Residential and inpatient treatment

It is debatable whether a period of inpatient treatment can improve the eventual outcome. Some studies have compared outcomes after patients have been randomly allocated to either inpatient or outpatient treatment. Usually no difference has been found. However, the interpretation of these results and their extrapolation to clinical reality has been debated. Finney et al.6) concluded that the studies often lacked statistical power. Furthermore, the more seriously affected patients had sometimes been excluded before randomization/6. 6.Z) While evidence that it is inpatient treatment rather than intensity of treatment which improves outcome is lacking (6,69) admission to hospital can provide valuable respite for the drinker and the family when life is severely disorganized because drinking is out of control. Perhaps such respite need not be offered in a relatively expensive medical environment. However, if the patient has become suicidal as difficulties increase or has developed serious medical complications, then hospital admission may be indicated, ideally to specialized facilities if available. Longer stays in hospital are not supported by research. For example, Trent(79 found no evidence of worse outcome when the United States Navy reduced the length of its inpatient alcoholism treatment programme from 6 to 4 weeks. The role of inpatient treatment is considered further in Chapterii4.i2..2.5,.

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