Understanding Levels of Care in Addiction Treatment

There are different levels of care in addiction treatment, ranging from levels 1-4. These levels have been created by the American Society of Addiction Medicine, or the ASAM. Levels help to differentiate and clarify the level of services provided. If you or a loved one are considering treatment for a substance use disorder, an assessment of needs will be conducted to understand which level of care would be most beneficial. Understanding levels of care in addiction treatment helps individuals make sense of the services they will be provided.

What Are Levels of Care in Addiction Treatment?

Levels of care in addiction treatment are categorized by intensity of services. 

Based on the ASAM’s categorization of care, they are:

  • Level 1: Lowest level of intensity and has the lowest commitment in terms of time. 
  • Level 2: An intensive outpatient program, which requires more hours weekly than an outpatient program, but still offers participants the ability to reside at home. 
  • Level 3: A residential treatment program where someone lives in a treatment facility but is not acutely withdrawing from a substance.  
  • Level 4: Inpatient level of care. Where an individual receives round-the-clock medical support. 

Level of care can and will likely shift over time as you or a loved one make progress towards long-term recovery. There is nothing wrong with receiving a high level of care. Why? Because you are receiving the level of services that will best prepare you for meeting your recovery goals.

Continuum of Care

While you or a loved one may begin the recovery journey at a specific level of care, you’re able to participate in a “continuum of care.” This means you can continue receiving treatment as your needs change over time. You might enter a treatment facility receiving inpatient services, but you can eventually transition to a residential program and then to an intensive outpatient program. 

The continuum of care ensures you’re able to safely move from one level of care to the next based on your progress and needs. Any habits or awareness you gain will inform the following level of care you receive. You or a loved one will continue to build a foundation of strength, self-awareness, and more.

Levels of Care and Their Time Commitments

Each level of care requires different time commitments. Level 1 requires the lowest level of time commitment, while level 4 is the most intense and requires 24-hour care. Time commitments are an important factor to consider when you and a specialist determine which level of care is best for you.

Recovery Residence

Recovery residences allow people to live in a community with others who are in recovery. Recovery residences are also commonly called sober living houses or halfway houses. Living at a recovery residence may be where someone lives while receiving outpatient support or while participating in an intensive outpatient program. 

As outpatient support and IOPs are categorized as level 1 or 2, those living in recovery residences are not receiving the intensity of care of a residential or inpatient treatment. However, it is beneficial to live with others who have a shared goal of long-term recovery. Many say that recovery residences help to promote a sense of community through shared living experiences. Similarly, you’re able to access support and accountability by sharing common lifestyle goals.

Level 1. Outpatient

Based on the ASAM, Level 1, or outpatient treatment, is the least intense level of care. On average, these programs require a commitment of 6 hours per week. 

While someone may have begun their recovery journey at level 4, outpatient programs are the least restrictive. You live at home and may be balancing a full-time job.

Level 1 may involve weekly “check ins” or appointments with professionals that have familiarity in treating substance-use disorders. Some of these services may include cognitive behavioral therapy (CBT), which helps people make sense of their thoughts and behaviors. Many who participate in outpatient care attend support groups.

Level 2. Intensive Outpatient Program

Level 2 represents intensive outpatient programs, commonly referred to as IOPs. Intensive outpatient programs are similar to outpatient programs in that they are non-residential. However, intensive outpatient programs require more hourly commitment per week than outpatient programs. Intensive outpatient programs typically require 6 hours of participation daily, though this varies across programs. 

You or a loved one may move to an IOP after being in a residential treatment center. IOPs often include group therapy, support groups, and other therapies that help promote long-term recovery. IOPs provide a strong balance between living at home and frequent programming to support substance abuse disorders. Like all levels of care, some focus can be dedicated to treating mental health disorders.

Level 3. Residential

Residential care, or level 3, requires someone to live at a hospital, clinic, or other treatment facility. During this time, participants will have highly structured days, ranging from therapy sessions to activities that support recovery. The average time commitment of a residential program ranges from 30-90 days. 

According to the ASAM, there are different levels of care that one may receive within residential programs. These levels are 3.1, 3.5 and 3.7. Similar to levels 1-4, the higher the number, the higher the intensity of care. 

Level 3.1 is “clinically managed low-intensity residential”. Level 3.5 is “clinically managed high-intensity residential”. Level 3.7 is “medically managed residential.” These levels differentiate when an individual may need support with additional health complications, such as mental health disorders. 

Level 4. Inpatient

Inpatient is the most intense level of care provided for individuals. At this level, active intoxication and/or withdrawal potential leads to needing a high level of supervision. Withdrawal can create medical risks that should be managed by medical professions.

Why Does Time Commitment Matter in Choosing a Treatment Program?

It is important to consider time commitment in choosing a treatment program. While some individuals might want to accelerate their recovery, the best habits are built when you’re receiving care that matches where you’re in your recovery journey. While it may not be preferable for some individuals to enter an inpatient program, the intensity of care promotes the longevity of recovery. That said, your recovery is wholly dependent on your own goals. You should consider the value of investing in the level of care that is optimal for where you are in your recovery.

IHAT: A Flexible Alternative to Traditional Levels of Care

While some treatment programs may be rigid in their approach to treating substance abuse, IHAT works with you to customize a unique treatment plan. We prioritize convenience, privacy and flexibility. Some individuals have not found success in residential programs. It is important to consider alternatives as you navigate your unique journey to recovery. Aware is an excellent option for those who are curious about receiving substance abuse treatment from the comfort of their own home. By receiving treatment at home, you are able to maintain aspects of comfort and familiarity. With a completion rate that is 2.5 times that of traditional rehab, many people benefit from the approach that we offer.

Next Steps

Aware Recovery Care is an excellent resource for recovery. We provide support with alcohol, opioids, and other substances. If you are interested in speaking to our team of knowledgeable professionals, visit our contact page