Outcome after in-patient detoxification for alcohol dependence: A naturalistic comparison of 7 versus 28 days stay

Research has tended to show that the gains of residential rehabilitation ar e short-term and cost-inefficient, This study compares the outcomes of two samples, one group staying at a non-statutory sector alcohol detoxification unit for less than or equal to7 days (short stay: SS) with a second group also admitted for detoxification but who stayed at the Unit for a further 8 -21 days (long stay: LS). Allocation was not at random: the longer stay was either at the request of the client, referring or treatment agency itself and then had to be approved by an external funding agency. Sixty-four DSM-I V (Diagnostic and Statistical Manual of Mental Disorders) alcohol-dependent subjects were studied. Baseline data included socio-demographic informatio n, illicit drug use during the past 12 months, severity of alcohol dependen ce, alcohol problems, physical/psychological symptoms, depression and indic es of quality of life. At baseline, LS subjects reported more recreational cannabis use than SS subjects. Sixty-two (97%) subjects were re-interviewed 12 weeks after baseline assessment. During follow-up, equal proportions of each group relapsed (greater than or equal to 21 units/7 day period for ma les; greater than or equal to 14 units/7day period for females). There was a trend for SS clients to have consumed less alcohol in total than the LS c lients. The trend was towards improvement in the study measurements for the SS group, though none of the changes was significant. In the LS group, all variables tended towards a deterioration in health status. The longer stay did not appear to confer any extra benefit to the LS group. Cannabis use a nd illicit drug use at baseline, while commoner in the LS group, did not pr edict drinking or social adjustment in the follow-up period in this sample and thus could not be used to explain the lack of a better outcome in the L S group.