Detoxification from alcohol at home managed by general practitioners.

General practitioners have an important role in identifying and responding to problem drinkers, but no study has attempted to document their use of detoxification at home. A questionnaire was mailed to all general practitioners in Exeter Health District (n = 168) that was concerned with how they managed patients who presented with problems related to alcohol. The 145 (86%) responses showed that collectively they were identifying many more cases of problem drinking than any other local treatment agency. Of the estimated 230 patients a year for whom detoxification was arranged, half were managed at home, 40% in a local psychiatric hospital, and 9% in a local general hospital. Of those who were managed at home, 38% were unsupervised, a close relative held the medication for 45%, and 17% were supervised by a nurse. Fifty six percent (81) of doctors favoured chlormethiazole (Heminevrin) treatment, and many (17%) were prepared to prescribe this for longer than 10 days. Three quarters of the respondents thought that there was a need for specialist community services, such as community alcohol teams, to support general practitioners by supervising detoxification at home.