Alcohol dependence not only reduces life expectancy, but also causes considerable loss of quality of life of the dependents of and persons around those with alcohol dependence. This article presents new evidence on the impact of alcohol dependence on health-related quality of life in Spain. Three samples were recruited: 150 alcoholics and 64 family members of alcoholics, with both samples taken from an alcoholism treatment unit, and 600 persons from the general population. We used the short form 6D, a preference-based generic instrument, applying the utility scores estimated for Spain. It was found that the annual mean loss of quality-adjusted life years associated with alcohol dependence was 0.144 and 0.083 for the alcoholics and their close family members, respectively. This impact becomes more notable after controlling for socio economic variables and was higher than that estimated in similar studies. Possible explanations for these differences are discussed. The results from this work can be applied to economic evaluation studies measuring benefits from policies targeted at reducing the prevalence of alcohol dependence.

Our findings confirm the benefits of adopting a heterogeneous approach to measure the effects of alcohol misuse. The estimated utilities could have both clinical and economic applications.

Alcohol dependence causes multiple problems not only for the person suffering dependence but also for others. In this study, the contingent valuation method is proposed to measure the intangible effects of alcohol dependence from the perspective of the persons directly involved: the patients and their relatives. Interviews were conducted with 145 patients and 61 relatives. Intangible effects of alcohol dependence were determined based on willingness to pay for a hypothetical treatment for dependence, with different success scenarios (100% and 50%). The mean monthly willingness to pay among the alcohol-dependent population was €129 and €168, respectively, for the treatments with 100% and 50% success. The willingness to pay of relatives was greater in both scenarios (€307 and €420, respectively), which could be explained by their greater perception of the family, labour, and health problems resulting from alcohol dependence. Regression analysis showed that patients' willingness to pay is positively related to treatment efficacy, personal income and moderate health deterioration, and negatively related to feeling discouraged and depressed. The results from this study can be applied to economic valuation studies that aim to measure the benefits of programs intended to reduce the prevalence of alcohol dependence. The intangible costs estimated can be added to the direct and indirect costs commonly used.

RESUMENOBJETIVOS: demostrar la seguridad del proceso de desintoxicación ambulatoria de la dependencia alcohólica. METODOLOGÍA: análisis retrospectivo de 100 desintoxicaciones indicadas en la Unidad de Alcoholismo de Vigo, recogiendo las siguientes variables: sexo, edad, ámbito de desintoxicación, fármaco utilizado para la desintoxicación, otros fármacos para deshabituación (aversivos, anti-craving), desintoxicación completada, sintomatología de abstinencia leve, moderada o grave. Se utilizó para la desintoxicación Clometiazol en 66 casos, Tetrabamato en 29 y benzodiacepinas en 3 casos. Se cruzaron las variables estudiadas con la presencia o no de síntomas de abstinencia, utilizando la prueba del chi cuadrado.RESULTADOS: Se completó la desintoxicación ambulatoria en 88 casos sin la aparición de síntomas; aparecieron síntomas leves o moderados en 15 casos y ninguno presentó síntomas graves de abstinencia. Solo 2 casos precisaron ingreso hospitalario. Ninguna variable se correlaciona con la aparición de sínto-mas de abstinencia. CONCLUSIÓN: La desintoxicación ambulatoria es un proceso seguro, una vez excluida causa de ingreso. 29ABSTRACT GOAL: to show that out-patient detoxification is a safe process to treat alcoholic addiction.METHODS: a retrospective analysis of 100 detoxifications reported in the Alcoholism Unit of Vigo was performed. The following variables were included in the study: gender, age, detoxification environment, main drug used for detoxification, other drugs used for alcoholism treatment (aversive, anticraving), complete detoxification; symptoms of slight, moderate or serious abstinence. The following drugs were used for detoxification: Clometiazol in 66 cases, Tetrabamato in 29 and benzodiazepines in 3. A comparison analysis of these variables was carried out using the chi square test.RESULTS: The out-patient detoxification was successfully completed in 88 cases; slight or moderate symptoms of abstinence showed up in 15 cases, and none of them had serious symptoms of abstinence. Only 2 cases needed to be hospitalized.CONCLUSION: Out-patient detoxification is a safe process, if a reason for hospitalization is excluded.

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