Inpatient vs. Outpatient
Member
Join Date: Apr 2004
Location: Keepin' my side of the litterbox clean
Posts: 2,136
Hi, cat .... I can only give you an answer based on my own experience. My AH was in both inpatient and outpatient. Neither worked. He wasn't able or willing to commit himself to the program.
Member
Join Date: Feb 2009
Posts: 2,059
hi-
you might get better responses over on the alcoholics forum?
from what i've seen here, the key requirement appears to be that the alcoholic has hit their bottom and embraces recovery....when this is true, either could work. if it's not true, neither will work.
naive
you might get better responses over on the alcoholics forum?
from what i've seen here, the key requirement appears to be that the alcoholic has hit their bottom and embraces recovery....when this is true, either could work. if it's not true, neither will work.
naive
Member
Join Date: Sep 2005
Location: Houston, TX
Posts: 2,126
Neither 'inpatient' nor 'outpatient' works; it's the alcoholic who works.
All I can tell you from my experiencer is.........: I didn't do any treatment, inpatient or outpatient (I just celebrated 23 years of continuous recovery this past June); in fact, I only have one recovery friend who did (inpatient for her); all my revcovery friends have 20+ years......so.........
Like I started off.....Neither 'inpatient' nor 'outpatient' works; it's the alcoholic who works.
NoelleR
All I can tell you from my experiencer is.........: I didn't do any treatment, inpatient or outpatient (I just celebrated 23 years of continuous recovery this past June); in fact, I only have one recovery friend who did (inpatient for her); all my revcovery friends have 20+ years......so.........
Like I started off.....Neither 'inpatient' nor 'outpatient' works; it's the alcoholic who works.
NoelleR
Retired Pro Drunk
Join Date: Jul 2006
Location: Saint Paul, MN
Posts: 901
Originally Posted by thecat3 
which one has more success or does it matter which one to pick?
Member
Join Date: Jan 2009
Posts: 26
I agree it is the alcoholic that has to do the work..... but when you ARE ready to get sober, for someone who is seriously addicted I think outpatient is too 'free'.
Especially right at the beginning, when coming across a tough moment or very strong cravings, it is much easier to go out and let yourself go when you are doing outpatient.
As opposed to inpatient where you can't just go off, get smashed and come back.
Esp for the first month or so I think inpatient works better for those heavily addicted.
Especially right at the beginning, when coming across a tough moment or very strong cravings, it is much easier to go out and let yourself go when you are doing outpatient.
As opposed to inpatient where you can't just go off, get smashed and come back.
Esp for the first month or so I think inpatient works better for those heavily addicted.
Member
Join Date: Sep 2005
Location: Houston, TX
Posts: 2,126
"...As opposed to inpatient where you can't just go off, get smashed and come back..."
In the US, except in a few rare cases, both 'outpatient' and 'inpatient' are voluntary, and folks can leave at any time they choose (AMA- against medical advice).
Real 'recovery' doesn't really start until the person is back in the real world; inpatient is very insular, and keeps the person safe, to some degree. Both 'outpatient' and 'inpatient' give the person the tools to work for their recovery, but if they don't choose to use them once back in the world.....it really makes no difference atall which one was chosen.....
"which one has more success or does it matter which one to pick?" "...Have you talked with a health care professional who specializes in addiction? What did they recommend? Do that one..."
Unfortunately, it's usually not 'our' choice; it's usually up to the 'bean-counters' who work for the insurance.....what they're willing to pay (again, speaking for the US, here). Also, concerning that 'health care professional' my choice would be one who is also a recovering/recovered A and not just 'book learned.'
Again, I'll state, as I did previously, in my recovery experience, I don't see much difference between the two (unless a person needs detox)....and in fact, again in my experience, I know more folks who are clean/sober today who did neither 'inpatient' nor 'outpatient'------ (o:
NoelleR
In the US, except in a few rare cases, both 'outpatient' and 'inpatient' are voluntary, and folks can leave at any time they choose (AMA- against medical advice).
Real 'recovery' doesn't really start until the person is back in the real world; inpatient is very insular, and keeps the person safe, to some degree. Both 'outpatient' and 'inpatient' give the person the tools to work for their recovery, but if they don't choose to use them once back in the world.....it really makes no difference atall which one was chosen.....
"which one has more success or does it matter which one to pick?" "...Have you talked with a health care professional who specializes in addiction? What did they recommend? Do that one..."
Unfortunately, it's usually not 'our' choice; it's usually up to the 'bean-counters' who work for the insurance.....what they're willing to pay (again, speaking for the US, here). Also, concerning that 'health care professional' my choice would be one who is also a recovering/recovered A and not just 'book learned.'
Again, I'll state, as I did previously, in my recovery experience, I don't see much difference between the two (unless a person needs detox)....and in fact, again in my experience, I know more folks who are clean/sober today who did neither 'inpatient' nor 'outpatient'------ (o:
NoelleR
Member
Join Date: Jun 2009
Location: California
Posts: 131
So, I am not a health care professional.... but, in the last 5 months, I have learned a great deal about alcoholism and addiction.... so I will give you a summary of what I learned in the IP/OP question...
1. As many others have said, the individual has to be completely committed to getting 'doing the work.' I know someone who went through 5 programs over a 2 year period before he finally hit bottom and made the personal commitment to getting better. The 6th program 'stuck.' He is 2 years sober now and is VERY commited and invested in his sobriety.
2. I asked an addiction specialist the following question, "Assuming someone had hit bottom and really wanted to get well and money was no object, what would a treatment program look like and why?" The answer went something like this.
Here is what the defalt answer would look like. It of course needs to be modified and tailored the individual.
(a) 90-120 days of inpatient treatment at a qualifed residential treatment facility that is able to do both addiction work and handle any other 'dual diagnosis' issues that the patient may have. The TC should be single sex.
My belief is that inpatient is better because it provides the most structure for the patient and does not have them going home, or somewhere else every night. The level of temptation at a TC is lower. For instance, they aren't going to have to go to the grocery store to buy food, and walk past the beer and wine section when they are 4 days into their recovery.
Almost by definition, an alcoholic or an addict can't make good choices for themselves. Part of the point a good treatment program is to help them learn how to make better choices.
The 90-120 day length of stay is for 2 reasons. First, it takes a minimum of 30 days for the brain chemistry to stabilize. Until the fog lifts in the persons brain, you can't really say treatment has begun. If the patient literally can't think clearly, how are they going to be doing any meaningful work?
Most treatment programs have a phase model. In this model, as the patient advances in his or her recovery, they are given more freedom. At first, it may be to just go to the coffee shop on their own. Later, out dinner or shopping on their own. The idea is to gradually reintroduce them to the world of choices.
90 days is the minimum stay based on outcome based research. But there are some people who stay in a TC for as long as a year.
The single sex nature of the facility is helpful in most cases because it reduces, but does not eliminate, the likelyhood of a rehab relationship of some type developing which can become a roadblock in the reocvery process.
The TC should have a strong focus on 12 Step Work. People have a million reasons they don't like it and don't believe in it, but it is the ONLY approach that has proven itself over and over again to deliver results.
(b) After leaving the TC, the patient should go to some type of structured sober living environment. The purpose of the sober living environment is to maintain some degree of structure through the rules of the house while the patient gets more and more skilled at living in the real world. 12 Step work should continue.
The typical duration of stay at a sober living home is 6-12 months, but some people never leave.
(c) Unless someone is truly alone in the world, there needs to be a family component to the treatment approach. Alcoholism and addiction is a family disease. Assuming the patient is succesful is starting his or her journey of recovery, one of two things is true.
As part of a family approach, the patient can be given day and weekend passes from the sober living environment to spend time with the family, so that the patient can be phased back into the family system.
Again, this reperesnt a sort of baseline to work off of. We are all unique human beings and there is no one size fits all approach.
So to sum it up.... IP is better than OP... but IMHO any treatment program is better than nothing.
1. As many others have said, the individual has to be completely committed to getting 'doing the work.' I know someone who went through 5 programs over a 2 year period before he finally hit bottom and made the personal commitment to getting better. The 6th program 'stuck.' He is 2 years sober now and is VERY commited and invested in his sobriety.
2. I asked an addiction specialist the following question, "Assuming someone had hit bottom and really wanted to get well and money was no object, what would a treatment program look like and why?" The answer went something like this.
Here is what the defalt answer would look like. It of course needs to be modified and tailored the individual.
(a) 90-120 days of inpatient treatment at a qualifed residential treatment facility that is able to do both addiction work and handle any other 'dual diagnosis' issues that the patient may have. The TC should be single sex.
My belief is that inpatient is better because it provides the most structure for the patient and does not have them going home, or somewhere else every night. The level of temptation at a TC is lower. For instance, they aren't going to have to go to the grocery store to buy food, and walk past the beer and wine section when they are 4 days into their recovery.
Almost by definition, an alcoholic or an addict can't make good choices for themselves. Part of the point a good treatment program is to help them learn how to make better choices.
The 90-120 day length of stay is for 2 reasons. First, it takes a minimum of 30 days for the brain chemistry to stabilize. Until the fog lifts in the persons brain, you can't really say treatment has begun. If the patient literally can't think clearly, how are they going to be doing any meaningful work?
Most treatment programs have a phase model. In this model, as the patient advances in his or her recovery, they are given more freedom. At first, it may be to just go to the coffee shop on their own. Later, out dinner or shopping on their own. The idea is to gradually reintroduce them to the world of choices.
90 days is the minimum stay based on outcome based research. But there are some people who stay in a TC for as long as a year.
The single sex nature of the facility is helpful in most cases because it reduces, but does not eliminate, the likelyhood of a rehab relationship of some type developing which can become a roadblock in the reocvery process.
The TC should have a strong focus on 12 Step Work. People have a million reasons they don't like it and don't believe in it, but it is the ONLY approach that has proven itself over and over again to deliver results.
(b) After leaving the TC, the patient should go to some type of structured sober living environment. The purpose of the sober living environment is to maintain some degree of structure through the rules of the house while the patient gets more and more skilled at living in the real world. 12 Step work should continue.
The typical duration of stay at a sober living home is 6-12 months, but some people never leave.
(c) Unless someone is truly alone in the world, there needs to be a family component to the treatment approach. Alcoholism and addiction is a family disease. Assuming the patient is succesful is starting his or her journey of recovery, one of two things is true.
(1) The patient has changed and the family has not; or
(2) the patient has changed and family members have changed too.
In either case, the family system, patterns of behaviors, expectations and so on are all altered. It is a huge mistake to think that just becaus the alcoholic or addict has stopped using that every thing will be fine on the home front. The dance of alcoholism and co-dependence creates a highly dysfunctional system. Family or Couples therapy is not about changing someone, it is about sorting out a new way to live.(2) the patient has changed and family members have changed too.
As part of a family approach, the patient can be given day and weekend passes from the sober living environment to spend time with the family, so that the patient can be phased back into the family system.
Again, this reperesnt a sort of baseline to work off of. We are all unique human beings and there is no one size fits all approach.
So to sum it up.... IP is better than OP... but IMHO any treatment program is better than nothing.
Member
Join Date: Dec 2006
Location: Stumbling toward happiness
Posts: 4,706
thecat,
Does he want to get sober? Does he admit he has a problem....and wants to do whatever it takes to solve it?
If so, he will find a way to make either one work.
If he's not ready, then neither one will work. Wish I had better news...they have to want it for themselves, not for their wife, not for their baby, but for them. Does he?
Does he want to get sober? Does he admit he has a problem....and wants to do whatever it takes to solve it?
If so, he will find a way to make either one work.
If he's not ready, then neither one will work. Wish I had better news...they have to want it for themselves, not for their wife, not for their baby, but for them. Does he?
Member
Thread Starter
Join Date: Dec 2008
Location: NY
Posts: 52
GiveLove,
at times he does admit to the problem, but I think because family annoys him about it, at other times he does not admit that this problem exists.
as soon as he recovers from drinking episode, his life is filled with full time school and full time job and family(me to deal with) so as it seems there is no time for anything else. In addition to that he works out preety much daily and does run marathons. It just gets postponed and nothing gets done.
He does not want to go away,he says he wants to continue to work and dropping a nursing program is big for him and he does not want to take Antabuse. He also states that I am his support and he loves our baby.
The sad part is he have done extensive research about alcoholism. He knows so much about it.
at times he does admit to the problem, but I think because family annoys him about it, at other times he does not admit that this problem exists.
as soon as he recovers from drinking episode, his life is filled with full time school and full time job and family(me to deal with) so as it seems there is no time for anything else. In addition to that he works out preety much daily and does run marathons. It just gets postponed and nothing gets done.
He does not want to go away,he says he wants to continue to work and dropping a nursing program is big for him and he does not want to take Antabuse. He also states that I am his support and he loves our baby.
The sad part is he have done extensive research about alcoholism. He knows so much about it.
Member
Join Date: Dec 2006
Location: Stumbling toward happiness
Posts: 4,706
((( thecat )))
I know how sad that feels. My sister, who lost her battle with heroin, was an RN in an inner city hospital. She knew everything about addiction, but still couldnt' fix her own.
Since you can't control his choices, the best you can do is make the right choices for yourself and your baby. I know how hard it is, though. Have you ever heard of the book "Codependent No More" ? Lots of us here have read it and found some really, really good insights on why we do what we do, and how to build better lives....no matter what the addict in our family chooses.
Hugs,
GL
I know how sad that feels. My sister, who lost her battle with heroin, was an RN in an inner city hospital. She knew everything about addiction, but still couldnt' fix her own.
Since you can't control his choices, the best you can do is make the right choices for yourself and your baby. I know how hard it is, though. Have you ever heard of the book "Codependent No More" ? Lots of us here have read it and found some really, really good insights on why we do what we do, and how to build better lives....no matter what the addict in our family chooses.
Hugs,
GL
Member
Thread Starter
Join Date: Dec 2008
Location: NY
Posts: 52
GiveLove,
I am so sorry about your sister. RN is a challenging and demanding job (well all jobs are) but between working under pressure between patients, family, docs and coworkers and long hours, a person is only human.
thanks for recomendations. i really do appreciate it.
I am so sorry about your sister. RN is a challenging and demanding job (well all jobs are) but between working under pressure between patients, family, docs and coworkers and long hours, a person is only human.
thanks for recomendations. i really do appreciate it.
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