Skip to main content
Public Health Reports logoLink to Public Health Reports
. 1990 Sep-Oct;105(5):475–481.

Providing cost efficient detoxification services to alcoholic patients.

N N Beshai 1
PMCID: PMC1580107  PMID: 2120724

Abstract

The literature was reviewed to determine whether social model detoxification programs are safe and adequate for treating persons with alcohol withdrawal symptoms. The alcohol withdrawal syndrome has three stages. Each stage, more severe than the last, is reached by a smaller percentage of those withdrawing from alcohol. The literature showed that the majority of alcoholics can be detoxified safely in social model programs. These programs presented two main benefits, program cost efficiency and the patients' increased commitment to treatment compared with those treated at medical model programs. Medically operated detoxification programs appeared necessary for patients with a severe withdrawal condition at intake (abnormal blood pressure and pulse) and those with a history of severe withdrawal symptomatology. The results of the review reiterated the importance of screening clients at intake to ensure the safety of the patient and the appropriateness of the detoxification program.

Full text

PDF
475

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adinoff B., Bone G. H., Linnoila M. Acute ethanol poisoning and the ethanol withdrawal syndrome. Med Toxicol Adverse Drug Exp. 1988 May-Jun;3(3):172–196. doi: 10.1007/BF03259881. [DOI] [PubMed] [Google Scholar]
  2. Ansoms S. Detoxication cure. Some points for discussion. Acta Psychiatr Belg. 1980 Mar-Apr;80(2):183–190. [PubMed] [Google Scholar]
  3. Arroyave F., McKeown S., Cooper S. E. Detoxification--an approach to developing a comprehensive alcoholism service. Br J Addict. 1980 Jun;75(2):187–195. doi: 10.1111/j.1360-0443.1980.tb02444.x. [DOI] [PubMed] [Google Scholar]
  4. Bowen O. R. Raising public awareness about the extent of alcohol-related problems: an overview. Public Health Rep. 1988 Nov-Dec;103(6):559–563. [PMC free article] [PubMed] [Google Scholar]
  5. Burroughs A. K., Morgan M. Y., Sherlock S. Double-blind controlled trial of bromocriptine, chlordiazepoxide and chlormethiazole for alcohol withdrawal symptoms. Alcohol Alcohol. 1985;20(3):263–271. [PubMed] [Google Scholar]
  6. Cadet M., Dollois B., Bernard J. F., Abitbol A. La prévention du syndrome de sevrage. Sem Hop. 1979 May 8;55(17-18):891–896. [PubMed] [Google Scholar]
  7. Cushman P., Jr Clonidine and alcohol withdrawal. Adv Alcohol Subst Abuse. 1987;7(1):17–28. [PubMed] [Google Scholar]
  8. Elton M. Alcohol withdrawal: clinical symptoms and management of the syndrome. Acta Psychiatr Scand Suppl. 1986;327:80–90. [PubMed] [Google Scholar]
  9. Flygenring J., Hansen J., Holst B., Petersen E., Sørensen A. Treatment of alcohol withdrawal symptoms in hospitalized patients. A randomized, double-blind comparison of carbamazepine (Tegretol) and barbital (Diemal). Acta Psychiatr Scand. 1984 May;69(5):398–408. doi: 10.1111/j.1600-0447.1984.tb02511.x. [DOI] [PubMed] [Google Scholar]
  10. Foy A., March S., Drinkwater V. Use of an objective clinical scale in the assessment and management of alcohol withdrawal in a large general hospital. Alcohol Clin Exp Res. 1988 Jun;12(3):360–364. doi: 10.1111/j.1530-0277.1988.tb00208.x. [DOI] [PubMed] [Google Scholar]
  11. Glue P., Nutt D. Clonidine in alcohol withdrawal: a pilot study of differential symptom responses following i.v. clonidine. Alcohol Alcohol. 1987;22(2):161–166. [PubMed] [Google Scholar]
  12. Hayashida M., Alterman A. I., McLellan A. T., O'Brien C. P., Purtill J. J., Volpicelli J. R., Raphaelson A. H., Hall C. P. Comparative effectiveness and costs of inpatient and outpatient detoxification of patients with mild-to-moderate alcohol withdrawal syndrome. N Engl J Med. 1989 Feb 9;320(6):358–365. doi: 10.1056/NEJM198902093200605. [DOI] [PubMed] [Google Scholar]
  13. Hillbom M. E., Hjelm-Jäger M. Should alcohol withdrawal seizures be treated with anti-epileptic drugs? Acta Neurol Scand. 1984 Jan;69(1):39–42. doi: 10.1111/j.1600-0404.1984.tb07778.x. [DOI] [PubMed] [Google Scholar]
  14. Hore B. D., Rossall C. J. The incidence of alcohol withdrawal symptoms in admissions to the Withington Hospital Detoxification Unit. Alcohol Alcohol. 1985;20(1):53–56. [PubMed] [Google Scholar]
  15. Hore B. D. The Manchester Detoxification Centre. Br J Addict. 1980 Jun;75(2):197–205. doi: 10.1111/j.1360-0443.1980.tb02445.x. [DOI] [PubMed] [Google Scholar]
  16. Knott D. H., Lerner W. D., Davis-Knott T., Fink R. D. Decision for alcohol detoxication: a method to standardize patient evaluation. Postgrad Med. 1981 May;69(5):65-9, 72-5, 78. doi: 10.1080/00325481.1981.11715753. [DOI] [PubMed] [Google Scholar]
  17. Kolin I. S., Linet O. I. Double-blind comparison of alprazolam and diazepam for subchronic withdrawal from alcohol. J Clin Psychiatry. 1981 Apr;42(4):169–173. [PubMed] [Google Scholar]
  18. McGovern M. P., Caputo G. C. Outcome prediction of inpatient alcohol detoxification. Addict Behav. 1983;8(2):167–171. doi: 10.1016/0306-4603(83)90010-2. [DOI] [PubMed] [Google Scholar]
  19. McGovern M. P. Comparative evaluation of medical vs. social treatment of alcohol withdrawal syndrome. J Clin Psychol. 1983 Sep;39(5):791–803. doi: 10.1002/1097-4679(198309)39:5<791::aid-jclp2270390527>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  20. Mukherjee P. K. A comparison of the efficacy and tolerability of clobazam and chlordiazepoxide in the treatment of acute withdrawal from alcohol in patients with primary alcoholism. J Int Med Res. 1983;11(4):205–211. doi: 10.1177/030006058301100402. [DOI] [PubMed] [Google Scholar]
  21. Newsom J. A. Withdrawal seizures in an in-patient alcoholism program. Curr Alcohol. 1979;6:11–14. [PubMed] [Google Scholar]
  22. Ng S. K., Hauser W. A., Brust J. C., Susser M. Alcohol consumption and withdrawal in new-onset seizures. N Engl J Med. 1988 Sep 15;319(11):666–673. doi: 10.1056/NEJM198809153191102. [DOI] [PubMed] [Google Scholar]
  23. Nutt D., Glue P., Molyneux S., Clark E. Alpha-2-adrenoceptor function in alcohol withdrawal: a pilot study of the effects of iv. clonidine in alcoholics and normals. Alcohol Clin Exp Res. 1988 Feb;12(1):14–18. doi: 10.1111/j.1530-0277.1988.tb00125.x. [DOI] [PubMed] [Google Scholar]
  24. Ogborne A. C., Adrian M. The use of hospital beds for the treatment of excessive drinkers without serious medical complications. Br J Addict. 1987 Feb;82(2):193–196. doi: 10.1111/j.1360-0443.1987.tb01460.x. [DOI] [PubMed] [Google Scholar]
  25. Richman A., Neumann B. Breaking the 'detox-loop' for alcoholics with social detoxification. Drug Alcohol Depend. 1984 Jan;13(1):65–73. doi: 10.1016/0376-8716(84)90033-4. [DOI] [PubMed] [Google Scholar]
  26. Ritson B., Chick J. Comparison of two benzodiazepines in the treatment of alcohol withdrawal: effects on symptoms and cognitive recovery. Drug Alcohol Depend. 1986 Dec;18(4):329–334. doi: 10.1016/0376-8716(86)90095-5. [DOI] [PubMed] [Google Scholar]
  27. Sausser G. J., Fishburne S. B., Jr, Everett V. D. Outpatient detoxification of the alcoholic. J Fam Pract. 1982 May;14(5):863–867. [PubMed] [Google Scholar]
  28. Shaw J. M., Kolesar G. S., Sellers E. M., Kaplan H. L., Sandor P. Development of optimal treatment tactics for alcohol withdrawal. I. Assessment and effectiveness of supportive care. J Clin Psychopharmacol. 1981 Nov;1(6):382–389. doi: 10.1097/00004714-198111000-00006. [DOI] [PubMed] [Google Scholar]
  29. Shen W. W., Chavez C. E., Huang T. D. Which detoxified alcoholic keeps the first clinic appointment? Drug Alcohol Depend. 1983 Jun;11(3-4):353–358. doi: 10.1016/0376-8716(83)90025-x. [DOI] [PubMed] [Google Scholar]
  30. Sparadeo F. R., Zwick W. R., Ruggiero S. D., Meek D. A., Carloni J. A., Simone S. S. Evaluation of a social-setting detoxication program. J Stud Alcohol. 1982 Nov;43(11):1124–1136. doi: 10.15288/jsa.1982.43.1124. [DOI] [PubMed] [Google Scholar]
  31. Stough D. B., 4th Alcohol detoxification: emergency room treatment and referral in Arkansas. J Ark Med Soc. 1984 Jul;81(2):113–119. [PubMed] [Google Scholar]

Articles from Public Health Reports are provided here courtesy of SAGE Publications

RESOURCES