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A rehab primer

Detoxification. Sequestered 24-hour treatment with medication such as methadone for withdrawal symptoms. Once only done in a hospital, many stand-alone rehab centers now offer limited detox units. After stays of one day to a week, patients get referrals to post-detox treatment.

Inpatient.
Residential treatment where patients’ days are heavily structured with group therapy, chores, writing assignments and 12-step meetings. Others focus more on individual therapy. Staff are available 24 hours.

Therapeutic Communities.
Residential programs that last from three months to more than a year, placing an emphasis on learning to live in society by playing a role in the program’s “community.” Residents keep the community running by cooking, cleaning and filing paperwork. Heavy doses of group, family and individual therapy are included.

Standard outpatient.
Less than nine hours a week of a mix of individual and group therapy, while patients live at home and maintain a job or go to school. The programs vary widely but most administer drug tests and help patients find self-help groups. Some can prescribe and monitor drugs to stave off withdrawal.

Intensive outpatient.
Five days a week of individual and group therapy. Some programs exist for adolescents, but it is generally recommended for adults.

Two views.
-Insurance companies say inpatient care can be too intense and intrusive a step for most addicts. “In an outpatient setting . . . you’re comfortable in your own community, your recovery is stronger,” said Dr. Christopher Dennis, medical director for Value Options.
-Drug treatment advocates say young addicts are being set up to fail. “Particularly with young people, outpatient isn’t going to work,” said Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence. — MICHAEL AMON

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