Exploring The Different Levels of Care in Substance Abuse Treatment

Searching for addiction treatment but don’t know where to start?

It’s hard to figure out what program will work best for you when there are SO MANY options.

Programs come in different levels of intensity. Lots of acronyms. Confusing abbreviations…

You get the picture.

Fortunately, learning about addiction treatment levels isn’t that difficult. Here’s what you need to know:

What You’ll Learn:

• Why Are There Different Levels of Care?
• The Levels of Addiction Treatment Explained
• How Do I Know What Level I Need?
• Leveling Up and Down

Why Are Different Levels of Care Important?

No two people struggling with substance abuse are alike. Nor should they be treated alike.

You don’t need to visit the emergency room every time you have a drink problem. But someone with a severe opioid use disorder does need intense medical intervention.

That’s why different levels of care were established. To ensure patients receive an appropriate level of treatment based on their particular needs.

Currently, only about 1 in 5 people who needed substance use disorder treatment got that treatment. That’s a LOT of people who may not be getting the exact level of care they need.

Part of the problem is not knowing where to start. Not understanding what level of care matches their needs.

If you’re searching for help with addiction treatment near Washington DC, knowing about the levels of care will make your decision easier.

American Society of Addiction Medicine (ASAM) created a continuum of care that ranges from level 0.5 to level 4. Level 4 being the highest level of medical care and level 0.5 being early intervention services.

Let’s dig into each level.

Level 0.5 – Early Intervention

Early intervention is often the starting point for many individuals.

This level of care focuses on providing prevention services to those who exhibit the warning signs of a potential substance use problem but do not fully meet the criteria for a diagnosis of addiction.

Services at this level may include:

• Brief educational sessions
• Screening and assessment
• Motivational interviewing

Simple enough, right?

Level 1 – Outpatient

Outpatient treatment is the least intensive and most flexible level of care.

At this level, people who attend treatment programs reside at home and participate in scheduled treatment activities during the day.

Generally, this level of care will include:

• One on one counseling
• Group therapy
• Addiction education

Think of outpatient treatment as mild intensity care for people with strong home support networks.

Level 2 – Intensive Outpatient Partial Hospitalization

Ok, now we’re starting to get into the meat.

Level 2 of care consists of two categories:

Intensive Outpatient Programs or IOP that require 9+ hours of treatment per week.

Partial Hospitalization Programs or PHP that require 20+ hours of treatment per week.

Compared to standard outpatient treatment, this level of care requires significantly more time dedicated to treatment.

People who may need more support than Level 1 outpatients can provide but don’t need 24/7 care might be candidates for this level.

Level 3 – Residential/Inpatient Treatment

Time to pack your bags. At this level of care you will be residing at the treatment facility.

Unlike outpatient care where people remain in their home environment, residential care removes individuals from outside distractions and places them into a live-in treatment environment.

A significant portion of the 48.5 million people who experienced a substance use disorder in the past year received this level of care.

As mentioned above, there are several different sublevels within Level 3 of care. They include:

Level 3.1 – Low intensity residential

Level 3.3 – Medium intensity residential

Level 3.5 – High intensity residential

Level 3.7 – Medically monitored intensive inpatient

Someone going through alcohol detox might require close medical monitoring (Level 3.7) while someone with mild addiction may do well in low intensity residential care (Level 3.1).

Level 4 – Medically Managed Intensive Inpatient

If Level 3 isn’t the highest level of care you were thinking…

Think again.

Level 4 care is provided in a hospital setting where patients will receive 24/7 care from medical professionals.

Anyone undergoing treatment at this level can expect to be monitored by doctors and nurses around the clock.

Patients who require this level of care have either:

• Serious withdrawal symptoms that may pose life-threatening dangers
• Another medical condition along with their addiction that requires monitoring
• Psychiatric issues that need stabilization

Don’t freak out if you find yourself here. You aren’t stuck at this level forever.

Similar to other levels, patients can move up and down this level based on treatment needs.

For example, someone may require intensive inpatient care (Level 4) to begin drug detox but step down to residential care (Level 3) when they are medically stable.

How Levels of Care Work Together

Remember how we said each level of care was NOT standalone? Here’s where that comes into play…

Let’s use the above example. Someone may enter Level 4 care to detox from drugs. The patient receives 24-hour care until they are stable to transition to Level 3 residential care.

Once they demonstrate progress in recovery, they can transition to Level 2 intensive outpatient treatment.

And finally, enter Level 1 outpatient treatment for “booster shots” of counseling and therapy.

The same thing can happen in reverse. Someone in outpatient treatment who relapses may need to step up to a higher level of care for a period of time.

Making sure someone is receiving the proper level of care at all times is the idea.

Deciding Where You Fit in

So how does an addict or alcoholic know what level they need?

Treatment professionals will administer various assessments to determine where on the continuum you fall.

Using something called the ASAM criteria, treatment professionals evaluate you across 6 categories:

1. Withdrawal Potential
2. Medical Issues
3. Mental Health
4. Readiness to Improve
5. Risk of Relapse
6. Living Environment

Once they factor in your current needs with your long-term recovery goals, they will be able to suggest a treatment level that best suits your needs.

Remember: you don’t have to figure this out on your own.

The Takeaway

As you can see, learning about levels of care isn’t that bad.

Keep these things in mind when learning about addiction treatment:

• Early intervention (level 0.5) and outpatient (level 1) are great for people who need less intensive care.
• Level 2 fills the gap between outpatient care and residential care.
• Levels 3 and up provide treatment in a controlled environment with some level of medical care.

Don’t overthink it. Recovery can begin at any level.

Remember our statistics from earlier? Millions of people just like you have recovered from addiction at every level of care.

You can be next. Just reach out to a treatment specialist and take that first step.