Inpatient versus outpatient treatment of substance abuse: Recent developments in the controversy

There has been considerable controversy the past decade on which is more effective, inpatient or outpatient treatment of substance abuse. During this same decade substance abuse treatment grew into a $40 billion industry with for-profit hospital programs accounting for as much as one-half the total figure. Recently, controlled studies have replaced the previous research literature which was largely composed of uncontrolled studies. A research consensus is developing that states inpatient rehabilitation has no advantages over outpatient treatment and that even hospitalization for detoxification is unnecessary for 90% of patients. Implications for public policy are that we are over-spending in the treatment of substance abuse by misallocating resources to the most intrusive intervention.Nicholas A. Cummings, PhD, is founder and chairman of the board of directors of American Biodyne and president of the Biodyne Institute, president of the National Academies of Practice, former president of the American Psychological Association, and founder of the four campuses of the California School of Professional Psychology.