Feature
Audit of alcohol detoxification
at Leeds Addiction Unit
Ashish Rana, Vikram Luthra, Muhammad Noman Khan Wazir, Rashmi Yadav and
Duncan Raistrick
Abstract
Purpose – At any one time, 76 million people have an alcohol use disorder. Detoxification is a common
intervention for alcohol dependence. There is a need regularly to assess and evaluate detoxification
practice. The aim and objective of this paper is to describe the findings of audits which assessed the
quality and safety of the detoxification experience and to implement changes to improve practice.
Design/methodology/approach – All community detoxifications in March 2009 and 2010 were
included for the successive audits. Notes were inspected retrospectively three months post completion
of detoxification using the audit standard.
Findings – A total of 50 and 59 people were eligible in respective audits. At 3 months post-detoxification
23 per cent of patients had dropped out of treatment compared to 15 per cent in the re-audit. In 2009,
31 per cent of patients remained completely abstinent and 10 per cent were drinking within safe limits
but in 2010 figures improved to 36 per cent and 22 per cent, respectively. Disulfiram was continued by
66 per cent of abstinent patients in the initial audit and 89 per cent in the reaudit. Improved follow-up
protocol, regular advice and monitoring of disulfiram resulted in better abstinence and reduced drop out
rates over successive years. Social and Behavioral Network Therapy and disulfiram taken under
medical supervision after detoxification play a pivotal role in relapse prevention.
Originality/value – The study considers the importance of the post-detoxification period, in terms of
maintaining a patient’s abstinence from alcohol.
Keywords Alcohol, Alcoholic drinks, Detoxification, Auditing
Paper type Research paper
Introduction
The World Health Organisation (2004) estimates that, at any one time, 76 million people have
an alcohol use disorder. In the UK, it is estimated that 24 per cent of adults drink in a
hazardous or harmful way (The NHS Information Centre, 2009). It has been argued that
alcohol is also responsible for an enormous burden of social, mental and economic
problems, including crime, accidents and domestic violence (Babor et al., 2003). Nearly,
3 per cent of all deaths are caused by alcohol per annum (Jones et al., 2008). Detoxification
from alcohol is a common intervention for alcohol dependence: its aim is to minimise the
severity of withdrawal symptoms that occur when alcohol consumption is abruptly stopped
or markedly reduced, thereby achieving an alcohol-free state with maximum safety and
minimum discomfort to the patient (Raistrick, 2000). To ensure that detoxification is delivered
to the highest standard of efficacy practitioners need regularly to assess and evaluate their
practice (Raistrick et al., 2006). While service audits are important tools for ongoing
improvement, the information on how to conduct such audits is not always readily available
(Greenwood and Farmer, 2000).
DOI 10.1108/17459261211211700 VOL. 12 NO. 1 2012, pp. 45-50, Q Emerald Group Publishing Limited, ISSN 1745-9265
j
DRUGS AND ALCOHOL TODAY
j
PAGE 45
Ashish Rana and
Vikram Luthra are both
Specialty Registrars, year 6,
Muhammad Noman Khan
Wazir is a Specialty Doctor,
Rashmi Yadav is a Specialty
Registrar, year 6 and
Duncan Raistrick is a
Consultant Psychiatrist,
all at Leeds Partnerships
NHS Foundation Trust,
Leeds, UK.