Are Medications Prescribed at PHP for Substance Abuse Recovery?

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Partial hospitalization (PHP) is a high level of care in addiction treatment that is part of the American Society of Addiction Medicine’s (ASAM) continuum of care. However, it may be considered an in-between phase between very high levels of care and lower levels of care.

When you go through PHP, will you have access to doctors, medical professionals, and medications? What happens if you have medical needs when you’re going through treatment? Are there medications that can treat substance misuse problems directly? Learn more about the medications that are available in a PHP and how you can be treated medically in addiction treatment. 

What Is Partial Hospitalization?


A partial hospitalization program (PHP) is a level of care that falls under intensive outpatient treatment (IOP). IOP is defined by the fact that it offers more than nine hours of treatment services. However, unlike base-level IOP, partial hospitalization is much more intensive, with more than 20 hours of services each week. PHP is a level of care that’s available to people for various medical and psychological issues. 

It’s common in the treatment of mental health problems like severe depression, anxiety, or eating disorders. However, in the context of addiction, PHP can help those with medical and psychological needs that are severe enough to warrant high-level care but not so severe that they require 24-hour care.

PHP may be a step on the road to recovery from medically managed inpatient treatment to lower levels of care like outpatient treatment for a few hours a week. As you progress in treatment, you may go from high-level inpatient care to PHP. However, PHP may also be used to treat people who are moving in the other direction. They may have a substance use disorder or mental health problem that’s getting worse, and PHP is used to prevent the need for hospitalization. 

If you’re in PHP, treatment services will be similar to a part-time or full-time job. You’ll attend treatment services during the day and return home at night. You may attend various therapies, meet with psychiatrists, meet with medical doctors, talk to nutritionists, or work with case managers. Addiction treatment is complex, and it may involve treating issues related to physical, psychological, and social issues that are linked to your substance use problems. Treating substance misuse without addressing other issues like financial problems and mental health may be likely to lead to a relapse. 

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Are Doctors Present in PHP?

Yes. PHPs are the highest level of outpatient treatment, so people who enter these programs will have high-level needs. In some cases, these needs require medical doctors, psychiatrists, and other medical professionals. Inpatient treatment offers the most comprehensive medical treatment and hands-on medically managed services. However, high-level outpatient treatment like PHP may also involve medical treatment and monitoring. When you go enter a PHP, you may meet with a doctor to discuss ongoing medical issues directly or indirectly related to addiction. 

Addiction is often associated with medical needs that should be addressed through the course of treatment. Many of these issues may require ongoing treatment. For instance, alcohol use disorders can lead to liver damage. 

When you seek treatment, you may visit your doctor through your recovery to check up on the healing process. If you need prescription drugs to treat your substance use or mental health issues, you may meet with a medical professional or a psychiatrist to address these issues. If you’re in PHP and you have a medical need that can be met by an on-site professional, you may be referred to someone who can.

What Is Medication-Assisted Treatment?


Medication-assisted treatment (MAT) is a form of addiction treatment that uses specific medications to treat the symptoms of a substance use disorder like withdrawal and cravings. It’s not a level of care in ASAM’s criteria of treatment like PHP is. Instead, it’s a method that may be used separately or alongside the continuum of care. 

MAT uses prescription drugs to treat chemical dependence and substance use disorders, especially opioid use disorders. The idea behind MAT is to alleviate uncomfortable withdrawal symptoms that may be a barrier to treatment for many people. Medications may be able to stave off withdrawal symptoms and prevent the need for people to take intoxicating or dangerous illicit drugs. This allows them to spend less time looking for drugs, high, or recovering from drug use. 

MAT uses opioid medications that are safer and easier to manage than other opioids, so people who go through it are still dependent on an opioid. However, MAT is usually reserved for people who have had a problem with chronic relapse. MAT lasts longer than traditional addiction treatment but can allow people to get out of the cycle of active addiction. This approach may be most effective when it’s paired with traditional treatment and the continuum of care. Because the medications allow you to skip the withdrawal phase, you may start with lower levels of inpatient treatment or PHP.

What Medications Are Prescribed in PHP?

Since addiction treatment is such a complex process that’s designed to treat a complicated disease, several pharmacological options may be used to treat substance use problems and co-occurring problems. Your treatment plan should be tailored to your individual needs. 

While you go through treatment, including PHP, doctors and clinicians should respond to your needs with the appropriate treatment. In many cases, that means prescribing a specific medication. However, a few medications are used to treat substance use disorders directly, and some are used to treat problems commonly associated with addiction recovery. 

Here are some common medications you may encounter in addiction treatment: 

  • Methadone. Methadone has long been used to treat opioid-related substance use disorders. The drug is a long-acting opioid that a person with an opioid dependency can take once per day to stave off uncomfortable symptoms. It also reduces cravings in people who are addicted to opioids. Methadone is less likely to cause intoxicating effects than other opioids, so people that take them can go about their lives and attend treatment. Methadone may be misused to achieve a high, though it’s typically only dispensed in one pill per day to prevent this.
  • Buprenorphine. Buprenorphine is similar to methadone, but it’s a partial opioid agonist. That means that it only partially activates opioid receptors. Its effects may be weaker than methadone’s, which makes it even less likely to cause intoxicating symptoms. It also has a low misuse potential and limited euphoric effects, even in higher doses. However, it can be effective at preventing opioid withdrawal symptoms and cravings. It’s growing in popularity in MAT services over methadone.
  • Naloxone. Naloxone is an opioid antagonist. It’s often used to treat opioid overdoses because of its ability to kick opioids off their receptors and block activation. Naloxone isn’t commonly used on its own during the course of treatment, but it may be combined with buprenorphine for added effects. The drug Suboxone is a combination of the two drugs that are used to prevent misusing the medication. 
  • Benzodiazepines. Benzodiazepines are often used in the early stages of treatment for alcohol or depressant use disorders. If you’re able to live on your own while you’re tapering off a depressant drug, you may be given benzodiazepines through the course of PHP. 
  • Sleep aids. Sleep problems are a common symptom people encounter during recovery. In fact, it’s something that as much as a third of American’s struggle with. Quality rest can be vital to both your physical and psychological recovery, so you may be prescribed sleep aids to improve your sleep. Several options help improve sleep, but non-benzodiazepine hypnotic sedatives like Ambien are common.  
  • Treating symptoms. Several other medical and psychological conditions can come with addiction recovery. In many cases, these symptoms may be treated with prescription medications to help you through the treatment process. For instance, depression or anxiety may be treated with SSRIs or SNRIs. 

Are Medications in PHP Covered by Insurance?

The cost of treatment may be a significant barrier for some people who need addiction treatment. Treatment, like other medical procedures and treatments, can be expensive. However, addiction treatment is worth the cost for many. 

Since active addiction can jeopardize your ability to hold a job, maintain your finances, and take care of yourself, getting treatment is often a good investment. However, treatment is covered by private insurance providers. 

The law requires insurance companies to treat substance use disorders and mental health treatment as medical care. Insurance companies offer similar levels of coverage for addiction treatment that they would for medical care and procedures. This coverage may extend to evidence-based therapies, including pharmacotherapies and prescription drugs. 

The level of coverage you receive will depend on your specific insurance plan, but it’s likely that you will receive some coverage for the prescriptions you are given through treatment. Your treatment center will work with your insurance company to show why the therapies and medications that are a part of your treatment plan are necessary. 

Sources

American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

ASAM. (n.d.). What is the ASAM Criteria? from https://www.asam.org/resources/the-asam-criteria/about

National Institute on Drug Abuse. (2018, July). Treatment and Recovery. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

RxList. (2018, February 6). Benzodiazepines Drug Class: Side Effects, Types & Uses. from https://www.rxlist.com/benzodiazepines/drug-class.htm

SAMHSA. (2019, November 22). Buprenorphine. from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine

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