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Alcohol Home Detox

Alcohol Home Detox

Allan, Smith and Mellin completed a study in 2000 for the Journal of Alcohol and Alcoholism which compared Alcohol Home Detox with hospital-based day patient care. The aim of the study was to compare the safety, effectiveness and acceptability of both methods of detoxification.

The study initially looked at past research into the matter and found that alcohol home detox was only likely to be a suitable setting for those with mild to moderate withdrawal symptoms, strong social support, and no medical or psychiatric complications (Fleeman, 1997).

The home detox used in the study consisted of the GP prescribing a course of chlordiazepoxide, and a nurse visiting every day of the detox to monitor withdrawal symptoms and advise on the use of the medication. The patients who entered the hospital-based day patient programme received the same medication and were assigned a key worker. The programme generally consisted of between 6 and 15 patients detoxing at the same time, forming a peer group.

The study followed up with patients 10 and 60 days after the detoxification start date. The follow-up consisted of a standardised interview that investigated past and recent alcohol use and also contact with treatment services. Patients also completed a number of self-report questionnaires which measured various aspects involved with the addiction, such as severity of alcohol dependence and social disruption. There was also a measure of patient satisfaction with the detox programme.

A higher proportion of the day-care patients fell into the severe dependency category than the home detox patients (81%), these patients also scored higher on measures of problems caused by alcohol and social disruption.

In the home detox condition, 79% of patients had achieved successful abstinence after 10 days, in comparison to 78% of the day-care programme patients. After completion of detoxification, 52% of the home detox group and 53% of the day-care patients became involved in further treatment.

At the 60 day follow-up patients were rated as either 'good' which indicated complete abstinence from alcohol or drinking less than 8 units a week, “improved” which indicated that if drinking had occurred, it did not exceed 21 units a week, and “unimproved” for those who were drinking more than 21 units a week or had become physically dependent on alcohol again. 45% of home-detox patients were classified as 'good', in comparison to 31% of the day-care programme. The results showed that those who had engaged with additional treatment following detox had significantly superior outcomes.

Overall, the results showed that both home and day detoxification provided safe and effective methods for withdrawing selected groups of patients from alcohol. However, it must be considered that those patients that took part in the day-care programme were a very severe group with very high rates of dependence, alcohol related problems and social instability, and therefore the similar success rates suggest that the day-care programme may have provided greater levels of abstinence given the patient sample for the home detox condition. The results also indicate the importance of ongoing treatment in maintaining abstinence.

References:

Allan, C., Smith, I. & Mellin, M. (2000). Detoxification from alcohol: A comparison of home detoxification and hospital-based day patient care. Alcohol and Alcoholism, 35, 66-69.

Fleeman, N. D. (1997) Alcohol home detoxification: a literature review. Alcohol and Alcoholism 32, 649–656.

Published by Addiction Advisor on 04/08/2011.

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