Addiction and recovery seem to be deceptively straightforward concepts, which reinforces many of the misconceptions that are woven into the fabric of public opinion. In fact, the addiction stigma, which continues to be a major deterrent, is largely informed — or misinformed, as it were — by stereotypes, generalizations and assumptions. But for all the misgivings people have about addiction, recovery may be understood even less.
More often than not, when a person mentions addiction treatment, he or she is referring to inpatient care, which is a form of treatment that provides patients with residential-style accommodations so he or she can live on-site for the duration of the program. However, since “inpatient” treatment could also be described as “residential,” there’s been some confusion over whether there’s a difference between these two categories of treatment and what that potential difference might be. So let’s see if there’s an answer to this burning question with particular regard for laws and regulations in the state of Georgia.
What Makes Treatment “Residential”?
Let’s focus our attention on that first word: residential. According to Merriam-Webster, residential is a term used to describe a dwelling used as a residence or by individuals who can be described as residents.1 Further, a residence is defined as a place where a person lives that should be distinguished from a place where a person stays temporarily.2 When we consider these definitions, we see a theme. The implication is that the people living in a home, facility, or any other type of establishment that could be described as residential are staying there on a long-term basis.
Of course, we learn a lot more about what makes addiction treatment residential by considering information supplied by the Georgia Department of Community Health. According to information made available to the public, the types of residential programs facilities may offer include residential sub-acute detoxification treatment, which refers to a fully-staffed detox program that’s not offered in an actual hospital setting; residential intensive treatment, referring to a highly structured program focusing on stabilization and teaching recovery skills; and residential transitional treatment, which is a type of program with much less structure and a focus on reacclimatizing patients as they return to their communities.3 In short, there’s a spectrum of intensity for residential programs, and mild, moderate and intensive treatment programs can each be described as residential. Therefore, since it’s not the intensity of treatment that determines whether a program is residential, what exactly distinguishes a residential program from inpatient care and other types of addiction treatment?
One of the most significant characteristics of residential programs is the length of time a patient may spend in residence. With many residential programs, the amount of time a patient spends in the program may be open-ended, meaning the length of the program can be extended as needed if a patient’s symptoms are slow to improve.4 However, the alternative to being open-ended would be for a residential program to have a defined range of time for which the program could last with six months or more being quite common.
But it’s not just the extended duration of treatment that distinguishes residential care from other forms of treatment. In fact, residential programs often offer more casual, comfortable accommodations rather than a clinical and hospital-like environment. Since a patient could potentially be in a residential program for an extended period of time, providing a more home-like experience in lieu of a sterile hospital-like environment helps patients to settle in, become better acclimated and focus more on the recovery process.
Distinguishing Residential From Inpatient Care
Of course, it’s quite easy to distinguish residential treatment from outpatient care, but the differences between residential and inpatient treatments are a bit trickier. Inpatient treatment is a type of program in which patients are provided with temporary accommodations so that they live on-site for the duration of the program, but the problem is that this sounds a lot like residential treatment. So where do we draw the line?
From a patient’s perspective, this distinction may be apparent in the environmental differences between the two as well as the length of each type of program. As previously stated, the accommodations afforded in a residential program are often more comfortable and “homey” since these programs are longer in duration, potentially lasting six months or more. By comparison, inpatient programs are often offered by facilities with much more clinical and hospital-like environments in which the patient receives treatment for one to three months.
Simply put, there is often more to a residential program than just medical stabilization for the earliest stages of recover. Residential programs often don’t need to provide intensive medical care throughout the entire stay because there’s less need for that type of care during the later stages of treatment.5 In fact, the curriculum of a residential program typically consists of a comprehensive array of elements that treat the body and the mind, such as counseling, group therapy, psychoeducational sessions and possibly some holistic treatments, too.
There’s a key reason why distinguishing between residential and inpatient care is so important, which leads to our final difference between these two types of treatment. In Georgia, there’s stricter monitoring and regulations for inpatient care than residential since residential programs aren’t offered in licensed hospitals.6 To be clear, these residential programs carry all the necessary licensing for substance abuse treatment, but they lack the accreditation to offer the type of medical care that’s available from hospitals and inpatient programs.
How Are Residential and Inpatient Care Used?
As you can see, there are some distinct differences between residential and inpatient care. The latter is often a more intensive, shorter-term form of care while residential is longer-term and offers more than just intensive medical care. Due to these differences, each type of treatment has specific applications in recovery.
When an addict or alcoholic completes the detoxification phase of recovery, he or she will likely continue with inpatient or residential care. While detoxification helps to rid the body of alcohol and drugs, inpatient and comprehensive residential treatment options can accommodate the physical and psychological needs patients have in the next stages of recovery. Residential care can also serve as a follow-up to inpatient care. After achieving medical stability and establishing a foundation in recovery, patients can transition from inpatient care to a residential program, allowing them to shift focus to mastering the skills of recovery.
Sources1. https://www.merriam-webster.com/dictionary/residential2. https://www.merriam-webster.com/dictionary/residence3. https://dch.georgia.gov/sites/dch.georgia.gov/files/111-8-19%20Final%20Rule%20Eff%209.29.pdf4. http://www.socialworktoday.com/archive/031912p8.shtml5. https://www.nationaleatingdisorders.org/treatment-settings-and-levels-care6. https://dbhdd.georgia.gov/sites/dbhdd.georgia.gov/files/related_files/site_page/ADresource%20oolKit2016.pdfWritten by Dane O’Leary