title: Ambulatory detoxification of patients with alcohol dependence.
abstract: Detoxification from alcohol can be undertaken in ambulatory settings with patients who are alcohol-dependent and show signs of mild to moderate withdrawal when they are not drinking. An appropriate candidate for outpatient detoxification should have arrangements to start an alcohol treatment program and a responsible support person who can monitor progress, and should not have significant, acute, comorbid conditions or risk factors for severe withdrawal. Long-acting benzodiazepines, the preferred medications for alcohol detoxification, can be given on a fixed schedule or through "front-loading" or "symptom-triggered" regimens. Adjuvant sympatholytics can be used to treat hyperadrenergic symptoms that persist despite adequate sedation. Progress can be monitored with the use of a standard withdrawal-assessment scale and daily physician contact. Detoxification is not a stand-alone treatment but should serve as a bridge to a formal treatment program for alcohol dependence.
authors.affiliation: University of Louisville School of Medicine, Louisville, Kentucky, USA. blondell@buffalo.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Blondell
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000188:drug therapy / Q000534:rehabilitation*; D000553:Ambulatory Care; D003266:Continuity of Patient Care; D006801:Humans; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control