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Inpatient Detox

Inpatient Detoxification Advantages

Advantages according to Alling (1992):

  • “The patient is in a protected setting where access to substances of abuse is restricted.
  • “The withdrawal process may be safer, especially if the patient is dependent upon high levels of sedative-hypnotic drugs, since the clinician can observe him or her closely for serious withdrawal symptoms, and medications can be adjusted.
  • “Detoxification can be accomplished more rapidly than it can in an outpatient setting.”

Inpatient detoxification is offered in medical hospitals, psychiatric hospitals, and medically managed residential treatment programs.

Acute Care Hospitals

Many acute care hospitals formerly operated subacute-care units, or chemical dependency units, that served as sites for uncomplicated detoxification. These programs, known as Minnesota Model programs, generally involved a 28-day inpatient stay followed by varying lengths of outpatient therapy and participation in self-help groups. Most were based on the Alcoholics Anonymous (12-step) model of personal change and the belief that vulnerability to AOD dependence is permanent but controllable. The goals of these programs were abstinence from all AODs and lifestyle alteration. Because of decreasing insurance reimbursement for stays in such units, many have ceased operation. In an effort to maintain treatment for those who need this type of care, some of the hospitals that house these units have developed other addiction services, such as intensive outpatient treatment programs.

Many acute care hospitals that do not maintain chemical dependency units commonly use a “scatter bed” approach, placing a patient in any clinical area of the hospital in which a bed is available Alling (1992).

Outpatient Detoxification Sdvantages:

Advantages according to Alling (1992):

  • It is much less expensive than inpatient treatment.
  • The patient’s life is not as disrupted as it is during inpatient.

Psychiatric Hospitals

Psychiatric hospitals occupy an important niche in the spectrum of detoxification settings because they are the preferred settings for patients who are psychotic, suicidal, or homicidal. In areas where medical hospital detoxification programs are not available, patients with no psychiatric comorbid conditions may be admitted to a psychiatric unit for detoxification. The detoxification protocols used in psychiatric hospitals are the same as those used in medical acute and subacute settings.

Medically Managed Residential Treatment Centers

Rather than acute care hospitals, medically managed residential treatment centers are AOD abuse medical care centers, where specialized services are provided by medical staff under the direction of a qualified physician with knowledge of and skills in addiction treatment. Psychosocial and behavioral services are usually provided as necessary components of successful treatment.