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Table 4 Categories of Treatment Modalities For Those with Substance Abuse and Chemical Dependence

From: Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

Modality Duration and characteristics of care Clientele
Detoxification Alcohol – 3 to 5 days inpatient. Usually with benzodiazepine tapering. Opioids – 10 to 180 days outpatient using methadone or buprenorphine. Those displaying or at risk for severe alcohol or opioid withdrawal distress.
Intensive Outpatient Therapy (IOP) 3 to 5 weeks. Patients live off-site and attend therapy for 4 to 6 hours per day. Those recently discharged from detoxification protocols or who require aggressive initiation of therapy
Individual, Group, and Family Outpatient Therapy 6 to 24 months. Clients attend hourly sessions once a week to discover and deal with issues related to their disease. The least intrusive modality for patients with chemical dependence. Those discharged from IOP and need continued recovery support (most patients) and those deemed able to establish sobriety with minimal intervention.
Education and Information Programs 4 to 6 weeks. Classes run in cycles providing information about substance abuse and its varied consequences Substance abusers not diagnosed chemically dependent who may respond to information and reason
Therapeutic Community 12 to 36 months. Clients reside at the facility entering with no status and earning privileges as their recovery matures Individuals are often court referred or otherwise coerced into treatment by parents or authorities. Clients have usually failed more conventional therapeutic approaches.
Inpatient Treatment Center Typically 1 to 4 weeks (although some individuals may stay longer). Live-in facility where patients are steeped in recovery activities and philosophy. Alcohol or opioid detoxification may be done on premises. Chemically dependent patients with or without physical dependence. Clients may have been unsuccessful in outpatient treatment or are first time admissions deemed to be unlikely to succeed in outpatient care.
Half-Way facility 1 year or longer. Recovery centered housing where housemates gain mutual support from each other's sobriety. Many are based on 12-step recovery traditions Clients in recovery who have been unable to sustain sobriety in standard community housing or who are homeless.
Opioid Maintenance in certified treatment programs Greater than 180 days of daily oral dosing with methadone or buprenorphine, or every-other-day dosing with LAAM or buprenorphine. Patients who are > 18 years of age, have at least a 1 year history of addiction, and are physically dependent on an opioid.
Opioid maintenance in office based practices Buprenorphine prescribed by authorized primary care physicians and dispensed by local pharmacies. Patients who are deemed by the physician to be in need of pharmacotherapy for opioid dependence.