refers to more than just the physical need to continue using the substance. It also refers to the underlying psychological components that keep a person engaged in substance abuse, such as stress or childhood trauma. This factor is why most IOPs require patients to engage in various group meetings and individual counseling sessions to address the psychological aspects of addiction. Individual and group therapies facilitate various discussion topics to provide the relevant skills and guidance needed to cope with these core issues. They also create a supportive environment to help patients actively practice implementing the acquired skills and build a strong community of peers in recovery.
The educational workshops provided by IOPs help patients learn about addiction and the science behind why people get addicted to certain substances. The workshops also teach patients about the mental health issues triggered by substance abuse (co-occurring disorders) to help patients better understand their condition and effectively manage them. Most IOPs also provide the necessary services to identify and treat co-occurring mental health disorders for long-term recovery.
Other services provided by IOPs, such as withdrawal management, skills development, and relapse prevention, equip patients with the necessary tools to cope with withdrawal and cravings and positively address triggers. Most IOPs also offer family therapy to help patients re-strengthen familial relationships that have been estranged due to substance abuse. Family involvement during treatment remains vital to keep patients motivated and dedicated to establishing long-term sobriety.
Why Choose an Intensive Outpatient Program?
Residential treatment programs inarguably provide the highest level of care for substance abuse treatment as it separates patients from their familiar environment to focus solely on rehabilitation. However, committing to such a time-demanding treatment program can be inconvenient for patients with important work, school, or family obligations. Residential treatment may also not be ideal for patients with a mild or moderate SUD that does not require around-the-clock supervision or detoxification. During such instances, IOPs help bridge the gap between inpatient and outpatient programs. IOPs allow patients to receive treatment on a part-time basis without compromising the intensive care of inpatient programs. It also provides patients with a greater sense of responsibility and privacy throughout treatment.
Since IOPs allow patients to go back to their routine life after treatment, it provides them with the opportunity to practice the skills learned through therapies right away. It also cuts down on the cost associated with accommodation, making it an inexpensive approach to recovery compared to inpatient treatment services.
The intensive and flexible nature of IOPs makes it a great treatment approach for substance use disorders. However, patients are advised to consult an addiction specialist or a physician before engaging in an IOP treatment to ensure that it’s the right treatment plan for them.
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