How Long Should You Stay in Rehab?

What Is the Optimal Length of Time for Rehab?

While NIDA states that treatment should last at least 90 days, this doesn’t necessarily mean that you’ll be in an inpatient rehab program for three months. You might begin with an initial stay in a residential addiction treatment facility for a month and then transition to outpatient treatment for two months. 

Ideally, you should remain engaged in ongoing aftercare support, which may include weekly therapy sessions and ongoing peer support group participation, indefinitely. 

There isn’t a one-size-fits-all when it comes to treatment duration. The optimal length of stay will depend on your individual needs, your treatment goals, and how you progress in recovery. 

The consensus is that a longer time in addiction treatment leads to better long-term outcomes, including a higher chance of sustaining recovery.[2]

Factors Affecting the Length of Rehab

The recommended length of rehab is influenced by several factors, such as the following:

• Type of substance: Certain types of addictions may require more time in rehab because they involve medical detox or a stronger physical hold. For example, alcohol use disorder (AUD), opioid use disorder (OUD), and benzodiazepine use disorder all require medical detox, which involves medication and medical care during the withdrawal process to ensure safety.
• Severity of addiction: If you’ve had an addiction for a long time or used high doses of the drug in question, you will likely require more intensive treatment. More complex cases generally require more time in rehab.
• Personal circumstances: If a person has a strong home environment, with a safe place to live and supportive family members and friends, they are less likely to relapse. If someone doesn’t have access to a good support network, they should remain in rehab for longer, until they are more stable in their recovery.
• Level of care needed: Some people need around-the-clock support to get sober from substances like alcohol. Others don’t need such close monitoring.
• Presence of co-occurring disorders: Underlying mental health issues such as depression or post-traumatic stress disorder can complicate recovery and influence where treatment should be provided.
• Insurance coverage: Insurance coverage and financial resources influence the recommended length of treatment. Many people stay in rehab as long as it is at least partially covered by their insurance provider. Even then, there will still be some out-of-pocket costs.
• Physical health: People who need treatment for an underlying physical issue (such as anorexia) may need a different treatment setting than those who do not.
• Patient motivation: Someone who is committed to sobriety might succeed in outpatient care, while someone who isn’t sure might relapse in that setting.
• Treatment history: Treatment should always be individualized to meet each person’s needs, and treatment will change depending on the person’s progress in rehab. It’s common for recovery to follow a non-linear path that might involve relapses and setbacks along the way. Treatment plans will need to be adjusted accordingly and that can affect the overall timeline. While treatment duration may be lengthened if relapse occurs, it may also be shortened if the person finds stability and feels strong in their recovery more quickly than anticipated.

Does the Type of Substance Impact the Length of Rehab?

It can, particularly if a lengthier detox period is needed. Some drugs of abuse don’t result in physical dependence, so there isn’t a traditional physical withdrawal process. Adjusting to not abusing any drug does involve some withdrawal period, but that process can be more intense for certain types of substances, such as opioids, benzodiazepines, or alcohol.

Cases of poly-substance abuse can also involve more intense withdrawal and early recovery periods. Talk to your doctor about what to expect for your specific situation.[7]

How Does Insurance Coverage Affect Rehab Timelines?

Your particular plan will dictate the amount of coverage you have for addiction treatment, and plans vary greatly in terms of what is covered.[8-10] 

Typically, insurance plans offer coverage for a specific period of treatment like 30 days, a set number of treatment sessions, and a specific list of treatment services. Because there is such a wide variation in coverage, call your provider and ask them for details. The treatment provider you choose will also verify your insurance coverage beforehand and can outline any out-of-pocket costs you might expect. 

Insurance companies often require that you first attempt a lower form of treatment before approving a more intensive form. For example, your insurance company may first require that you attempt outpatient treatment without success before approving coverage for inpatient rehab. 

Talk to your treatment provider about how to maximize your insurance coverage to ensure you get the most robust treatment possible. Ask them to map out all expected out-of-pocket expenses, so you aren’t surprised down the road.

Understanding Treatment Duration: Inpatient vs. Outpatient

Several different types of addiction treatment programs exist, and they all work a little differently. This chart can help you understand the time commitment involved with each option, along with how long the programs typically last:[18]

The National Institute on Drug Abuse (NIDA) recommends that treatment programs change as the patient’s needs change.[19] That means people might cycle through many of these treatment formats as their recovery progresses.

Overall, the NIDA says most people need at least three months in treatment, and longer treatment times tend to produce the best results.[19] However, you may not spend all of your 90 days in the same setting. Your program should change as your needs change.

Success Rates & Recovery

In 2021, researchers published a study of addiction treatment efficacy in the journal Social Science and Medicine. They examined published data about treatment success rates based on the length of time the programs lasted. They found that people who had long-term treatment (lasting 90 days or longer) had a 23.9% greater chance of abstaining or consuming moderately than people who had shorter treatment programs.[20]

Treatment providers know that longer stays mean a higher chance of success. However, in articles they write for websites like Stat, they express frustration about how treatment works in the real world. One advocate says treatment programs often last 28 days or less per insurance rules.[21]

While treatment time frames matter, the method of care matters too. In a study published in 2020 in JAMA, researchers examined six different types of treatment for addiction. Of the six pathways they examined, only those that involved medications like buprenorphine or methadone came with a reduced risk of overdose.[22]

The Importance of Not Stopping Treatment Early

Relapse is more likely if you leave treatment before it’s finished. Studies repeatedly show that longer treatment durations are associated with better long-term outcomes, including lower relapse rates and higher rates of sustained recovery.[11-13]

Addiction is a chronic condition, and there is no cure.[14-17] While you’ll reach stability in recovery and effectively manage your substance use disorder, the potential for relapse is always present. Because of this, engagement in a long-term recovery plan is crucial.

This will look different for different people. It might involve therapy sessions twice a week initially, but as you get stronger in your recovery over time, this might decrease to weekly or even monthly sessions. 

Some people begin by attending peer support group meetings, like 12-step meetings every day. Eventually, they may scale this back somewhat, but some level of involvement remains important.

While there isn’t a set timeline of exactly how long you should stay in rehab, make sure you don’t exit treatment too early. Talk to your treatment team, including your doctors, about the ideal treatment duration for you and be ready to adjust as needed.