Treatment guidance

What treatment actually looks like

Most people know they need help before they understand what help looks like. This hub explains the full process: what each level of care involves, what detox feels like day by day, how admission works, and what to look for when choosing a program. Clinical content reviewed by a licensed clinician.

Reviewed by a licensed clinician before publication
Levels of care

The full continuum, from detox to outpatient

Addiction treatment is not one thing. It is a connected set of programs, each designed for a different point in recovery. Understanding the continuum helps you identify where you are most likely to start and where you are headed.

Medical Detox

Detox

Medically supervised management of withdrawal. Required for alcohol, benzodiazepines, and opioids in many cases.

3 to 10 days

Residential

Inpatient

24-hour structured care in a treatment facility. Therapy, medical monitoring, and peer support around the clock.

28 to 90 days

Partial Hospitalization

PHP

Intensive day program, four to six hours a day, five days a week. You live at home or in sober living.

Two to six weeks

Intensive Outpatient

IOP

Structured sessions three hours a day, three to five days a week. More independence, ongoing clinical support.

Six to twelve weeks

Outpatient

OP

Weekly or bi-weekly individual or group therapy. Continuing care after completing a higher level of treatment.

Ongoing
Most intensive
Least intensive

TRICARE covers all five levels of care for substance use disorder. Residential and PHP require prior authorization. The appropriate starting point is determined by a clinical assessment, not by personal preference or insurance preference alone. Source: tricare.mil

Key topics

Where most people start their questions

Medical detox

What detox feels like, day by day

Hours 0–24

Onset of withdrawal

Symptoms begin as the substance clears. Anxiety, restlessness, and physical discomfort start. Medical team establishes baseline monitoring and begins medication support where appropriate.

Days 1–3

Peak symptoms

The most intense period for most substances. Alcohol and benzo withdrawal peaks here and requires the closest medical monitoring. Opioid withdrawal is intensely uncomfortable but rarely medically dangerous. Medications substantially reduce severity.

Days 3–5

Stabilisation

Physical symptoms ease for most people. Sleep, appetite, and mood begin to stabilise. Initial clinical assessment for co-occurring conditions such as PTSD or depression typically begins here.

Days 5–10

Transition planning

Physical detox completes for most substances. The focus shifts to the next level of care. The clinical team works with TRICARE to secure prior authorisation for residential or PHP before discharge. No discharge without a plan.

Read the full day-by-day guide

Alcohol and benzo withdrawal is a medical emergency without supervision

Unlike most substances, alcohol and benzodiazepine withdrawal can cause seizures and life-threatening complications. Never attempt to withdraw from heavy alcohol or benzo use without medical supervision. A medical detox setting is not optional in these cases.

What detox does and does not do

  • Safely manages physical withdrawal
  • Reduces withdrawal severity with medication
  • Screens for co-occurring conditions
  • Not a substitute for addiction treatment
  • Does not address the underlying causes
Admission

What happens when you call a program

The unknown is the biggest barrier. Here is exactly what the intake process looks like from first contact to day one.

First call

You will speak with an admissions coordinator. They ask about your substance use history, current medications, medical and psychiatric background, and insurance. This call is confidential. You are not committed to anything.

Insurance verification

The facility contacts TriWest to verify your TRICARE benefits and submits the prior authorization request. For residential treatment this takes one to several business days. You are updated at each stage. Emergency authorizations can be expedited.

Intake paperwork

On arrival you complete consent forms, a release of information if you want family contacted, and an initial treatment agreement. The paperwork is thorough but the staff walk you through it. Bring your insurance card and a photo ID.

Clinical assessment

A physician or nurse practitioner conducts a physical exam. A counselor or case manager completes a psychiatric and substance use history. For veterans this should include a PTSD screening. The assessment informs your treatment plan.

Treatment plan

Your care team develops an initial treatment plan based on the assessment. It covers the recommended level of care, therapy modalities, medication, and discharge goals. Plans are reviewed and updated regularly throughout treatment.

Settling in

You are oriented to the facility, shown your room or space, and introduced to the daily schedule. Phone and contact policies vary by program. Most allow family contact after the first day or two. The first 24 to 48 hours are about physical stabilisation and orientation, not intensive therapy.

How to choose

What to look for when evaluating a program

Particularly for veterans, not every program is equally prepared. These are the questions that matter most before you commit.

TRICARE accepted and in-network

Ask the facility to confirm they accept TRICARE and whether they are in the TriWest network. In-network significantly lowers your out-of-pocket costs.

Experience with veterans and PTSD

Ask whether they have a dedicated veterans program or staff trained in military culture and trauma. PTSD-informed care is essential if trauma is part of the picture.

Dual diagnosis treatment available

A program that treats addiction without addressing co-occurring PTSD or depression has lower success rates for veterans. Confirm they offer integrated treatment.

Licensed by Texas DSHS

Confirm the facility holds a current license from the Texas Department of State Health Services. You can verify at the Texas DSHS licensing database.

Clear discharge and aftercare plan

Ask from the start what discharge looks like and what continuing care support they offer. A strong residential program with no aftercare plan is an incomplete plan.

Red flag: pressure to enrol before insurance is confirmed

Any program pressing you to sign paperwork or pay before TRICARE authorization is confirmed deserves caution. Authorised programs work through the verification process first.

Red flag: vague answers about PTSD treatment

If a facility cannot clearly describe their trauma-informed approach when asked directly, their treatment model likely was not designed with veterans in mind.

Red flag: no discharge plan discussion until the end

Good programs discuss aftercare from the intake assessment forward. A discharge plan that materialises only in the last few days is a sign of weak continuing care infrastructure.

Read the full program evaluation guide

Ready to look at programs in San Antonio?

A neutral directory of licensed treatment centers in the metro, each with a plain description of services. Listing is not an endorsement. Verify coverage directly with each center and your TRICARE plan.

All treatment guides

Every topic in this pillar

Guides are added as they are published. Each is reviewed by a licensed clinician and sourced to official references before going live.

Detox and levels of care (Tier 3)

Medical detox timeline: day by day

What physically happens during detox for alcohol, opioids, and other substances. Day-by-day breakdown of what to expect, what medications are used, and when the hardest part passes.

Tier 3

Levels of care for addiction treatment: the complete guide

Detox, residential, PHP, IOP, and outpatient. What each level looks like day to day, how TRICARE covers each, and how to progress through the continuum.

PHP vs IOP: which level of care is right for you?

When partial hospitalization is the right step down, when intensive outpatient is the right fit, and how TRICARE authorization works for each.

Admission and choosing a program

What happens during admission: from first call to day one

The complete intake process. What you are asked, how TRICARE verification works, what to bring, and what to expect in the first 48 hours.

How to choose the right addiction treatment program

A checklist of what to verify before enrolling, what matters most for veterans, questions to ask every program, and red flags to watch for.

What to bring to residential treatment

A practical packing guide. What is allowed, what is not, what to do with your phone, and what paperwork you need ready before arrival.

Veterans and co-occurring conditions

PTSD and substance use: why they co-occur and how treatment handles both

The clinical relationship between PTSD and addiction in veterans, what integrated dual-diagnosis treatment looks like, and how TRICARE and VA cover it.

Tier 3
Common questions

What people ask before starting treatment

Clinical content reviewed by a licensed clinician. Sourced to official guidance where applicable.

Medical detox is the supervised management of withdrawal from alcohol, opioids, benzodiazepines, or other substances. It is not treatment for addiction itself; it is the first step that makes treatment physically safe. Whether you need medically supervised detox depends on what substance you have been using, how long, and how heavily. Alcohol and benzodiazepine withdrawal can be life-threatening without supervision. Opioid withdrawal is rarely dangerous but carries a high relapse risk without support. A medical evaluation determines the appropriate level of monitoring. Detox typically runs three to ten days.
PHP (Partial Hospitalization Program) is a structured day program: four to six hours a day, five days a week, while you live at home or in sober living. IOP (Intensive Outpatient Program) is less intensive: three hours a day, three to five days a week. Both provide group therapy, individual counseling, and psychiatric support without residential stay. PHP often follows residential or is used when the home environment is stable but more support than IOP provides is needed. IOP follows PHP or suits lower-severity presentations. Both are covered by TRICARE with prior authorization requirements that vary by plan.
Residential programs typically run 28 to 90 days. Some extended programs run six months or longer for complex cases including severe dependence or multiple previous treatment episodes. The length TRICARE authorises depends on medical necessity documentation from the treatment facility. Length of stay is determined by clinical assessment, not a standard calendar. TRICARE requires ongoing authorisation for extended residential stays, which the treatment team manages with your TRICARE contractor.
Admission starts with a phone call. You are asked about your substance use history, current medications, medical and psychiatric background, and insurance. If TRICARE is your coverage, the facility contacts TriWest to verify benefits and submit a prior authorisation request before you arrive. On day one you complete intake paperwork, undergo a physical assessment and psychiatric evaluation, and meet with a case manager to build your initial treatment plan. The process is clinical, not punitive. Bring your insurance card, a photo ID, and a list of current medications.
For veterans and military families, confirm TRICARE acceptance and in-network status with TriWest, ask about experience with co-occurring PTSD and substance use disorder, and verify the facility holds a current Texas DSHS licence. Beyond the clinical basics: look for evidence-based modalities (CBT, EMDR for trauma), ask about the daily structure, and ask what aftercare planning looks like. A facility that cannot clearly describe its discharge planning is a red flag regardless of the quality of the residential program.

If you need someone right now

You do not need to have all the questions answered first. Free, confidential support for veterans and families is available 24 hours a day.

Dial 988, then 1
Veterans Crisis Line · 24/7 · Free & confidential

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