Levels of Care
LEVELS OF CAREEXPLAINED*
Treatment of patients with addictions, especially substance use disorders, relies on a broad array of treatment settings and providers. Because addiction can often involve so called “reachable moments” (i.e. moments when the person with an addiction is in a position to accept help), it is essential that providers, families and patients themselves are able to find the right treatment setting and care givers at the right moment.
Here we refer to these various settings as “levels of care” because care for substance use disorders ranges in level of intensity from outpatient to inpatient and everything in between. Please see below for a one line description of various levels of care. If you click on “read more” you can see an expanded description and in some places an FAQ for each level.
It is also important to be aware the appropriate pharmacotherapy (medication) is an increasingly important part of good care for substance use disorders and while not listed explicitly as part of each level of care below, it does indeed cut across all levels of care.
Finally, caregivers and patients should remember that the determination of the right level of care can be a complex process – if there is any uncertainty about the patient’s safety or the adequacy of a particular option, it is best to begin with a formal evaluation and assessment by a health care professional.
Levels of Care Informative Graphics
Considered the most intensive level of care, these facilities are generally for patients whose condition is the most severe or unstable. Daily nursing and physician contact along with 24 hour medical monitoring is included in the level of care for patients with severe withdrawal needs and/or other medical or psychiatric needs acutely complicating their addiction issues.
Emergency Room, Inpatient Detox, Inpatient Medical Unit with Detoxification, Inpatient “Dual Diagnosis” or Psychiatric Hospitalization with Detoxification
Considered the second most intensive level of care, these facilities are generally for patients who are medically stable but still require both daily support from counselors and other clinicians as well as a 24 hour supportive milieu to prevent relapse.
Acute residential including CSS, TSS, holding, private pay, and court mandated variants, Sober House or Recovery House, Halfway House or ¾ House
Professional treatment outside of inpatient or residential units in the community. Patients may come to outpatient treatment after an inpatient or residential treatment, or they may attend appointments while still in sober housing. Many others will enter outpatient treatment first and may never require a “higher level” of care.
Ambulatory Detox, Partial Hospital Program, Intensive Outpatient, Routine Outpatient care, Specialty addiction services including methadone and buprenorphine programs, Primary care offices
Community mutual help organizations (MHOs), historically referred to as self-help groups, are generally peer-lead groups whose members have lived experience with substance use problems or other addictions and offer various non-professional tools, strategies and resources to help newcomers maintain sobriety and develop their own recoveries.
Community Support, Mutual Help or “Self-Help” organizations, Other faith based mutual help, Natural recovery