Outpatient alcohol detoxification: Implementation efficacy and outcome effectiveness of a model project

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.
Copyright (C) 2004 S. Karger AG, Basel.