When someone is in need of addiction treatment, it can be overwhelming and confusing, especially when many people don’t truly understand the differences in levels of care.  Substance use disorder is a disorder defined on a continuum that goes from mild to severe. And every person, through their individual substance misuse and circumstances, may qualify as meeting criteria for different levels of care as it relates to treatment.


Unfortunately, due to the nature of addiction, most people wait until they need a high level of care when seeking addiction treatment. In those circumstances, what the ideal continuum of care of addiction treatment would look like typically would be: detox and medical stabilization moving to a residential treatment or inpatient level of care, moving then to an extended care treatment model, then moving to an intensive outpatient (IOP) level of care, then moving to outpatient services. Some people may also move to a partial hospitalization (PHP) level of care rather than an IOP level of care if they are in need of more intensive clinical services and support. However, it is not always an ideal continuum that occurs, and many people are different and have different needs. However, regardless, it is important for people to understand the different levels of care that are available in addiction treatment and what each level of care actually means.



Detox, and medically monitored treatment, are for those people that need to be medically managed in an inpatient setting for withdrawal symptoms, withdrawal risks, medical issues, or emotional issues that require 24-hour medical monitoring and support. This level of care typically lasts between 4-to-14 days, depending on the individual situation and specific substances.


Residential Rehab or Inpatient Treatment

This level of care is the next step after detox, or often the initial access point to drug rehab if detox and medical stabilization aren’t necessary. This is often the traditional 28-day model of addiction treatment. This is a high-intensity or medium-intensity residential level of addiction treatment. Patients typically stay between two and six weeks, often in a campus-style or hospital style facility, with treatment occurring all day and 24-hour residential support.


Extended Care

The term extended care often means a number of things in addiction treatment. This is the level of care that often gets confusing for consumers, families, parents, spouses or loved ones. Extended care typically means a clinical level of care that is either a partial hospitalization (PHP) or intensive outpatient (IOP) clinical level of care that also has a housing or a living component. The confusion often occurs when providers promote their services as “residential” or “inpatient” when, in fact, that are not. Many providers actually house patients at traditional sober livings or recovery houses, which does not really equate to what is needed at this level of care. In an ideal setting, and what we believe extended care to be here at Maryland Addiction Recovery Center, extended care begins at a PHP level of care and includes a living component that is overseen by a staff of the treatment center or rehab that is integrated into the clinical and medical staff. It is a two-campus model (clinical campus and living campus) that allows for patients to begin learning life skills, applying skills learned in the clinical setting, beginning to incorporate more freedom and ability to learn how to live life in recovery. This model is meant to aid those to transition appropriately back to work, back to school, back to their family and relationships, and begin utilizing the tools the have learned in the residential or inpatient level of care.


Partial Hospitalization (PHP)

Partial hospitalization (PHP) is an outpatient level of care where a patient is in treatment basically for the full day. Sometimes this is called day treatment. This level of care does not include a living or housing component. Patients come to a clinical setting and receive therapy through group, individual, and family therapy (as well as sometimes other services) typically for 5-to-7 hours a day (schedules and times can vary between different rehab or treatment providers.)


Intensive Outpatient (IOP)

Intensive Outpatient (IOP treatment is, as mentioned in the name, also an outpatient level of care. While there are different approaches or schedules for IOP programs, most IOPs occur in group therapy settings and occur for a minimum of 9 clinical hours per week, but some IOP programs offer up to 18 or 20 hours of clinical services a week.



Outpatient can occur in different settings. This is typically the last step in a continuum, where a patient may attend a single group a week or possibly a group therapy session and an individual weekly therapy session. This level of care typically occurs when a patient is already living a productive life but requires or is in need of ongoing clinical meetings and support. It is less an addiction treatment program or a recovery program than it is ongoing support.


It is important for people to understand the different levels of care that occur in addiction treatment, and also understand that each level has ASAM criteria to be met. It is always important that if you or your loved one is in need of treatment for addiction or substance use disorder, that they outreach and set up an assessment or evaluation with a clinical professional that can make an accurate assessment, diagnosis, and referral to the appropriate level of care.


If you or someone you know needs help for addiction or co-occurring disorder issues, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive dual diagnosis addiction treatment in the Mid-Atlantic area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs. Please give us a call at (410) 773-0500 or email our team at info@marylandaddictionrecovery.com. For more information on all of our drug addiction, alcohol addiction and co-occurring disorder services and recovery resources, please visit our web site at marylandaddictionrecovery.com.