The continuum of substance abuse care means offering a wide range of treatments to meet the individualized needs of people in recovery, no matter their stage.

Any effective physical, behavioral or mental health treatment plan must include an evident and streamlined continuum of care to provide the best possible treatment. A solid continuum of care is especially crucial for individuals receiving drug and alcohol rehab.

Without treatment in a continuum of care, patients are more likely to fall through the gaps in the system, which results in poor care and an increased likelihood of relapse, overdose and other difficult outcomes.

What is a Continuum of Care?

When people refer to a continuum of care, you can imagine it as a single thread of treatment that begins when you choose to enter professional rehab and carries through to aftercare and beyond. In a continuum of care, patients generally "step down" to less intensive levels of care as they recover. In this model, your team personalizes and adjusts care to meet your unique needs every step of the way, including after you've left the facility.

Imagine if a heart attack patient had their symptoms treated during the incident and was then sent home without cardiac rehab services or any additional care. Most people would consider that a dangerous oversight. So many ways things could go wrong with possibly deadly consequences. Yet, people with substance abuse disorders frequently receive exactly that: fragmented care with life-threatening consequences as a result.

An ideal continuum of care will have a wide array of services and specialties to meet the individual's unique needs.

Some important services on the continuum would include:

  • Inpatient hospitalization: The highest level of care is reserved for people who need the most intensive services under the supervision of a team of professionals. These short-term services are frequently found in acute care hospitals.
  • Inpatient/residential treatment: Longer in duration than inpatient hospital stays, residential treatment can last from 28 days to one year or longer. These programs still provide 24-hour care from trained staff, but they will offer more freedom.
  • Partial hospitalization programs (PHP) :PHPs provide outpatient treatment five days each week for four to six hours each day, meaning the person lives and sleeps in their home. This level of treatment is a match for people who need structure and consistency but are not appropriate for inpatient or residential.
  • Intensive outpatient programs (IOP): If PHP is too much treatment, IOP could be the best option. IOPs provide about three hours of treatment two or three days of the week.
  • Outpatient: Standard outpatient therapy consists of hour-long therapy sessions ranging from several sessions each week or only one session each month. It can also include teletherapy services.
  • Aftercare: Aftercare services help you with coping skills for triggers, relapse prevention plans, extra resources and peer support so you can stay sober and live a healthy, fulfilling life once you've left the facility.

In addition to these treatments, a person may need detoxification services that help the body rid itself of the alcohol and drugs safely under the care of professionals. Detox can take place in an inpatient or outpatient setting.

Similarly, medication-assisted treatment, or MAT, should be present on the continuum to manage addictions, cravings, or underlying mental health disorders. Not every person will need all services on the continuum, but it is important for each service to be available.

Three Main Predictors of Long-Term Recovery Success

Three main factors predict whether someone will recover from substance abuse and maintain their recovery over a long period of time.

Those factors are:

  • Support and stability from loved ones
  • Engaging in longer periods of professional care
  • Social and community support, like organized support groups

If care is not continuous, starting from the time the person arrives at treatment, there are numerous places where someone can discontinue care and fall out of recovery. As a result, the cycle may start all over again.

When Patients Fall Through "Cracks" in the Care System

Transitioning out of treatment is a challenging time, and when there is not another service in place, the person's recovery is at greater risk. Studies show that only 20% of people who transition without continuing care will avoid relapse after one year. Adding continuing care increases the abstinence rate by 50%.

A person may go through medical detox during inpatient hospitalization and then wait weeks or months before getting into a rehabilitation program. They may never get referred to a program at all. A lot can happen in those weeks or months, and any number of addiction issues can land the person right back in the hospital, in jail or worse.

Likewise, when someone returns home from a typical 28-day drug and alcohol rehab program, more "cracks" can open up if follow-up plans are not in place. For many people, going home means returning to people who have no interest in supporting them in their recovery.

Lack of follow-up can cause them to lapse into old habits, resulting in another acute crisis and starting the process over. In the worst cases, the person will overdose following their period of sobriety and suffer grave physical effects.

Benefits of Providing a Continuum of Care

Providers like The Recovery Village have implemented programs that bridge care at every stage of the detox and recovery process, including after their client returns home. For example, a patient in crisis in a hospital may be immediately referred to our detox facility, where they can go when physically stabilized. While in detox, a place in a drug and alcohol rehab is secured, so the patient goes directly from detox to rehab.

Before they leave rehab, our clients receive a follow-up plan for returning home, including resources they can use while transitioning to everyday life. The Recovery Village offers many aftercare options that carry people into lifelong recovery after their treatment, including:

  • Sober living homes
  • Alumni programs
  • Support groups
  • Case management
  • Long-term therapy

Many people are involved in helping patients return to health and productivity after they decide to treat their addiction. The people in recovery themselves do the hardest work of all. Without proper support throughout their journey, the possibility of relapse looms large. If you want to learn more about drug and alcohol rehab that is tailored to the whole person, we encourage you to contact us at any time.

Melissa Carmona

Editor – Melissa Carmona

As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more

Eric Patterson

Medically Reviewed By – Eric Patterson, LPC

Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more

Proctor, Steven; Herschman, Philip. "The Continuing Care Model of Substanc[…]' 'Enough?'" Psychiatry Journal, March 27, 2014. Accessed October 15, 2020.

National Institute on Drug Abuse. "Principles of Drug Addiction Treatment: […]uide (Third Edition)." January 2018. Accessed October 15, 2020.

Springer, Dave. "Substance Use Disorder Continuum of Care[…]gaging the Community," Department of Health and Human Services. October 31, 2015. Accessed October 15, 2020.

Substance Abuse and Mental Health Services Administration. "Detoxification and Substance Abuse Treatment." October 2015. Accessed October 15, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.