I work at an inpatient drug rehab, but the rehab also offers outpatient alcohol treatment, and I also happen to be a recovering alcoholic who has endured all types of treatment methods.  In my opinion, outpatient treatment for alcohol is a lousy option compared with the alternatives.

Now I do not mean to be too negative here, as I am sure there are some people out there for whom outpatient is a really good option.  I am sure some have found success using outpatient treatment.  But in my experience, and in my observation of others, it is a substandard solution to a very difficult problem.  My personal philosophy is basically this:

1) The struggling alcoholic needs inpatient rehab, OR

2) If they do not need inpatient, then they can do just fine with 12 step meetings (free).

Now that is a bit of an oversimplification perhaps, and I am sure there are some people who will balk at the idea of using 12 step meetings as treatment.  But this is what I have seen work in people’s lives.  People who go to outpatient just don’t seem to do that well, unless they are also heavy into other support groups (such as 12 step recovery).  People who repeatedly fail at getting sober need to consider inpatient rehab.  Just my opinion, but it is backed up by what I see on a regular basis, and I am in the unique position of being able to watch a LOT of recovering addicts and alcoholics.  Not only do I work in a detox and residential unit, but we also have a long term rehab attached to us, and we have a sister office that does counseling and outpatient services.  So I see different people go in and out of these various services, some meeting with success and many others meeting with repeated relapses.

I firmly believe that if someone is still actively drinking alcohol or using drugs, then they need something more than outpatient treatment to get them started on the right foot in recovery.  There are too many factors that go into early recovery that are complicated by being in our everyday environment.  Triggers to drink and use drugs are everywhere, and going to an inpatient rehab eliminates these threats.  A lack of support in a moment of weakness is easily possible during the course of outpatient treatment, but during an inpatient stay, there is constant peer support in an intimate environment.

For the majority of situations, outpatient alcohol treatments are not intensive enough to be truly helpful.  Just my 2 cents.