The safety and short-term effectiveness of home detoxification (HD) was investigated by contrasting rates of treatment completion and of complications of 41 service users with those of a retrospectively matched inpatient comparison group. The latter comprised patients of a detoxification unit matched for age, sex and degree of alcohol dependence with HD subjects. HD subjects had severe problems with alcohol--they averaged 28.7 on the SADQ, 4.6 serious alcohol-related problems in the previous 2 months, a GGT of 123.8 and 174.6 reported units of alcohol consumed in the week before treatment. A high follow-up rate was achieved for both HD subjects and their relatives; there was close agreement between clients' reports, carers' reports and breathalyser readings with regard to further alcohol consumption. The HD subjects were visited at home an average of 6.9 times over 6.15 days. Chlormethiazole was prescribed in 36 cases at an average maximum daily dose of 6.3 capsules--significantly fewer than for the inpatient group. Both rates of completion and complication were virtually identical in the 2 groups. It is concluded that these data suggest HD is equivalent in both its safety and immediate efficacy to more expensive inpatient care.

The value of a new Home Detoxification service was assessed in a variety of ways employing data collected from 41 clients of the service, their family and GP's. By 60 days from the start of treatment, 11 clients were abstinent, two were controlling their drinking with relatively few problems, 13 had 'improved', 14 were not 'improved' and one had an unknown outcome. Subsequent involvement in treatment by both clients and their partners was high in comparison with other studies. Significant predictors of 'Good' outcome included attendance for after-care by client and by spouse/partner and a low Alcohol Problems Inventory score. High levels of satisfaction were expressed with the HD service by clients, their carers and GP's. The great majority of clients gave 'home' as their preferred place of treatment and nearly half claimed they would have been unwilling to accept hospital care. There was evidence of significant, though modest, shifts in GP's management practices towards less use of hospitals and greater use of the patient's home after 15 months of the programme.

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