A prior study in a tightly controlled clinical research environment found individuals with an alcohol use disorder (AUD) benefited more from inpatient (IP) than outpatient (OP) care, if they presented with high alcohol involvement and/or low cognitive functioning. This study sought to: (a) validate and extend these findings within the uncontrolled environment of a community-based treatment center, and (b) test whether inpatients had fewer days of involuntary abstinence (e.g., incarcerations) relative to outpatients. Based on their need for inpatient treatment, using prior cut-points for alcohol involvement and cognitive functioning, participants were randomly assigned within inpatient need group (No Need for IP; Needs IP) to either 21-days of inpatient substance misuse treatment or 21-days of outpatient treatment, all followed by 6 months of continuing outpatient care. Follow-up were conducted an 90-day intervals across 18 months.

Inclusion Criteria:

• Eligible for treatment through the Chemical Dependency treatment programs of a large, community-based healthcare network
• Drank alcoholic beverages within the last 90 days
• Have a current address (not homeless)
• Free of legal stipulations that would affect treatment decisions
• Have a past 3 months Alcohol Use Disorder
• Primary alcohol, or alcohol and drug problem

Exclusion Criteria:

• Homeless
• Drug problem only