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Sub-Acute Care: Is This a Solution for Your Recovery?

September 14, 2016 - - 0 Comments

Drug Rehab

There are a wide variety of services available to substance use abusers whether their means of abuse is alcohol or drugs.  In general, recovery services are in two parts,

  1. Withdrawal
  2. Ongoing treatment via counseling, group therapy, and/or medication

For purposes of this post, the type of treatment under review is the treatment for withdrawal for substance abuse patients.

What is Substance Abuse Withdrawal?

Detoxification can be physically and emotionally draining.  It is a necessary process for anyone with a substance abuse diagnosis to undertake.  There are a number of kinds of detoxification, but in general, when used in the framework of addiction medicine, the term means:

A series of processes designed to assist those in the first stage of sobriety, to want to stop using unhealthy substances.  Done without help, most folks who try and “go cold-turkey” find they cannot get to sobriety or they cannot keep it up.  A well-thought out detox program means removing blockades and impediments to the detoxification process.

According to the American Association of Addictive Medicine, withdrawal brings on some or most of the following side effects:

  1. Anxiety, irritability, agitation, restlessness;
  2. Nausea, vomiting, lack of appetite;
  3. Elevated heart rate, rapid pulse, and shakiness;
  4. Nightmares, intense dreams, and insomnia;
  5. Poor judgment, impaired memory, and lack of concentration
  6. Heightened awareness of light, sound, and touch
  7. Hallucinations –  light, sound, and touch
  8. Feeling of paranoia such as those of the paranoid or persecutory types; and
  9. Seizures

What Options Are There for Detoxification?

With the likelihood of detoxification side effects, that depend on the amount and the length of time a substance abuser used alcohol, illegal drugs, and prescription medication, it is no wonder that there is a need for supervised withdrawal.  Thanks to the Affordable Care Act and other legislation, substance abuse is treated as any other medical illness.  Accordingly, if you have insurance, you are covered for some form of detoxification and support.  The amount of coverage is reduced by deductibles and copays if applicable.

The American Association of Addictive Medicine notes there are several choices for detoxification, they include the following:

  • Level I-D: Ambulatory Detoxification without Extended Onsite Monitoring (e.g., physician’s office, home health care agency).  This level of care is an organized outpatient service monitored at predetermined intervals.
  • Level II-D: Ambulatory Detoxification with Extended Onsite Monitoring (e.g., day hospital service).  This level of care is monitored by appropriately credentialed and licensed nurses.
  • Level III.2-D: Clinically Managed Residential Detoxification (e.g., non-medical or social detoxification setting).  This level emphasizes peer and social support and is intended for patients whose intoxication and/or withdrawal is sufficient to warrant 24-hour support.
  • Level III.7-D: Medically Monitored Inpatient Detoxification (e.g., freestanding detoxification center).  Unlike Level III.2.D, this level provides 24-hour medically supervised detoxification services.
  • Level IV-D: Medically Managed Intensive Inpatient Detoxification (e.g., psychiatric hospital inpatient center).  This level provides 24-hour care in an acute care inpatient setting.

Level II and level III patients benefit the most from some sort of inpatient or residential care.  Following successful completion of withdrawal, a patient can be followed as an outpatient, a resident, or as an inpatient.  For those electing to keep up their sobriety as an outpatient, the situation is called sub-acute care when coupled with a residential or medical facility supervision for detox.

The Centers for Medicare and Medicaid describe subacute detoxification as medically supervised care provided in a residential sub-acute setting to manage the debilitating physical and emotional effects of withdrawal from alcohol and/or other drugs.  It is common for folks suffering from substance abuse to abuse more than one substance at a time.  Frequently, alcohol abusers also abuse other drugs such as opiates.

To qualify for the designation as a sub-acute care facility rendering withdrawal services the organization must:

  • Provide individual planned individual and group counseling sessions;
  • Be staffed 24 hours per day, 7 days per week;
  • Be supervised by a licensed physician or his/her designee; and
  • Services offered to patients be for 3 to 5 days.


His and Her Houses offers industry leading Sub-Acute treatment programs. We were founded in 1994 and we base our programs on five key principles: commitment, honesty, integrity, respect, and service. These five principles guide us in all that we do and all the care we provide. Contact us today to see how we can help you or your love one at (888) 376-7268.

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