Home-based detoxification for individuals with alcohol or drug dependence: A systematic review of the recent literature.

Issue: 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.

Approach: A systematic search of published and unpublished studies from 2010 onwards was conducted.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.

Key Findings: 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.

Implications: 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.

Conclusion: 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.