A Comparison of Home Detoxification and Minimal Intervention Strategies for Problem Drinkers

Abstract

The Home Detoxification Service (HDS) established in central Scotland was introduced in response to a high admission rate of problem drinkers to the acute psychiatric wards in Bellsdyke Hospital. This paper reports the results of a comparison of two types of management for people referred to the HDS by local general practitioners (family doctors). Ninety-five patients referred to the HDS were randomly allocated to two groups of differing treatment intensities. With one group, the home detoxification (HD) programme was utilized and with the other, minimal intervention (MI) strategies were employed. Post-treatment outcome information collected after 6 months was examined in relation to drinking behaviour, changes in levels of alcohol-related problems and uptake of on-going support from other alcohol agencies. The majority of patients in both treatment groups demonstrated some degree of improvement in relation to these criteria and the most striking factor was that patients in the HD group remained abstinent twice as long after treatment as those in the MI group.

Community detoxification for alcohol dependence: A systematic review

“…Twenty studies were eligible for the review and these included four RCTs , two case series , three qualitative studies , six observational studies , three quasi‐experimental studies and two mixed‐methods studies . Thirteen studies were conducted in United Kingdom (UK) , two each in the United States of America (USA) and Australia , and one each in Ireland , Brazil and Canada . The monitoring of the detoxification was done either at home or in outpatient settings .…”

“…Thirteen studies were conducted in United Kingdom (UK) , two each in the United States of America (USA) and Australia , and one each in Ireland , Brazil and Canada . The monitoring of the detoxification was done either at home or in outpatient settings . Sample sizes ranged from 4 to 517, and the wide range was because of the range of study designs included in the review.…”

“…The Severity of Alcohol Dependence Questionnaire was used to diagnose AD in seven studies , and International Classification of Diseases 10th Revision criteria were used to define AD in two studies . One study defined ‘severe alcoholism’ using the Michigan Alcoholism Screening Test .…”

“…One study defined alcohol withdrawal syndrome as presentation with hand tremors and one other physical manifestation of withdrawal . Some studies used standardised tools, such as the Severity of Withdrawal Symptom Checklist and the Modified Selective Severity Assessment to monitor the severity of withdrawal. These tools were used to determine withdrawal status for entry into the study.…”

“…Medications for detoxification were prescribed either in primary care or in community‐based addiction services . Detoxification symptoms and signs were monitored either at the patient's home or in outpatient settings (e.g. primary care clinics ).…”