Rens Eva, Ceelen Anna, Martens Nicolaas, Van Camp Lynn, Destoop Marianne
Multiversum Psychiatric Hospital, Boechout, Belgium.
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Drug Alcohol Rev. 2025 Feb;44(2):649-666. doi: 10.1111/dar.13986. Epub 2024 Dec 12.
There is growing awareness of the benefits of treating patients in their own home, yet home-based detoxification of individuals with substance use disorder has received limited attention. While home-based alcohol detoxification seems to be safe and effective for patients without severe withdrawal, little is known about detoxification for illicit or polysubstance dependence. This review synthesises recent findings on home-based detoxification for alcohol and other substances.
A systematic search of published and unpublished studies from 2010 onwards was conducted. Studies describing home detoxification interventions and programs, along with qualitative, quantitative and mixed-methods research, were included. Study quality was assessed using the Mixed Methods Appraisal Tool. Findings were narratively synthesised.
Eleven publications were included. Many studies are descriptive, explorative or use a small sample, but four studies are of high quality. Five publications focused exclusively on alcohol detoxification. The outcomes in reducing or abstaining from substance use seem acceptable, except for opioids. Patients and families reported high satisfaction, viewing it as less stressful than inpatient care. However, no conclusions can be drawn regarding the effectiveness compared to other detoxification settings.
The limited evidence base illustrates a great need for further investigation and controlled trials of home-based detoxification and comparison between detoxification settings. Investigating the broader applicability across substances is crucial.
Home-based detoxification shows potential as a safe and patient-preferred intervention, though more research is required to assess its broader effectiveness and feasibility across various substances. It could play a valuable role within established care models.
人们越来越意识到在患者家中进行治疗的益处，但针对物质使用障碍患者的居家戒毒却很少受到关注。虽然居家酒精戒毒对没有严重戒断症状的患者似乎是安全有效的，但对于非法药物或多种物质依赖的戒毒情况却知之甚少。本综述综合了近期关于酒精和其他物质居家戒毒的研究结果。
对2010年以来已发表和未发表的研究进行了系统检索。纳入了描述居家戒毒干预措施和项目的研究，以及定性、定量和混合方法研究。使用混合方法评估工具对研究质量进行评估。研究结果进行了叙述性综合。
纳入了11篇出版物。许多研究是描述性的、探索性的或样本量较小，但有4项研究质量较高。5篇出版物专门关注酒精戒毒。除了阿片类药物外，在减少或戒除物质使用方面的结果似乎是可以接受的。患者和家属报告满意度很高，认为其压力比住院治疗小。然而，与其他戒毒环境相比，无法就其有效性得出结论。
有限的证据基础表明，迫切需要对居家戒毒进行进一步调查和对照试验，并对不同戒毒环境进行比较。研究其在各种物质中的更广泛适用性至关重要。
居家戒毒显示出作为一种安全且患者偏好的干预措施的潜力，不过需要更多研究来评估其在各种物质中的更广泛有效性和可行性。它可以在既定的护理模式中发挥重要作用。
