Inpatient Prescription Drug Rehab: What to Expect

Over the last two decades in the United States, prescription drug use and misuse increased by more than 250%, with over 2 million people having an addiction to prescription drugs.¹ It is common for those with substance use disorders to not seek help, but when they do, they more frequently seek out self-help groups such as a 12-step program.¹ However, 12-step programs like Narcotics Anonymous (NA) are no substitute for formal addiction treatment. An inpatient prescription drug rehab can provide you with the support, structure, and treatment you need to quit using prescription drugs and live a substance-free life.

In this article:

• What is the Inpatient Process for Prescription Drug Addiction?
• Who is a Candidate for Inpatient Prescription Drug Rehab?
• How to Find Inpatient Prescription Drug Rehab

What is the Inpatient Process for Prescription Drug Addiction?

Inpatient prescription drug rehab involves living at the facility for the duration of your treatment program, which may last 30, 60, or 90 days, depending on your needs.

The process begins with an intake assessment, often leading to medical detox and then your addiction treatment plan in a facility before concluding with aftercare.

Intake Assessment

A mental health professional or certified drug and alcohol counselor will typically conduct an intake assessment to guide your treatment planning. The professional will use the American Society of Addiction Medicine (ASAM) criteria software, a structured computer-based interview, which evaluates biopsychosocial factors that influenced the development of your prescription drug addiction.²

The assessment will evaluate:

• Your prescription drug use
• Your mental health
• Your physical health
• Your withdrawal risk
• Your family history of drug and alcohol use
• Your family history of mental illness
• Sociological factors like support system

Contextually, they phrase the questions to match each client’s substance of choice—in this case, prescription medications—and assess the medical and psychiatric needs that often underlie prescription medication misuse such as stimulants to manage attention-deficit/hyperactivity disorder (ADHD) and narcolepsy; sedatives (CNS) for anxiety, panic disorders, and sleep disorders; and opioids for pain, coughing, and diarrhea.^3,4,5

Your treatment plan for inpatient prescription drug rehab is also dependent on the information you disclose regarding your experienced level of impairment, social functioning, substance use, and symptoms.² Inclusionary criteria examine whether you are currently intoxicated, as well as other factors, such as:²

• Periods of sobriety and their duration
• Method of use (e.g., intravenous, snorting, huffing, or oral consumption)
• Frequency of use
• Dosage
• Immediate medical needs

Once the evaluation is complete, your treatment provider will collaborate with you and the rest of the treatment team to create an individualized treatment plan that meets your needs and situation. If they determine that you need to first start with detoxification, which is part of the continuum of care but is not a standalone treatment, you can expect to hear the term medical detox.⁶

Assessment is ongoing, so adjustments to your treatment plan can be made to help you be successful.

Detoxification

Detoxification, or detox, is part of the continuum of care specific to substance use disorders. It includes a set of interventions designed to treat acute intoxication and withdrawal to prevent what would otherwise be life-threatening complications if left untreated.⁷ Detox for prescription drug addiction involves three parts:^6,7

• Evaluation: This part of the process aims to answer these questions: Are there still traces of the substance in your bloodstream? How concentrated is it? Are there any physical or mental health concerns that also need to be addressed?
• Stabilization: Here a series of medical and psychosocial interventions are employed to help you get through acute withdrawals until you are substance-free and medically stable.
• Preparation for treatment: The assessor will help familiarize you with the process, what to expect, and discuss how the milieu contributes to your recovery.

Sedative Withdrawal

One category of prescription medication that is often misused is central nervous system (CNS) depressants, which include benzodiazepines, non-benzodiazepines (e.g., Ambien), and barbiturates.³ Because of the potency of these medications, the symptoms of withdrawal fall into the category of complex and would qualify you for detox and then inpatient treatment:³

• Seizures
• Overactive reflexes
• Shakiness
• Agitation
• Anxiety
• Insomnia
• Hallucination
• Severe cravings
• Increased heart rate, blood pressure, and temperature with sweating

Opioid Withdrawal

Another category of prescription medication that is often misused is opioids, which are used to manage pain. Some extreme withdrawal symptoms that would need to be addressed during detox may include:⁴

• Sleep problems
• Cold flashes with goosebumps
• Muscle and bone pain
• Diarrhea and vomiting
• Uncontrollable leg movements
• Severe cravings

Prescription Stimulant Withdrawal

A third category of prescription medication that is misused is stimulants, which are used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy.⁵ Stimulants increase energy, attention, and alertness. Withdrawal symptoms can include:⁵

• Fatigue
• Depression
• Sleep problems

After detox, you will then transition to another facility for treatment if the detox center does not also have a treatment center.

Addiction Treatment Plan

Inpatient prescription drug rehab is similar to inpatient treatment environments for other substances, in that it involves a myriad of behavioral therapies and psychotherapy, as well as medication, if applicable.^3,4,5

Every inpatient prescription drug rehab has a slightly different treatment approach and philosophy; however, you can expect your treatment plan for prescription drug addiction to include the following:

• Individual therapy
• Group counseling
• Family therapy
• Peer support groups
• Drug education classes
• Vocational training
• Medication management

There are no FDA-approved medications for stimulant or sedative addiction; however, there are FDA-approved medications for the treatment of opioid addiction. These medications include:⁴

• Methadone: A full opioid agonist that relieves withdrawal symptoms and cravings and reduces the risk of relapse
• Buprenorphine: A partial opioid agonist that reduces cravings and withdrawal symptoms without causing a high
• Suboxone (buprenorphine/naloxone): A combination formula that alleviates withdrawal symptoms and cravings and discourages medication misuse because the addition of naloxone will cause someone to go into withdrawal if they inject it

Aftercare Planning

As you near the end of your inpatient prescription drug rehab, staff will begin your discharge planning, which includes aftercare. Aftercare happens after inpatient treatment and provides you with the opportunity to integrate what you learned in treatment as well as continue counseling, refining coping skills to manage triggers to relapse, and reengaging in behaviors of daily life.⁸

Aftercare can take the form of:⁷

• Making and maintaining a structured routine
• Establishing, identifying, and maintaining boundaries
• Continuing participation in self-help groups
• Finding or maintaining a sponsor
• Enrolling in groups that are more specific to other problem areas that were identified while you were in treatment (e.g., co-dependence, parenting classes, domestic violence classes)
• Addressing any legal issues (e.g., requirements of probation, restitution, meetings with Child and Family Services)
• Ongoing individual therapy
• Group counseling
• Sober living homes
• Step-down care at a partial hospitalization program

An integral part of aftercare is also continuing to compile your own list of contributing factors to relapse. A 2021 study found that the following factors may contribute to relapse:⁹

• Peer pressure
• Parental status
• Number of substances, peer group influences, stressful events, family conflict
• Type of accessibility
• Amount of substances used
• Psychological stress
• Hospitalization
• Hospitalization time

Who is a Candidate for Inpatient Prescription Drug Rehab?

Not everyone is a good candidate for inpatient prescription drug rehab, in which case, outpatient is an option. If your withdrawal symptoms are not complex, you will likely be a better fit for outpatient treatment. Conversely, if you have a history of complex withdrawals that trigger psychiatric symptoms, delirium tremens, or seizures, then you will be referred to inpatient.⁷

Additionally, if you have a psychiatric illness that includes severe symptomatology such as suicidality or homicidality, you may need inpatient care.⁷ If you have an underlying medical condition that either has not been addressed or is a contributing factor to your prescription medication addiction, then you may be a good candidate for inpatient treatment. Lastly, a significant contributing factor to whether you will be a good fit for inpatient prescription drug rehab will be your ability and willingness to adhere to treatment recommendations.⁷

Remember, it may be wise to first loosely determine if you or someone you know is needing intensive around-the-clock services to help manage withdrawals or if medical attention or psychiatric attention is needed for a co-occurring disorder.¹⁰

How to Find Inpatient Prescription Drug Rehab

If you need help finding an inpatient prescription drug rehab program for yourself or someone else, give us a call at 800-908-4823 (Who Answers?) . One of our compassionate and knowledgeable treatment support specialists is available 24/7 to assist you. Recovery is just a phone call away.

Resources

1. McHugh, R. K., Nielsen, S., & Weiss, R. D. (2015). Prescription Drug Abuse: From Epidemiology to Public Policy. Journal of Substance Abuse Treatment, 48(1), 1-7.
2. Stallvik, M., Gastfriend, D.R., & Nordahl, H.M. (2015). Matching Patients with Substance Use Disorder to Optimal Level of Care with the ASAM Criteria Software. Journal of Substance Use, 20(6), 389-398.
3. Institute on Drug Abuse. (2018). What are Prescription CNS Depressants?
4. National Institute on Drug Abuse. (2021). What are Prescription Opioids?
5. National Institute on Drug Abuse. (2018). What are Prescription Stimulants?
6. Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). MAT Medications, Counseling, and Related Conditions.
7. Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Detoxification and Substance Abuse Treatment.
8. Carvalho A.F., Heilig M., Perez A., Probst C., & Rehm J. (2019). Alcohol Use Disorders. The Lancet; 394(10200), 781-792.
9. Kabisa, E., Biracyaza, E., Habagusenga, J.d. & UmUbyeyi, A. (2021). Determinants and Prevalence of Relapse Among Patients with Substance Use Disorders: Case of Icyizere Psychotherapeutic Centre. Substance Abuse Treatment, Prevention, and Policy, 16(13), 1-12.
10. U.S. Department of Health and Human Services. (2016). Facing Addiction in America.