Outpatient Alcohol Detoxification: Implementation Efficacy and Outcome Effectiveness of a Model Project

Abstract

Background: The aim of the study was to examine the practicability and implementation efficacy of an alcohol outpatient detoxification model and the concomitant ‘motivational’ psychotherapeutic approach. Method: This was an open prospective study to examine the implementation efficacy, practicability and medical safety of a novel psychotherapy-based, integrated outpatient detoxification model in alcohol-dependent patients. Patients were carefully screened for relevant neuropsychiatric disorders and other exclusion criteria and then seen on a daily outpatient basis for 5–7 days. Patients received psychotropic or other medication, if necessary (CIWA-A score >16). Beside management of withdrawal symptoms, psychotherapeutic interventions were conducted to motivate the patient for further alcohol therapy. Results: Of 557 patients screened 331 entered the program. For medical reasons 226 patients had to be admitted for inpatient detoxification, 122 patients in a special alcohol unit, 101 patients in a general hospital. 198 (60%) of the outpatients received psychotropic medication during treatment. 312 (94%) of these patients successfully completed treatment. 301 (91% of the initial sample) patients entered a consecutive 3-month motivational phase of a two-phase alcohol treatment program. 139 (46%) patients successfully completed the 1-year consecutive outpatient treatment. Conclusions: Outpatient detoxification, at least in a highly structured frame, can be considered as a safe and efficient therapeutic approach. The data of this study also indicate that psychotherapeutic interventions and motivation for further abstinence and treatment may work in alcohol-dependent patients on an outpatient basis. Further controlled trials are necessary to compare the effects of outpatient versus inpatient withdrawal.

Efficacy of an Intensive Outpatient Rehabilitation Program in Alcoholism: Predictors of Outcome 6 Months after Treatment

“…The outpatient facility offers a high-structured, intensive two-phase treatment model with a similar setting to conventional inpatient treatment with respect to intensity and quality of psychotherapy. The model has been described in detail [7,8] . An initial 12-week motivational phase is followed by the 6-to 9-month rehabilitation phase which is the subject of research.…”

The alcohol withdrawal syndrome

“…In one study, 94% of patients deemed suitable for outpatient management of AWS successfully completed detoxification in this setting 48. Outpatient management of AWS is indicated where the patient is willing to participate, does not have significant comorbid medical, psychiatric, cognitive or polysubstance use problems, has transportation to/from the follow-up visits, and has support in the community.…”

Sozialmedizinische Prognose der Entzugsbehandlung Suchtkranker

“…Abhängig-keitsdiagnose, problematische Schulden, Abhängigkeitsdauer und Familienstand hatten keinen signifikanten Effekt auf die Abstinenz im Beobachtungszeitraum. [2,5,11,15,16,17,21,24,29,31,32,33,34,40].…”