Alcoholism - Treatment for Alcohol Withdrawal

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Inpatient Versus Outpatient Treatment

Inpatient Treatment. Inpatient care is usually reserved for patients whose alcoholism places them in danger. Inpatient treatment may be performed in a general or psychiatric hospital or in a center dedicated to treatment of alcohol and other substance abuse. Factors that indicate a need for this type of treatment include:

• Coexisting medical or psychiatric disorder
• Delirium tremens (a neurological condition associated with withdrawal that involves uncontrollable trembling, sweating, anxiety, and hallucinations or other symptoms of psychosis)
• Potential harm to self or others
• Failure to respond to conservative treatments
• Disruptive home environment

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A typical inpatient regimen may include the following stages:

• A physical and psychiatric work-up for any physical or mental disorders
• Detoxification -- this phase involves initiating abstinence, managing withdrawal symptoms and complications, and ensuring that the patient remains in treatment
• On-going treatment with medications in some cases
• Psychotherapy, usually cognitive behavioral therapy
• An introduction to AA

Some -- but not all -- studies have reported better success rates with inpatient treatment of patients with alcoholism. However, newer studies strongly suggest that alcoholism can be effectively treated in outpatient settings.

Outpatient Treatment. People with mild-to-moderate withdrawal symptoms are usually treated as outpatients. Treatments are similar to those in inpatient situations and include:

• Psychotherapy or counseling
• Medications that target brain chemicals involved in addiction
• Social support groups such as AA
• Cognitive therapies
• Involvement of family and other significant people in patient's life

The current approach to outpatient treatment uses “medical management” -- a disease management approach that is used for chronic illnesses such as diabetes. With medical management, patients receive regular 20-minute sessions with a health care provider. The provider monitors the patient’s medical condition, medication, and alcohol consumption.