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Effectiveness of daily outpatient alcohol detoxification by an Irish public psychiatric hospital – A pilot study

Published online by Cambridge University Press:  13 June 2014

Vincent Agyapong
Affiliation:
RCSI Rotational Training Scheme in Psychiatry
Jackie Benbow
Affiliation:
Department of Psychiatry, Connolly Hospital, Blanchardstown, Dublin 15, Ireland
Roy Browne
Affiliation:
St Brendan's Hospital, Dublin 7, Ireland

Abstract

Objective: To assess the effectiveness of daily outpatient alcohol detoxification in an Irish public psychiatric hospital.

Method: The outpatient records of patients presenting to the Assessment Unit of St Brendan's Hospital in one year (August 2004-July 2005) with symptoms of Alcohol Dependence Syndrome (ADS) and commencing daily outpatient detoxification were examined retrospectively for parameters relevant to the objectives of the study. The results were compiled and analysed using descriptive statistics.

Results: Forty patients underwent outpatient alcohol detoxification in one year and complete records were available for 32 patients (80%). Twenty patients had fixed addresses in the hospital catchment areas, eight patients had no fixed addresses and the remaining four patients had addresses outside the catchment areas. Seven patients (22%) presented with a co-morbid psychiatric condition including depression (four patients), anxiety disorder (two patients) and personality disorder (one patient). All seven patients were known to psychiatric sector services. Of the 32 patients commencing detoxification, 28 patients (87.5%) attended on the second day whilst 22 patients (69%) attended their third day's appointment. Only 17 patients (53%) completed the outpatient detoxification. Thirteen patients (40.6%) received at least two outpatient detoxifications during the year; of whom seven patients (58%) received their second detoxification within two months of the first one. The record of 20 patients (62.5%) showed that they had received advice regarding selfreferral to counselling services.

Conclusion: A high proportion of patients (47%) presenting with symptoms of ADS did not complete daily outpatient detoxifications. A high proportion of all patients (40.6%) also underwent multiple outpatient detoxifications during the year. It is possible that the separation between alcohol detoxification and alcohol counselling services in Ireland contributed to these disappointing results.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2007

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References

1.Press Release, 22 09 2004, Department of Health and Children, Ireland. Accessed online 12 12, 2005 at: www.dohc.ie/press/releases/2004/20040922.html.Google Scholar
2.O'Connor, PG, Schottenfeld, RS. Patients with alcohol problems. N Engl J Med 1998; 338: 592602.CrossRefGoogle ScholarPubMed
3.National Institute on Alcohol Abuse and Alcoholism. Tenth special report to the U.S. Congress on alcohol and health, 2000. Washington, DC: US Department of Health and Human Services; 2000.Google Scholar
4.Blondell, RD. Ambulatory Detoxification of patients with Alcohol Dependence. Am FamPhys 2005; 71(3).Google ScholarPubMed
5.US Preventive Services Task Force. Screening for alcohol misuse. Accessed online December 12, 2005 at: www.ahcpr.gov/clinic/uspsdrin.htm.Google Scholar
6.National Institute on Alcohol Abuse and Alcoholism. Helping patients with alcohol problems: a health practitioner's guide. Bethesda, MD: US Dept. of Health and Human Services, National Institute of Health, National Institute on Alcohol Abuse and Alcoholism, 2003, NIH publication no. 03-3769.Google Scholar
7.Gordon, AJet al.Three questions can detect hazardous drinkers. J Fam Pract 2001; 50: 313–20.Google ScholarPubMed
8.Kasser, C, Geller, A, Howell, E, Wartenberg, A. Detoxification; principles and protocols. American Society of Addiction Medicine. Accessed online December 12, 2005 at: www.asam.org/publ/detoxification.htm.Google Scholar
9.Kenna, GA, Mcgeary, EJ, Swift, RM. Pharmacotherapy, Pharmacogenics, and the Future OF Alcohol Dependence Treatment. Am J Health-Syst Pharm 2004; 61(21): 22722279.CrossRefGoogle Scholar
10.Hayashida, Met al.Comparative effectiveness and cost of inpatient and outpatient detoxification of patients with mild to moderate alcohol withdrawal syndrome. N Engl J Med 1989; 320: 358–65.CrossRefGoogle ScholarPubMed
11.Mayo-Smith, MF. Management of alcohol intoxication and withdrawal. In: Graham, AW, Schultz, TK, Wilford, BB. Principles of addiction medicine. 2nd ed. Chevy Chase, Md.: American Society of Addiction Medicine, 1998: 431–40.Google Scholar
12.Glickman, L, Herbsman, H. delirium tremens in surgical patients. Surgery 1968; 64: 882–90.Google ScholarPubMed
13.Furguson, JA, Suelzer, CJ, Eckert, GJ, Zhou, XH, Dittus, RS. Risk factors for delirium tremens development. J Gen Intern Med 1996; 11: 410–4.CrossRefGoogle Scholar
14.Wojnar, M, Bizon, Z, Wasilewski, D. The role of somatic disorders and physical injury in the development and course of alcohol withdrawal delirium. Alcohol Clin Exp Res 1999; 23: 209–13.CrossRefGoogle ScholarPubMed
15.Lewis, DC. The role of the generalist in the care of the substance-abusing patient. Med Clinic North Am 1997; 81:831–43.CrossRefGoogle ScholarPubMed
16.Finney, JW, Hahn, AC, Moos, RH. The effectiveness of inpatient and outpatient treatment for alcohol abuse: the need to focus on mediators and moderators of setting effects. Addiction 1996; 91: 1773–96.CrossRefGoogle ScholarPubMed
17.Soyka, M, Horak, M. Ambulatory detoxification of alcohol patients; evaluation of a model project. Gesundheitswesen 2000; 62(1): 1520CrossRefGoogle ScholarPubMed
18.Alcohol addiction treatment services in Ireland. Public Information; Dept. of Health and Children, Ireland. Accessed online December 12, 2005 at: www.dohc.ie/public/information/alcohol_and_drug_treatment_services/alcohol.Google Scholar