Residential Drug and Alcohol Treatment in the UK: Policy and How It Stacks Up Globally

In the UK, entering a residential drug or alcohol treatment program is rare. Only 2% of those in treatment are expected to enter residential care. Out of every hundred people seeking help, just two receive intensive inpatient care - a cautious approach compared to other countries.

How the UK Approaches Residential Treatment

England has seldom made a residential treatment standard. The government favours community and outpatient care, reserving residential treatment for complex cases. Recent data shows about 4–5% in treatment use residential services - 4.3% in 2020/21 - a decrease from prior years.

That 2% goal isn’t a legal requirement. It’s more of a baseline, a way to make sure residential treatment stays available for people who really need it. There’s a special focus on people with multiple, complex challenges or those coming through the criminal justice system - groups who often need more intensive support.

What the Government and Local Councils Are Doing

Local councils have to figure out how much treatment their communities need, including residential care, then fund and organise those services. Even though the decisions happen locally, the Department of Health and Social Care (DHSC) expects every council to do its bit towards that 2% national goal, setting its own targets to get there.

On 6th January 2026, the Parliamentary Under-Secretary for Health and Social Care, Ashley Dalton, doubled down on this commitment in Parliament. DHSC isn’t just watching from the sidelines - they’re working with treatment providers to open up access and help councils commission better services. One of their tools is a self-assessment toolkit for residential treatment, which helps councils improve quality, get better value, and make sure what they offer matches what people actually need.

DHSC also runs a forum for residential treatment providers and joins in annual planning with councils and other partners. They set targets for how many people should get residential care and work closely with other government departments, like the Ministry of Justice, to make sure people coming out of the criminal justice system aren’t left behind.

Money and Planning

Funding is a big piece of the puzzle. The government has set aside £3.4 billion, ringfenced for drug and alcohol treatment and recovery over the next three years. It’s the first time in over a decade that these services have had guaranteed funding across multiple years, giving councils more confidence to plan and boost their treatment capacity - including residential treatment when needed.

How the UK Compares Internationally

The UK’s focus on outpatient and community care isn’t unusual in Europe. Most European countries prefer opioid substitution therapy and psychosocial support, which are cheaper and easier to roll out than residential care. Across the EU, about 13% of people in treatment go into residential programmes, and that percentage hasn’t changed much over the years, up from 11% in 2014.

But there’s a lot of variation. Some countries - Italy, for example - have a much bigger tradition of inpatient care, with 10–20% of people in treatment getting residential help. While it’s not the main approach, residential care is much more visible there than in the UK.

The US takes it even further. Around 12–15% of people in treatment get residential care, depending on the year. Outpatient is still the most common, but it’s easier to get into a residential programme in the States, especially if you have severe needs. People also tend to finish treatment at higher rates in residential settings compared to outpatient care.

Australia sits somewhere in between. In 2021–22, about 16% of treatment episodes were residential. Most treatment still happens outside of hospitals, but Australia’s system offers a more even mix of inpatient and community-based support.

Policy Rationale and Future Direction

The World Health Organisation doesn’t say there’s one perfect amount of residential treatment every country should aim for. Instead, it points out that the right mix depends on things like the country’s resources, funding, service setup, and policy goals. Residential treatment eats up a lot of resources, so countries like the UK have chosen to use it mainly for people with the most complex, long-standing needs.

So, the UK’s goal of 2% residential treatment looks pretty cautious when you stack it up against other countries. The government says it isn’t just chasing numbers - it wants to make sure residential treatment is high-quality, clinically sound, and actually reaches the people who need it most. The latest funding deal is supposed to help local authorities open up more spots where they’re needed, but still keep a strong focus on community-based care.

Conclusion

Sure, 2% is low compared to other countries, but the UK made this choice on purpose. The aim is to build treatment that can reach more people, using proven community programs, while keeping intensive inpatient care available for those with the toughest challenges. For people with severe substance use problems, residential treatment really can change lives, offering routine, stability, and ongoing support. If the UK meets or even beats that 2% target, it means more people with the highest needs are getting the right help - and that could lead to better recovery rates and healthier communities all around.