Inpatient Addiction Treatment Versus Outpatient Addiction Treatment
Addiction Treatment
A number of addiction treatment options now exist for alcoholism. It is first important to determine whether inpatient or outpatient care would best benefit the individual. Inpatient addiction treatment is performed in a general or psychiatric hospital or in a center dedicated to treatment of alcohol, drug addiction and other substance abuse problems. It is recommended for the following people:
• Those with a coexisting medical or psychiatric disorder
• Those with delirium tremens
• Those who may harm themselves or others
• Those who have not responded to conservative drug addiction treatments
• Those who have a disruptive home environment
Some — but not all — studies have reported better success rates with inpatient addiction treatment of patients with alcoholism. In those studies, patients who were hospitalized for treatment had fewer complications and re-hospitalizations, and longer abstinence rates, than patients treated as outpatients. However, newer studies strongly suggest that alcoholism can be effectively treated in a doctor’s office.
The new approach to outpatient treatment uses “medical management” — a disease management approach that is used for chronic illnesses such as diabetes. With medical management, patients receive regular 20-minute sessions with a health care provider. The provider monitors the patient’s medical condition, medication, and alcohol consumption.
An important 2006 study in the Journal of the Medical American Association (JAMA ) found that medical management can successfully treat alcoholism when it is combined with either:
• Drug treatment
• Behavioral counseling with a therapy technique called combined behavioral intervention (CBI)
Inpatient Addiction Treatment Options. A typical inpatient addiction treatment regimen may include the following stages:
• A physical and psychiatric work-up for any physical or mental disorders
• Detoxification – this phase involves initiating abstinence, managing withdrawal symptoms and complications, and ensuring that the patient remains in treatment
• On going treatment with medications in some cases
• Psychotherapy, usually cognitive-behavioral therapy
• An introduction to Alcoholics Anonymous
Outpatient Addiction Treatment Options. People with mild to moderate withdrawal symptoms are usually treated as outpatients. Treatments are similar to those in inpatient addiction treatment and include:
• Psychotherapy or counseling
• Medications that target brain chemicals involved in addiction
• Social support groups such as Alcoholics Anonymous
• Cognitive therapies
• Quitting smoking (smoking interferes with the brain’s recovery from alcoholism)
After-Care Treatment. After-care employs services that help alcoholics maintain sobriety. For example, in some cities, sober-living houses provide residences for people who are trying to stay sober. They do not offer formal treatment services, but the people living there offer each other support and maintain an abstinent environment. A 2002 study reported that work therapy improved the outcome for homeless veterans who were being treated for substance abuse.
Factors That Predict Success or Failure After Drug Addiction Treatment
A 2001 analysis of studies reported that 25% of people were continuously abstinent following drug addiction treatment, and another 10% used alcohol moderately and without problems. Even among the remaining group, alcohol consumption was reduced by an average of 87%. Most studies strongly suggest that intensive and prolonged treatment is important for successful addiction recovery, whether the patient is treated within or outside a drug addiction treatment center.
Certain factors play a role in success or failure. Patients from low-income groups tend to have worse results in general. Their difficulties are often intensified by lack of insurance, low self-esteem, and minimal social support. To locate drug addiction treatment that can help, call the national addiction treatment helpline at 1-800-511-9925.
