Should Outpatient Alcohol Detox be Used at All?

Should Outpatient Alcohol Detox be Used at All?


Outpatient alcohol detox is one of the worst ideas I’ve ever heard about in substance abuse therapy.  Normally what happens with traditional alcohol detox is that you have the alcoholic in an inpatient setting under direct medical supervision.  This has always been preferable because alcohol withdrawal is actually very dangerous in that the alcoholic is somewhat prone to having seizures.  In fact, people can actually die from alcohol withdrawal if it is not handled properly.

Being in an alcohol detox unit for many years, I have actually seen a number of seizures occur due to alcohol withdrawal, and in many cases the people had been up walking around at the time and therefore had a fall involved with the incident. Obviously this is not good and it could very easily happen to anyone who is detoxing from alcohol.  Many of these seizures occurred in people who had never had a seizure before in their entire life.

Parade Jacob
Creative Commons License photo credit: flossyflotsam

Now if you combine this risk towards have seizures during alcohol detox with other factors that are involved with alcohol detox, it makes for a very risky situation.  I suppose the idea behind outpatient detox is that people will be sent to their home with medication, and they are to self administer that medication over the course of the next few days while not drinking.  That is what needs to happen in order for them to get through alcohol detox.

What kind of success rate could we really expect from this type of setup?  If people are in their homes, then they are likely in the exact same environment in which they drank every day. They are also probably being exposed to the same people who they normally might have drank or used drugs with.  Part of the advantage of inpatient detox is that you remove the alcoholic from their drinking environment.  With outpatient detox, you obviously lose this advantage.

Many alcoholics have complications as well when it comes to their health. A lot of times, our drinking tends to cover up medical issues that we might be having, and these issues come to the surface when we finally get sober.  This tendency demands medical attention during alcohol detox, because that is when complications and problems arise.  A certain percentage of alcoholics who are detoxing have to go to the emergency room for some issue or another due to complications.  Under outpatient alcohol detox, this likely would never happen and serious medical conditions would go untreated.

Another argument against outpatient detox has to do with the benefits that people receive while they are in rehab.  One, they are getting peer support from the other people who are in treatment with them (this is not to be underestimated).  And two, they are getting professional help from therapists and counselors who are trying to guide them and match them up with resources to stay sober in the long run.  When you do an outpatient form of detox, you miss out on these two crucial benefits, unfortunately.

We can do better than this, people.  Demand inpatient treatment.  Alcoholism requires it.