Home detox refers to the situation where a patient receives treatment for physical dependence on alcohol while they are predominantly based at home.
This is different to an inpatient setting, and could involve day visits to a medical centre, hospital or community setting specialising in alcohol detox.
It could also involve medical professionals visiting the person in their own home to monitor and guide them through their detox process.
It could be carried out by solely by a GP or by visits from specialist nurses or community alcohol practitioners. (8)
Careful Planning
Managing a person’s detox from alcohol requires a lot of careful thought and planning because of the potentially serious nature of the withdrawal symptom that could be experienced by people with an alcohol dependency.
Withdrawal from alcohol at its most severe can lead to seizures, tremors and an irregular heartbeat, all of which require medical assistance as alcohol is a central nervous system depressant (4)so constant monitoring of the detox process is essential. (7)
It has been assumed because of this that people following any detox programme would have to visit a medical centre and stay there throughout the detox process which can take up to a period of several weeks.
However, this is not necessarily the case. Community and home based alcohol detox treatment is an option as well now.
Inpatient services tend to incur higher costs so any opportunity to perform the detox in a less expensive way will be investigated, although the safety of the patient is always paramount. (3,8)
At OK Rehab, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.
To find out more, simply reach out to our 24/7, confidential hotline on 0800 326 5559.
Combating Stigma and Shame
For some years now, a large number of patients have gone through a safe alcohol detox process in the comfort of their own home.
This is can be easier for patients to accept, as there is more of a stigma associated with being admitted to a residential setting for treatment as an inpatient.
The feeling of shame and the stigma associated with being admitted for treatment as an inpatient is a very strong barrier for people in accepting treatment.
A home detox is a solution to overcome this barrier, but it must be completed safely and risks kept to a minimum.
In any case, it’s better to be supervised while completing a home detox than not having any treatment at all. (6,8)
Expert Methods, Backed by Research
Community alcohol teams have been around since the late 1960s, although the quality of their services and resources has increased immensely since then and they provide a home and community detox service. (8)
Providers of home detox services have access to a great deal of specialist knowledge and are able to liaise with different medical professionals when needed, such as drug specialist nurses, social workers with substance misuse experience, counsellors, general practitioners and psychiatrists.
There has been a substantial amount of scientific research carried out in the area of substance misuse over the last 20 years, and the established theories and practices that have been developed guarantee a high degree of reliability about the safety of the detox process from alcohol.
It can be said with a great deal of authority that all detox treatments are carried out safely with a high level of attention to detail. (5,8)
Research in this area is ongoing, and updated on a constant basis. This ensures that all professionals working in the area of medical detox have up to date knowledge on all aspects of the process.
Research suggests that there is no difference in the complications that occur between home detox and those going through the process in an inpatient setting, and long term abstinence rates appear to be equal. (5,8)
At OK Rehab, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.
To find out more about home detox, simply reach out to our 24/7, confidential hotline on 0800 326 5559.
The Importance of a Comprehensive Assessment
Whether home detox is safe is purely down to the individual circumstances of each person, a comprehensive assessment of all aspects of the person’s life will be undertaken by an experienced alcohol specialist.
People considering home detox as an option will be asked about their level of drinking, the type of drinks they consume, the situations they tend to drink in and how many times they have tried to cease drinking previously.
This helps build a picture of a person’s drinking behaviour. (1a)
Factors that will be important in reaching the decision include their level of tolerance, their support network, whether they have a dual diagnosis (another mental health diagnosis) or any underlying physical health conditions.
If any of the previously mentioned points are prevalent then it may well be best for them to attend an inpatient setting. (5,9)
Alcohol withdrawal lasts around 5 days and individuals with severe withdrawal which tend to appear between 24-48 hours after last consuming alcohol would probably be advised to attend an inpatient setting. (8)
As well as the severity of the withdrawal, another consideration regarding where the detox should take place is the level of support the person has available to them in their social network.
Someone who is isolated without much support maybe advised that it would be better for them to have treatment at an inpatient setting.
Alcohol Model of Care for Alcohol Misusers (MoCAM)
An important point to consider when assessing if it is safe for a person to have a home detox is which tier of the Alcohol Model of Care for alcohol misusers they are assessed to be in.
If they are assessed to be in tier 3, then they are probably OK to have detox at home. If, however, they are in tier 4, then they are assessed as being vulnerable to experiencing severe withdrawal symptoms if they cease drinking, which can be life threatening.
According to the Alcohol Model of Care, people assessed as being a tier 4 patient should have their alcohol detox treatment as an inpatient, whether it be in a hospital or specialist residential rehab setting. (8)
At OK Rehab, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.
To find out more about home detox, simply reach out to our 24/7, confidential hotline on 0800 326 5559.
Well Established Procedures Ensure Safety
A well established home detox protocol has been developed over the years, and a feature of this protocol includes set appointments every day throughout the detox period.
This is set by a qualified medical specialist (usually a nurse) in the area of substance misuse, who will regularly monitor the patient to asses progress and check for potential complications.
The whole process will be overseen by a GP, or psychiatrist with expertise in managing alcohol detox. (9)
The drugs Chlordiazepoxide or Diazepam are likely to form part of the detox treatment as they have been found to be safe to use and both possesses an anticonvulsant effect to help protect against any epileptic seizures.
The potentially dangerous consequences of of detoxifying from a central nervous system depressant like alcohol are greatly reduced by using minor tranquillizers such as Valium or Xanax, as these drastically cut down the risk of seizures and other possible risky withdrawal symptoms. (4)
Extra care will also be shown towards the patient’s safety. For example, if this medication causes drowsiness, patients will be provided with a list of things that they should avoid doing.
This includes driving or operating machinery. Those undergoing a medicated detox should also take extra care when carrying out other day-to-day activities such as cooking. (1a)
Even extremely at risk groups can be safely monitored and maintained in a home setting, as the whole process is intensely monitored with daily contact to ensure the patient’s well-being. (5,8)
Family Dynamics / Support Network
Ideally, those struggling with addiction need supportive and understanding friends and family members to help them through this challenging time.
Without this, a community based facility may be a better option. (9) Here they can build strong relationships with community based, supportive professionals and turn to them for support during this difficult period.
It is so important to obtain an accurate picture of each person’s family situation.
It’s not safe to assume the family environment will be entirely supportive throughout the process, as any conflict or disharmony could cause enough stress to trigger a relapse, or for the patient to lose focus on the task at hand.
If a person is involved in family tensions that previously caused stress that triggered drinking, contact with these family members could be a potential risk factor that may derail the detox treatment.
At OK Rehab, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.
To find out more about home detox, simply reach out to our 24/7, confidential hotline on 0800 326 5559.
Beware of Environmental Triggers
On the one hand it may seem logical for a person to want to go through a detox programme at home or in a community setting instead of staying at a specialist rehab setting for a specific period of time.
It can be beneficial for people to have detox at home due to the familiar, comforting surroundings present, and the supportive presence of a loving family.
However, all of these surroundings formed the environment that the person’s alcohol dependence developed in, so crucial aspects that led to the formation of the alcohol dependence will still be strongly present in the person’s life if they perform the detox at home. (7)
Many researchers who have investigated the psychology of addiction put forward the suggestion that in order for someone to recover from addiction, they need to remove the aspects of the environment that the addiction developed in from their lives in order to move on.
These familiar environmental cues can easily trigger a person’s desire to drink alcohol. (1,2,7)
For example, if a person has got into the habit over the years of regularly drinking alcohol at home whilst having friends over to watch sports, it may be difficult to be able to refrain from drinking in this situation after rehabilitation.
Familiar buildings, locations, sights, smells and sounds can all act as triggers for a person whose brain has registered firm associations between these stimuli and the act of drinking alcohol. (7)
Different surroundings to boost chances of recovery
If it is suspected that a person is vulnerable to cues that could trigger drinking, it might be better for them to get away from all of these environmental cues.
Residential rehab offers a change of environment with regular monitoring, free from any distractions or reminders of previous drinking experiences.
A completely new environment focused on total abstinence with a strict regime designed to alter a person’s mindset towards alcohol may be the best strategy to ensure any detox process is given the best chance of succeeding.
At OK Rehab, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.
To find out more about home detox, simply reach out to our 24/7, confidential hotline on 0800 326 5559.
Criteria for Home Detoxification
As has been mentioned previously a comprehensive assessment of person’s suitability for home detox should be carried out to assess whether their circumstances provide the best chances of a successful outcome.
A list of criteria has been developed by medical experts over the years to assess whether someone is a suitable candidate for home detox and includes: (5,8,9)
- They must be able to demonstrate a commitment to long term rehabilitation
- They must have little or preferably no involvement with other drugs
- They must be clear of having any significant medical conditions
- There must be a strong support network of family and friends available for the person to turn to throughout the treatment
- There is no evidence of them being suicidal, depressed or psychotic
- They must be able to convince medical professionals that they possess strong self-control and have no impulsive tendencies
- They must be seen to have a strong socio-economic foundation
Medical practitioners will always take the cautious approach due to the dangerous withdrawal symptoms when making a decision.
Every person is different, and on many occasions, a subjective judgement is required.
Even though the Alcohol Model of Care has developed clear tiers to help them identify which patients are the most vulnerable, some patients may be right on the border line between tier 3 and tier 4 rather than obviously fall into one of the tier categories.
Its important to add that clear guidelines and policies must be set, and if they are adhered to, then having an alcohol detox at home is very safe.
If there was any doubt then medical experts would take a safety first approach due to serious nature of alcohol withdrawal and strongly recommend that the person undergoes the detox process in an inpatient setting where they can be monitored regularly. (5,8,9)
Detox is only part of the recovery process
Remember, detox on its own is not really sufficient enough as a treatment to help people recover from being a dependent drinker. It focuses only on the physical dependence, i.e the withdrawal symptoms.
It’s more effective to combine the detox with psycho-social interventions as well. (3,5)
A person going through detox treatment must be motivated to engage in personal therapy and regularly attend AA meetings to work on the psychological and social reasons for their substance misuse.
If they are not sufficiently motivated to do this then it may be in their best interests to attend an inpatient setting.
At OK Rehab, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard it can be to change your relationship with addiction.
To find out more about home detox, simply reach out to our 24/7, confidential hotline on 0800 326 5559.
References
(1) Bargh, J. A., Chen, M., Burrows, L. (1996). Automaticity of Social Behaviour: Direct Effects of Trait Construct and Stereotype Activation on Action. Journal of Personality and Social Psychology, 71, 230-244.
(1a) Birmingham and Solihull NHS Foundation (2021) Medically Assisted Withdrawal From Alcohol at Home. Available@ 00007595_low-res_ARCH detox_Medically assisted withdrawal.pdf
(2) Danner, U. N., Aarts, H., de Vries, N. K. (2008). Habit v Intention in the Prediction of Future Behaviour: The Role of Frequency, Context Stability and Mental Accessibility of Past Behaviour. British Journal of Social Psychology, 47 245-265.
(3) Edwards, G., Marshall,E.J., Cook, C. (2003) The Treatment of Drinking Problems., Cambridge University Press
(4) Fisher, G. (2011) Understanding Why All Addicts are not alike. Praeger. Oxford, England.
(5) Lewis, J., Williams, S (2003) Home Detoxification Peterson, T. & McBride, A. (ed) Working with Substance Misusers: A Guide to Theory and Practice London. Routledge.
(6) Midgley, S., Petersen, T. (2002) Anti Discriminatory Practice in Substance Misuse Work. Peterson, T. & McBride, A. (ed) Working with Substance Misusers: A Guide to Theory and Practice London. Routledge.
(7) Moss, A, Dyer, K (2010) The Psychology of Addictive Behaviour. Palgrave McMillan. New York
(8) Rassool, G.H. (2011) Understanding Addictive Behaviours. Palgrave MacMillan. New York
(9) Raistrick, D. (2004) Alcohol Withdrawal and Detoxification in Heather, N., & Stockwell, T. (ed) The Essential Handbook of Treatment and Prevention of Alcohol Problems by (2004). John Wiley & Sons. Chichester
