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Inpatient or Outpatient Addiction Treatment: Which Makes the Most Sense?

July 23, 2015
by Roland Reeves, MD
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Alcohol and drug addiction is a highly complex disease, but the good news is that even people who have struggled with substance abuse and addiction for many years can recover and live healthy, productive lives. Although any attempt at treatment is a step in the right direction, the best solution is treatment that works the first time. Unfortunately, treatment is not a one-size-fits-all situation and there is no single solution that works for everybody. While outpatient treatment works for many people, others require intensive residential treatment for long-term recovery.

Treatment length is an important factor for both outpatient and residential treatment. Studies by the National Institutes of Health (NIH) indicate that long-term recovery is directly connected to adequate treatment length, and that outcomes for both outpatient and residential treatment are more successful when treatment lasts at least 90 days.

Unfortunately, financial considerations are a factor for many people, and money is often the deciding factor when people choose outpatient treatment. Even individuals with insurance are often surprised to learn that their insurance limits residential treatment to 28 days or less – often as few as five days. Studies have proven that in most cases, such short-term treatment is woefully inadequate for long-term recovery.

While money is an important consideration, there are other practical reasons why outpatient works best for some people. Outpatient treatment, which usually involves one to five sessions every week, is less disruptive for people who have family, work or academic responsibilities that don’t allow for a long absence. Many people opt for outpatient treatment because they prefer to keep treatment private for various reasons, including potential threats to employment.  

Outpatient treatment is most likely to work for people who have supportive friends and family that can provide some accountability. This can be difficult for some families who may strongly deny enabling, yet they may provide housing, food, phones, money, or transportation to a loved one with addiction. This person with addiction then has no real reason to change. A “bottom” is a moving target, and families often allow it to continue to get lower by their continued support of the addict. John Southworth of Southworth Associates, and a Godfather of interventionists in this country, is often heard to say “the first thing I do is fire the family!”

Statistically, outpatient treatment is more likely to result in relapse, and many people seek residential treatment after one or more failed attempts at recovery. A problem with this approach is that each attempt is preceded by increasing damage to the person’s health, relationships, career, finances, and life in general, and they may not live long enough to finally recover from this fatal disease.



Roland Reeves MD

Physician, T R Reeves


Roland Reeves, MD, provides medication assisted treatment for the practice T R Reeves, MD, in...

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