Inpatient or residential addiction treatment. Inpatient treatment is the most intensive level of treatment, offering 24-hour care in a secure unit of a treatment facility or hospital. Residential treatment is a step down from inpatient treatment. While there is structure and some monitoring to treatment, the big difference between residential and inpatient treatment involves the setting in which it is carried out. While inpatient treatment is typically carried out in a treatment facility or hospital, residential treatment is usually carried out in more of a home-like environment.