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The following are useful texts on home detox extracted by top detoxification specialist David Cooper.
Allan C; Smith I; Mellin M. Detoxification from alcohol: A comparison of home detoxification and hospital-based day patient care. Alcohol and Alcoholism 35(1): 66-69, 2000. (12 refs.)
An uncontrolled study was carried out to examine two types of ambulatory care for patients undergoing detoxification from alcohol. The safety, efficacy, and acceptability of home detoxification was compared to detoxification within a day hospital setting. Seventy- nine per cent of home detoxification patients, many of whom had major alcohol-related problems and were severely dependent on alcohol, were successfully detoxified at 10 days.
The day hospital group overlapped in severity with the home group and 78% completed detoxification. At 60 days, 45% of home detoxification patients and 31% of the day hospital group showed significant improvements in a range of alcohol- related difficulties. Improved outcome was associated with attendance for further treatment for both groups. Both home and day hospital detoxifications were viable alternatives to in-patient detoxification for selected groups of patients.
Alwyn T; John B; Hodgson R. Outcomes and processes of change of a home detoxification psychosocial intervention treatment trial. (meeting abstract). Addiction Biology 7(3): 329-330, 2002. (0 refs.)
The aims of this study were to determine whether a relatively brief psychological intervention can add to the effectiveness of home detoxification and to explore the processes of change that facilitate success. The 91 participants were assigned randomly to either the psychological intervention or treatment as usual (control). The brief psychological intervention involved motivational interviewing, coping skills, and social support. Baseline and outcome assessments included measures of alcohol consumption, day’s abstinent, alcohol-related problems, severity of dependence, desire to drink, drinking situations, social support and satisfaction, health-care utilization, self-esteem, and perception of health.
Outcomes measured at the 3-month and 12-month follow-ups indicate that the psychological intervention resulted in significant positive changes in alcohol consumption, abstinent days, social satisfaction, self-esteem, and alcohol-related problems. The psychological intervention resulted in wide-ranging health service benefits and was a ninth of the cost of inpatient treatment. It was concluded that home detoxification is safe and effective for all drinkers, including those who are severely dependent. The findings confirm that the changes processes in alcohol treatment depend on the interaction of a number of factors, including availability and quality of social networks and individual characteristics. A further conclusion was that psychological masculinity and femininity may be more salient to contemporary society than gender differences.
Bartu AE. Detoxification. In: Cooper DB, ed. Alcohol Use. Oxford: Radcliffe Medical Press, Ltd, 2000. pp. 173-184. (17 refs.)
This chapter describes the alcohol withdrawal syndrome. It reviews the onset of withdrawal symptoms, the duration of withdrawal, and those at risk. It then considers management and supportive care, identifying standard protocols that are available. Several illustrative case studies are provided.
Bischof GH; Richmond CJ; Case AR. Detoxification at home: A brief solution-oriented family systems approach.Contemporary Family Therapy 25(1): 17-39, 2003. (43 refs.)
The authors propose an outpatient, solution-oriented, family systems approach to detoxification from alcohol and/or drugs. Research indicates that outpatient detoxification is a viable option, one that will likely be utilized even more frequently as health care costs continue to rise. Non-traditional assumptions about the process of detoxification are suggested that challenge traditional notions about detoxification being only a biomedical, pre-treatment event. Criteria are provided for determining the appropriateness of clients for outpatient detoxification and offer information about typical withdrawal symptoms and guidelines for the detoxification environment at home. A case example illustrates the application of this approach in a community mental health program. Suggestions for adapting this approach to various settings are also offered.
Roche AM; Watt K; Fischer J. General Practitioners' views of home detoxification. Drug and Alcohol Review 20(4): 395-406, 2001. (35 refs.)
There is a growing movement towards community-based health care for the treatment and management of alcohol and drug problems across Australia. In spite of substantial evidence to support the clinical efficacy, cost-effectiveness, and the utility of home detoxification, it is not an activity that has been readily embraced by Australian General Practitioners (GPs). Thus, GPs' views on this issue are vital if there is to be any form of viable home detoxification programme for alcohol and/or other drugs. A qualitative study was undertaken to determine General Practitioners' views in regard to alcohol and drug home detoxification. A qualitative data collection method, focus groups, was used.
Focus group participants were obtained from a maximum variation sampling technique. Twelve focus groups were conducted in rural and metropolitan Queensland Australia, over a four-month period. Fifty-two participants (43 general practitioners and 9 other health professionals, 20 females and 32 males). Mean age was 40.5 years (age range 19-70).
Views about home detoxification were dependent on level of experience with substance abuse treatment. Overwhelmingly, GPs argued that for home detoxification to become viable, there would need to be a more responsive infrastructure, clear policy guidelines, training and more reasonable remuneration than currently exists. GPs require improved training in addiction and drug and alcohol problems. Revised remuneration schemes will facilitate better GP management of complex chronic problems such as addiction. Even though GPs' held quite negative views about alcohol and drug dependent patients there was a high level of willingness to become involved in their treatment and support. Although the clinical efficacy of home detox has been demonstrated GPs have understandably mixed views about their potential involvement. Improved training, support and resourcing is needed to substantially facilitate the expansion of GPs' role into this growing area of care.
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