What Are Levels of Care?

When someone goes into addiction treatment, they will be sent to one of 4 levels of care. For some people, they need to start in a detox facility and work their way down, while others may not. It’s important to remember that you may not need to start at the highest level of care. Sometimes it might be appropriate for you to begin with an intensive outpatient program. It really comes down to whether or not a doctor believes you’re at risk for fatal withdrawal symptoms. In any case, this article will break down the different layers of care you might experience in your recovery journey.

What Does Treatment Look Like?

Level 4 is the highest form of care and provides medically managed intensive inpatient services. For those of you who’ve been to the drunk tank, you know exactly what this is. Level 4 care is designed to prevent fatal withdrawal symptoms for heavy alcohol and drug users. Although full detox from substances can take up to 3 or 4 weeks, most programs will support you for 1-7 days. They typically take insurance and are designed solely to help you get through the most intense part of substance withdrawal.

The next step down is level 3 and includes extended care services and residential treatment centers. In other words, 30-90 day rehabs and long term sober living programs. Both structures aim to create a safe and supportive environment during the infancy of recovery. The key differences are residential treatment provides a shorter length of stay, has a clinical curriculum and accepts insurance. Extended care is designed to help create and sustain new behaviors, which take more than 90 days to create. One important side note is most insurance companies cover patients for 14-21 days, not a full 30 days. 

Level 2 care incorporates partial hospitalization (PHP) and intensive outpatient programs (IOP). Both treatments are primarily clinically driven with an emphasis on group therapy. Unlike level 3 and level 4 care, these treatments allow clients to live at home. PHP or day treatment includes 5 hours of group therapy for 5 days per week. Conversely, IOP is less intensive and has 3 hours of group therapy per day for 3-5 days per week. Both treatments typically include individual therapy sessions, access to the facility’s amenities, medication management, and urinary analysis. When you’re considering level 2 treatment, you should inquire into the specific amenities each facility includes. Some programs have been known to include gym memberships, yoga, acupuncture, various outdoor activities and animal assisted therapy.

From here is level 1 and it refers to outpatient services (OP). People usually only go to this level once they have successfully completed one of the levels above. The main difference between OP and level 2 treatment is a dramatic decrease in group therapy. OP typically involves 9 or less hours of group therapy per week, urinary analysis, access to facility amenities, and an individual therapy session. If you need medication management, make sure you ask whether or not your treatment center will provide it.

Peer To Peer Support

ASAM also includes a level below 1, which is 0.5. This refers to early intervention or peer support services. Interventions are self explanatory so we won’t do a deep dive into the specifics. I will say that early interventions are a reputable way of getting people into treatment. Not everyone needs to hit rock bottom before they figure out that recovery treatment might save their life. An additional peer support service is recovery coaching. This provides people with 1 or multiple hours of individualized support to help people change their behaviors and hold them accountable.

If you or your loved one wants to learn more about the different support services we offer, contact us today.