Treatment Programs for Substance Use Disorder [Internet]

Excerpt

According to the National Indicators Report using data of more than 200,000 Canadian adults aged in their mid-to-late 30’s seeking community-based treatment services from 2016 to 2018, 68% individuals reported alcohol as the most common substance use disorder (SUD), followed by cocaine and cannabis. More than half of the individuals had at least 2 SUDs. Males were the predominant gender for substance abuse compared to females (62% versus 38%).

SUD treatment programs are generally divided into 2 categories: inpatient or outpatient programs. Inpatient treatment may be part of a hospital program or may occur at a special clinic that requires patients to stay in the facility with 24-hour medical and emotional support. The treatment in inpatient programs is more intensive and is designed to treat serious addiction, and the duration of treatment varies from 28 days to 6 months. On the other hand, patients treated in the outpatient programs typically stay at home and come to the facility during the day, maintaining their normal daily routines. Outpatient treatment occurs in hospital clinics, mental health clinics, counsellor’s offices, or local health unit offices. The treatment in outpatient programs is suitable for patients with mild to moderate addiction and the duration of treatment varies from 3 months to more than a year. Depending on the patient’s condition and the level of care requirement, the patient can attend a standard outpatient treatment (1 or 2 group therapy sessions a week) or an intensive outpatient treatment (10 to 20 hours of counselling or group therapy spread over 3 days a week). The outpatient programs are more affordable but usually have a lower success rate compared to inpatient programs.

A recent CADTH report published in 2017 examined the clinical effectiveness of inpatient and outpatient treatment programs in adults with SUD and found some evidence regarding the comparative treatment between inpatient and outpatient programs for alcohol and substance use problems. Because of limitations of the included studies, no strong conclusions could be made.

The aim of this report is to review the comparative clinical effectiveness of inpatient and outpatient programs, as well as the clinical effectiveness of each program for treatment of SUD, regardless of comparators. The report also reviews evidence-based guidelines regarding treatment programs for SUD.