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The Right Candidate for Outpatient Care

Outpatient treatment occurs when an individual attends treatment at a clinic or other facility, then returns home or to some other structured living situation, and carries on with their daily activities. The person gets treatment in a separate facility from their home.

Individuals with alcohol use disorders will most often spend the majority of their time in treatment on an outpatient basis. The use of inpatient or residential treatment, where an individual lives in the same facility where they get treatment, is designed to address special situations. Inpatient or residential treatment is not a requirement for everyone who has an alcohol use disorder. Instead, individuals with special conditions or needs will most often be placed in these treatment facilities, and in some cases, individuals can be placed in residential treatment at their own request if they do not have the confidence to live fully independently while getting treatment for their alcohol use disorder. However, even in these cases, these individuals will eventually transition to outpatient treatment.

According to the books Concepts of Chemical Dependency, The ASAM Principles of Addiction Medicine, and Alcohol: Its History, Pharmacology, and Treatment, there are other situations where individuals should not be involved in outpatient treatment for alcohol use disorder.

  • If a physician or other substance use disorder treatment provider specifies that the person should be treated in an inpatient or residential unit, outpatient care is not appropriate.
  • If it is suspected that the person will suffer moderate to severe alcohol withdrawal, inpatient care is needed When a person with an alcohol use disorder begins to abstain from alcohol and experiences withdrawal symptoms, these symptoms can be potentially fatal. Individuals undergoing moderate to severe alcohol withdrawal should be supervised in a medical facility until the withdrawal period has passed.
  • When the person needs 24-hour medical supervision for some other medical condition, outpatient care is not appropriate. There can be numerous circumstances where a person might require 24-hour medical supervision or care. A person may have cirrhosis of the liver associated with alcohol abuse, alcohol poisoning, or some other medical condition that requires 24-hour monitoring. These individuals are not appropriate for outpatient care until their condition can be stabilized.
  • In some cases, such as with severe cirrhosis, it may not be appropriate for the person to return home. In these instances, they may require some form of inpatient or residential treatment on a continual basis.
  • When a person has a severe emotional or psychological disorder that requires 24-hour supervision, inpatient treatment is needed. Individuals who are actively suicidal, actively psychotic, or have a severe mental health disorder, such as bipolar disorder, a personality disorder, eating disorder, etc., may not be appropriate for outpatient treatment initially. In many cases, these conditions can be treated and stabilized, and the person can then transition to outpatient treatment. When individuals are a danger to themselves or others due to their mental health disorder, they often require inpatient or residential treatment initially.
  • In some cases, individuals who have toxic living conditions may not be appropriate for outpatient treatment initially. These conditions are often judged on a case-by-case basis but can include having an abusive spouse or partner, living in an area that results in a high risk for the individual to relapse, being homeless, etc.
  • Individuals who are judged by treatment providers to have severe alcohol use disorders that make them extremely vulnerable to relapse may be deemed inappropriate for outpatient treatment initially. These individuals often need to get a strong foothold in recovery before being transitioned to some form of outpatient treatment, but eventually, they will transition to some form of independent living and outpatient treatment.
  • If the person feels they would benefit more from inpatient treatment, it is often the more appropriate choice. Inpatient treatment allows clients to wholly focus on their recovery efforts, and this can often result in greater treatment benefits.

In most other cases, individuals with alcohol use disorders are appropriate for outpatient treatment. Most individuals will eventually become involved in some type of outpatient treatment that may include medically assisted treatment or management (the use of medications and medical consultations), substance use disorder therapy (individual therapy or group therapy), participation in 12-Step groups like Alcoholics Anonymous, and/or involvement in complementary treatments like art therapy, music therapy, etc. For most individuals with alcohol use disorders, some form of outpatient treatment will be the main focus of their overall recovery program.