THE DETOXIFICATION EXPERIENCE OF ALCOHOLIC INPATIENTS AND PREDICTORS OF OUTCOME

This paper reports the detoxification experience and outcome at 6 mont hs and 1 year following detoxification from alcohol in 160 patients ad mitted to a south-east London in-patient detoxification unit. Patients ' socio-demographic characteristics are also described. The sample was predominantly middle-aged, mainly male, and highly dependent on alcoh ol. Subjects had been drinking heavily for many years and suffered phy sical and social complications in consequence. The rate of convulsions was 3.1% and of delirium tremens 1.25%. The details of the level of d rug usage during detoxification and the assessment of severity of the withdrawal syndrome are also reported. The severity of the withdrawal syndrome and the incidence of significant complications of withdrawal were higher in those with a previous history of four or more episodes of detoxification, a previous history of withdrawal fits or evidence o f high levels of tolerance and dependence assessed either by the Sever ity of Alcohol Dependence Questionnaire (SADQ) or by drinking on a typ ical heavy drinking day in excess of 24 U of alcohol. It is suggested that subjects with one or more of these attribute should be treated on an inpatient, rather than an out-patient, basis unless adequate suppo rt and monitoring systems are in place. Overall, patients made improve ments on a wide range of social and psychological variables, but the ' abstinent' and 'controlled drinking' groups made significantly higher improvements on all variables in both follow-up periods. When patients improved their drinking status and reduced the levels of drink-relate d physical and social complications, in both time periods, their use o f social and health resources decreased significantly. Living circumst ances at intake were predictive of drinking status at both followup st ages. The amount drunk on a heavy drinking day, at both follow-up stag es, was predicted by severity of withdrawal, SADQ and living circumsta nces at intake in that order of importance.