Determinants of chemical dependency treatment placement: Clinical, economic, and logistic factors

Logistical, political, and economic factors frequently combine to preempt clinical considerations in chemical dependency treatment placement. A study of 319 alcoholics with or without concurrent drug use disorders was conducted to determine the relative efficacy of inpatient, outpatient, and inpatient-to-outpatient treatment and to identify patient characteristics associated with differential outcome by treatment type. Successful 6-month follow-up of 73% of the patients revealed a 67% abstinence rate with no significant differences by treatment setting. The routine use of standardized instruments and procedures for diagnosis and assessment is recommended along with changes in service delivery systems and insurance coverage as steps toward optimal treatment placement.