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.


METHODS
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.
Soyka
Michael
M
Psychiatric Hospital, University Munich, Munich, Germany. Michael.Soyka@psy.med.uni-muenchen.de
Horak
Michael
M
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000534:rehabilitation*; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D000431:Ethanol / Q000009:adverse effects / Q000493:pharmacokinetics; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D011613:Psychotherapy; D011615:Psychotherapy, Group; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000534:rehabilitation; D013695:Temperance / Q000523:psychology / Q000706:statistics & numerical data; D016896:Treatment Outcome
D011619:Psychotropic Drugs; D000431:Ethanol