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Intensive Outpatient Program (IOP)

Treatment for substance use disorders will commonly be individualized with a range of patient considerations in mind—including each person’s unique set of risks, strengths, needs, and recovery goals.1 Patients and treatment providers may work together to evaluate these fundamental elements when deciding on the most appropriate starting level of care, while additionally allowing for later adjustments to care as recovery progress is made. There may be several types of substance use disorder treatment available throughout the country, with varying levels of support based on the intensity of the need and the circumstances of the patient.1

Intensive outpatient programs (IOPs) are one form of intensive substance use disorder treatment and, for some people, may be a viable treatment alternative to inpatient or residential services.2 As their name indicates, IOPs are conducted in an outpatient treatment setting, and are generally recommended for individuals who do not require medical detox or 24–hour supervision.2 This article will explore how IOPs work, who is likely to benefit from them, what to expect when entering an IOP, and how to find an intensive outpatient treatment for yourself or a loved one.

What Is an Intensive Outpatient Program?

Though they may involve similar therapeutic approaches, intensive outpatient addiction treatment programs are relatively more time intensive than more traditional outpatient drug treatment, though less so than inpatient or residential drug treatment programs, where patients receive 24–hour support and services.2 IOP programs generally comprise of at least 9 hours of services spread over at least 3 days per week.3

IOPs address substance use disorder issues while not letting go of some of the responsibilities that a patient might have, such as career or family responsibilities that might need to be put aside in order to enter a residential treatment program.2

Intensive outpatient programs can be cost-effective, which may allow people to stay at this level of care longer, allowing patients to gain more stability due to less substance misuse and greater social interaction.3 IOPs help patients develop support systems, adopt a new lifestyle, address problems, and learn how to solve them as they navigate day-to-day situations.3

Intensive outpatient treatment programming can take place in many settings, including hospitals, rehab campuses, community centers, and any other setting that is licensed by the state to provide these services.3 While some IOP settings facilitate access to a broader range of services than others, any intensive outpatient program can be viewed as part of a spectrum of care levels, with individuals potentially benefiting from a variety of services along their recovery journeys.

IOP and the Continuum of Care

The continuum of addiction care consists of 5 levels of treatment. According to the American Society of Addiction Medicine (ASAM), these levels are:1

  1. Prevention or early intervention.
  2. Outpatient.
  3. Intensive outpatient or partial hospitalization.
  4. Residential or inpatient.
  5. Intensive inpatient.

Intensive outpatient substance use disorder programs can function as an entry point into the continuum of care, a step-up program if a patient needs a more intense level of care, and a step-down program when they meet their treatment goals and objectives in higher levels of care.3 In such circumstances, intensive outpatient care providers can help the patient find a suitable residential facility and arrange for a smooth transition between these levels of care.3

Who Benefits from an IOP Program?

An IOP can serve a broad range of people since it may be relatively shorter in the duration of weekly services it provides, more cost-effective and, as an outpatient program, avail more flexibility than inpatient or residential addiction treatment programs.3

An IOP can be very effective for individuals who are stepping down from a higher level of care or have relatively less severe substance use related health issues and/or barriers to successful recovery but still need more support than the weekly sessions often provided in outpatient treatment.3

An IOP will not likely be a suitable level for those at risk of severe withdrawal or withdrawal complications, as well as those experiencing acute psychiatric symptoms, including suicidality (any immediate threat to the client’s safety might be an indication that the patient needs a higher level of care).3 Other factors, such as readiness to change or a lack of stability in the living situation, might also be contributing factors for a client to be placed in a higher level of care.3

Intensive outpatient is a level of care most suited for people who can progress in their recovery outside of a controlled environment by relying on the support of the groups, counseling, and community provided through participation in an IOP.3

What to Expect in an IOP

Intensive outpatient therapeutic interventions are often very similar to the range of clinical services provided in other levels of care, and may include medication management, family therapy, group therapy, and individual therapy.3 Services involved in each person’s plan are determined through assessment with a clinician and are delivered within the expected 9 hours of treatment each week. Treatment can be delivered more frequently based on the client’s needs.3

There are many types of groups in most IOP programs. Some are educational, and others are process-oriented, where patients can obtain the support that they need from the group by processing through issues that come up in their lives.3 Patients work to accomplish goals throughout their time in an IOP. This leads to more confidence in their ability to maintain recovery independent of treatment.3

How to Begin IOP Treatment

Determination of what level of care a patient can and should go into may include a discussion with a doctor, addiction specialist, therapist, or other licensed professional through the use of ASAM criteria and diagnosis using the Diagnostic and Statistical Manual of Mental Disorders (DSM 5).1 The decision to seek out any form of addiction treatment takes a significant amount of courage and humility. Many people are eager to help guide you in this process.

American Addiction Centers (AAC) offers IOP program options. You may also have questions about the cost of this kind of treatment and whether it is covered by your health insurance. Paying for this type of outpatient substance abuse treatment may be much more manageable than you might think. Find information about your insurance coverage instantly, or contact an admissions navigator at .

Frequently Asked Questions

1. Does insurance cover intensive outpatient programs?

Intensive outpatient treatment programs have been found to be effective means of reducing costs for healthcare payers.4 

2. Can you work while in an intensive outpatient program?

Due to the programming requirement of 9 hours per week and the independent living situation of many people seeking IOP treatment, it may be possible to work, continue going to school, or meet other commitments outside of treatment hours. However, this may vary from program to program and from person to person.3 Many individuals find that working while in an IOP may help manage real-time issues related to triggers at work and resolve them with the help of supportive IOP counselors and staff.3

3. How effective are intensive outpatient programs?

For some, IOP programs can be just as effective as residential programs in addressing their needs for substance use recovery.2 However, these determinations should always be made with a healthcare provider, as people who have more intense substance misuse issues or are likely to have withdrawal symptoms may require residential, detoxification, or inpatient levels of care.3

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