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In-patient setting and long duration for the treatment of alcohol dependence? Out-patient care is as good.

A combined narrative/meta-analytic review of the results of a number of well-conducted randomized controlled clinical trials indicates that there is no evidence that usual treatment delivered in an in-patient or residential setting is superior to treatment delivered on an out-patient or non-residential basis for the treatment of alcohol dependence. Nor is there any evidence to support the view that in-patient/residential treatment is superior to day patient intervention, or that longer in-patient treatment is superior to shorter in-patient treatment. The studies suggest that in-patient/residential care should not be considered as a standard setting for intervention for alcohol dependence. However, the results of these trials do not contradict the view that in-patient/residential care remains suitable for specific sub-populations of alcohol dependent individuals, such as those requiring closely supervised detoxification, respite care, or who (because of the extreme severity of dependence on alcohol) may require an intense form of supervised intervention. Research should be conducted to establish whether treatment on an in-patient basis does yield an advantage for this last group.