Utilization review of treatment for chemical dependence.

Utilization review of treatment for chemical dependence has become increasingly important as evidence accumulates that outpatient treatment can be effective in many cases. The authors discuss the basic questions that guide utilization review of treatment for chemical dependence, summarize research that has led to the increasing emphasis on outpatient and partial hospital treatment approaches, and review the American Psychiatric Association's guidelines for utilization review of chemical dependence treatment. Case examples illustrate issues in the treatment of adolescents, patients with dual diagnoses, and relapsing patients. The authors conclude that utilization review supports use of inpatient care only for patients who require intensive services, including those who are a danger to themselves or others, have serious physical or psychiatric disorders, or have not responded to an adequate trial of outpatient treatment.