detox: inpatient or out?

24 Jul

CRITERIA FOR AMBULATORY DETOX

  • no symptoms of delirium tremens (DT):
    • fever,
    • disorientation,
    • seizures,
    • drenching sweats,
    • severe tachycardia or hypertension
  • Able to take oral medications
  • reliable family member or close contact who can stay with the patient (usually three to five days) 
  • Able to commit to daily medical visits
  • No unstable medical condition
  • Not psychotic, suicidal, or significantly cognitively impaired
  • Not pregnant
  • No concurrent other substance abuse that may lead to withdrawal 
  • No history of DTs or alcohol withdrawal seizures

 

Relative contraindications for ambulatory detox

  • age >60 years
  • evidence of end organ damage from alcohol
    • bone marrow toxicity as evidenced by an elevated MCV
    • renal insufficiency,
    • ascites
    • cirrhosis

 

Submitted by J. Stanton.

 

References: uptodate.com; picture

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