Answers to the questions we hear most

No. They are different amounts of structure, not different grades of quality. More hours help when symptoms, withdrawal risk, or an unstable home environment need closer monitoring; fewer hours help when a person needs room to practice recovery in real life. The goal is the least restrictive level of care that can reasonably support progress.

From PHP, IOP, or outpatient: how a level of care is chosen

Ranges vary by program, state rules, and health plan. As a general reference point, SAMHSA describes intensive outpatient programs as involving a minimum of about 9 hours of services per week for adults, partial hospitalization as a step above that, and standard outpatient as less than 9 hours. Your actual schedule is set in your treatment plan.

From PHP, IOP, or outpatient: how a level of care is chosen

A licensed clinician does, using a structured multidimensional assessment that looks at withdrawal risk, medical and psychiatric status, readiness for change, relapse risk, and your living environment. Your input is part of that assessment, and your insurance plan may also review the recommendation.

From PHP, IOP, or outpatient: how a level of care is chosen

Yes, and it usually does. Levels of care are meant to step down as stability grows, or step up if symptoms intensify. Reassessment during treatment is a normal part of the process, not a sign of failure.

From PHP, IOP, or outpatient: how a level of care is chosen

Not necessarily. Some people need medically monitored withdrawal management or a 24-hour setting first; many do not. Withdrawal management by itself is also not the same as treatment, so it is normally followed by ongoing outpatient care.

From PHP, IOP, or outpatient: how a level of care is chosen

Schedules differ by program and by treatment plan. SAMHSA describes intensive outpatient care as generally a minimum of about 9 hours of services per week for adults, often arranged as three-hour blocks across three or more days, with day, evening, or weekend options so people can keep working or caring for family.

From What actually happens in an intensive outpatient week

Group work is the primary modality in most intensive outpatient programs, but a week normally also includes individual counseling — typically about once a week or as needed — plus case management, family psychoeducation where appropriate, and medication management if a prescriber is involved in your care.

From What actually happens in an intensive outpatient week

Not on day one. Groups are a mix of psychoeducation, skills practice, and process work, and participation usually builds over the first week or two. Telling the facilitator you would rather listen at first is a reasonable request, not a problem.

From What actually happens in an intensive outpatient week

Programs are expected to have crisis policies covering hours when the building is closed. Ask specifically how after-hours contact works before you enroll. For emergencies, 988 is available 24/7, and 911 is the right call if someone is in immediate danger.

From What actually happens in an intensive outpatient week

It varies with progress rather than a fixed calendar. For context, SAMHSA reported a median length of stay of 81 days among adults who completed intensive outpatient treatment in 2017 discharge data. Many people then step down to less intensive outpatient care.

From What actually happens in an intensive outpatient week

Most programs use some form of monitoring, and it is used clinically rather than punitively — a positive test is information that the plan needs adjusting. Ask how results are handled, who sees them, and what happens after a return to use.

From What actually happens in an intensive outpatient week

It means a person has both a substance use disorder and another mental health condition at the same time — most often anxiety, depression, PTSD, a psychotic disorder, or a personality disorder. Clinicians usually call this co-occurring disorders.

From Dual diagnosis: why substance use and mental health are treated together

Common enough that programs plan for it. NIDA reports that according to the 2023 National Survey on Drug Use and Health, 35% of U.S. adults aged 18 and over who have another mental disorder also have a substance use disorder.

From Dual diagnosis: why substance use and mental health are treated together

Sequencing care that way is not what the research supports. NIDA states that it is usually better to treat co-occurring conditions at the same time rather than separately, and that integrated treatment leads to better health outcomes.

From Dual diagnosis: why substance use and mental health are treated together

Sometimes only over time. Symptoms overlap, and substances can both mask and mimic psychiatric conditions, which is why comprehensive assessment tools are used and why diagnoses are revisited as the picture clears rather than fixed at intake.

From Dual diagnosis: why substance use and mental health are treated together

Medication decisions belong to a prescriber who knows your full history, so bring your current medication list to your assessment. Do not stop a prescribed psychiatric medication on your own; talk to the prescriber first.

From Dual diagnosis: why substance use and mental health are treated together

MAT stands for medication-assisted treatment. You will also see medications for opioid use disorder (MOUD), medications for alcohol use disorder, and medications for addiction treatment (MAT) used by federal and state agencies. They all describe the same idea: FDA-approved medication combined with counseling and behavioral therapy.

From Medication-assisted treatment explained — what MAT is and is not

For opioid use disorder, the FDA-approved medications most commonly used are buprenorphine, methadone, and naltrexone. For alcohol use disorder, the most common are acamprosate, disulfiram, and naltrexone. Extended-release injectable naltrexone is approved for both.

From Medication-assisted treatment explained — what MAT is and is not

No. SAMHSA describes these medications as normalizing brain chemistry — blocking the euphoric effects of opioids and alcohol, relieving physiological cravings, and restoring normal body functions — as part of a whole-patient approach that includes counseling.

From Medication-assisted treatment explained — what MAT is and is not

There is no universal answer. SAMHSA notes these medications are safe for long-term use, from months to a lifetime, and advises consulting your doctor before stopping. Stopping is a clinical decision made with a prescriber, not a milestone you are expected to hit.

From Medication-assisted treatment explained — what MAT is and is not

Not currently. NIDA states that no medications are yet available to treat stimulant or cannabis use disorders, so treatment for those relies on behavioral therapies.

From Medication-assisted treatment explained — what MAT is and is not

Naloxone and nalmefene are FDA-approved opioid overdose reversal medications that reverse the toxic effects of an overdose. Many households affected by opioid use keep naloxone on hand; ask a prescriber or pharmacist how to obtain and use it.

From Medication-assisted treatment explained — what MAT is and is not

Only with their written permission. Substance use treatment records carry heightened federal confidentiality protection under 42 CFR Part 2 in addition to HIPAA, so a program cannot confirm or discuss someone's care without a valid release of information signed by the client.

From How families can help without taking over

It is education for families about substance use disorders, patterns and consequences of use, family dynamics, and how treatment and recovery work. SAMHSA lists family psychoeducation among the core services of intensive outpatient programs, and engaging families as the client defines them is a standard program goal.

From How families can help without taking over

Treat it as clinical information rather than betrayal. NIDA notes that relapse rates for substance use are similar to those for other chronic illnesses, and that a return to use means treatment needs to be resumed or adjusted — not that it failed. Encourage contact with the treatment team promptly, because overdose risk is elevated after a period of not using.

From How families can help without taking over

Surveillance tends to shift the relationship into policing, which usually costs trust without improving safety. If you are worried about immediate danger, that concern belongs with the treatment team or a crisis line rather than a search. Safety planning is a reasonable thing to ask the program about.

From How families can help without taking over

The SAMHSA National Helpline, at 1-800-662-4357, provides free, confidential referral and information 24/7, including for family members. Many programs also offer family groups, and mutual-support groups for families exist in most communities.

From How families can help without taking over

No. Limits you can actually keep — about money, driving, or substances in the home — tend to reduce conflict rather than create it. The distinction that matters is between a limit on your own participation and an attempt to control another adult's behavior.

From How families can help without taking over

The California Department of Health Care Services has sole authority to certify and monitor outpatient alcohol or other drug programs — substance use disorder treatment programs offering treatment, recovery, detoxification, or medications for addiction treatment. Certified programs must comply with DHCS's Certification for Alcohol and Other Drug Programs requirements.

From What DHCS certification and Joint Commission accreditation actually mean

No. Certification is renewed on a two-year cycle. Providers must submit a renewal application with biennial fees at least 90 days before their certification expires, and failure to do so results in automatic termination at the end of the two-year period.

From What DHCS certification and Joint Commission accreditation actually mean

Certification is state oversight under California law. Joint Commission accreditation is voluntary review by an independent, nonprofit accreditor, awarded after an on-site survey against published behavioral health care standards. A program can hold one, both, or neither.

From What DHCS certification and Joint Commission accreditation actually mean

DHCS maintains directories of licensed and certified facilities and programs, and its Licensing and Certification Division investigates complaints against California alcohol and other drug programs. You can also ask any program directly for its certification number and accreditation details.

From What DHCS certification and Joint Commission accreditation actually mean

No credential guarantees an individual outcome. What they establish is that a program has been reviewed against external standards for staffing, clinical services, documentation, client rights, and environment — and that it remains subject to ongoing oversight.

From What DHCS certification and Joint Commission accreditation actually mean

Yes. Program certification is separate from individual credentialing. Therapists and medical providers are licensed by their own California boards, and registered or certified alcohol and other drug counselors fall under DHCS oversight — the state's complaint process covers counselors as well as programs.

From What DHCS certification and Joint Commission accreditation actually mean