When is INPATIENT or RESIDENTIAL treatment for drug/alcohol problems needed?

Hello! Dr. Heinzerling here again for another blog entry. Today's topic is another one that I frequently receive questions about: "Do I need an inpatient/residential treatment program?" A common misconception is that getting treatment for a drug or alcohol problem involves living for a time at a "rehab." Actually, most treatment for drug or alcohol problems in the US is provided in outpatient settings. Inpatient (usually in a hospital setting) and/or residential (where patients live for a period at the treatment program) can play a very important role for particular patients but is not always required. The best way to find out if a patient needs an inpatient or residential program is to speak with a professional addiction health care provider (a doctor or counselor/therapist) who can assess the patient and determine whether inpatient or residential treatment is the best option. Below are some general points that addiction professionals usually take into account in deciding whether to recommend inpatient/residential treatment (this info should not substitute for the advice of a health care professional!):

•  Residential/inpatient treatment is usually indicated for patients with severe medical and/or psychiatric conditions in addition to drug/alcohol problems. Inpatient treatment allows doctors to more closely monitor the medical/psychiatric condition and provide more intensive treatment. 
• Residential treatment is best for patients who are homeless or do not have a safe place to stay. In addition, patients living in an environment where drug/alcohol use is highly prevalent may need to be in a residential program to escape the triggers that are common in their usual environment. 
• Patients who have been unable to control drug/alcohol use during outpatient treatment may need a period in a more controlled environment to establish even initial drug/alcohol abstinence.
• In addition, some patients may need a medical/inpatient detoxification to prevent serious medical complications from withdrawal symptoms, especially in the case of alcohol and benzodiazepines. This is an issue that definitely requires consultation with a medical doctor.

Clearly, inpatient/residential programs can provide more intensive treatment than outpatient programs but also are more expensive and may disrupt the patient's life (i.e. not possible to continue with work or family responsibilities during treatment).Patients can maintain some of their normal activities and pursue outpatient treatment, but it is critical to also arrange for significant support (such as attending self-help groups and support from family and friends) to supplement outpatient treatment as the patient will continue to be exposed to drug/alcohol triggers in the outpatient setting. On the other hand, patients who do inpatient or residential treatment eventually have to learn to control drug/alcohol problems outside of the inpatient setting and outpatient treatment most directly prepares patients for this. One final thought is that another option is an outpatient treatment program combined with a sober living facility, which is a place to stay where everyone is committed to NOT using drugs or alcohol (sober livings are NOT treatment programs but can provide critical support to patients during outpatient treatment).

Well thanks for tuning in and remember that the best way to determine if you would do better with an inpatient or outpatient program is to consult with a health care professional with expertise in addiction! I hope this info helps you to better be able to ask your health care provider the right questions that will help you to decide what course to take. As always feedback is welcome on our website (www.uclasarx.org) or via our twitter feed (uclasarx).



Tags: faq, inpatient, keith heinzerling, misconceptions, outpatient, residential