According to the following article, Psychiatr Serv. 2014 Jun 1; 65(6): 718–726,
“Substance Abuse Intensive Outpatient Programs: Assessing the Evidence,”
Dennis McCarty, Ph.D. et al concluded: “Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up.”
Dr. Stauffer’s article is an opinion piece that doesn’t offer clear evidence for his stance. While there are benefits to short-term residential care for a certain subset of patients (including those for whom unsupervised detox may be dangerous), there are also many drawbacks to prolonged lengths of inpatient stay. These include separation from family and friends, lost productivity at work, and the inability to confront, in the real world, those triggers for substance abuse that the individual must learn to deal with. Then there’s the cost. Dr. Stauffer may also have a financial interest in residential treatment for 90 days being the standard of care. In my experience, the money would be better spent in intensive outpatient programs that provide surveillance and support for as long as the patient needs it but keeps them integrated with their community. While I agree that “Addiction Treatment is Broken” I take strong issue with Dr. Stouffer’s solution.
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