I don't need drug and alcohol rehab! I can get a detox at home.
Updated: Aug 7
Let me start by saying that it is possible to do this, and I work with a consultant psychiatrist in addictions who can do this for you. Yes, in some circumstances it is possible to get drug and alcohol rehab at home. If necessary, a whole team can be brought in to look after you at home. There are certain exclusions to this, but they can be arranged, if clinically viable. If you want to do this: call. Imagine you have broken your leg. What is the first thing that comes to mind? I suspect it is going to hospital, having some images taken, perhaps surgery or a cast? A pair of crutches? A moon boot? Being immobile for a period and perhaps, not being able to go to work? (Depending on what you do and how you get there). You may need physiotherapy and/or some adaptations to your home and walking aids: Depends on the severity. At the very least, you are going to need safe and effective medical care. No one, I hope, would try and fix this themselves at home. Yes, there are situations where statutory services will provide home alcohol detox. However, from experience of working in these settings, this is not something that a client will be aligned to, straightaway. There are very narrow circumstances in which this is available and significant considerations which are discussed later. https://www.charlesriverrecovery.com/danger-of-at-home-recovery-alcohol-detox/ Dependency on alcohol and/or drugs is an illness (https://iuhealth.org/thrive/is-addiction-really-a-disease) and therefore needs proper medical attention. With regards to treatment at home for alcohol dependency, there are very strict clinical guidelines as to what treatment options you can offer in the home: https://www.nice.org.uk/sharedlearning/alcohol-withdrawal-management-for-acute-admissions-to-hospital The criteria are very narrow for home treatment and 99% of companies who offer it do so illegally. The Care Quality Commission (CQC) does not regulate home alcohol detox https://www.cqc.org.uk/ as this is a treatment programme, not a regulated activity. To explain fully, the situation would make for a long and complex answer. The regulation is around the services provided and not the prescription issued. The consultant psychiatrist (addictions specialist) that I work with is fully registered with the Care Quality Commission (CQC) to provide treatment at home. However, most companies that advertise this service are not and are trading: illegally. In short, the situation is this: A doctor, with General Medical Council (full) registration can issue a prescription for the medication needed for a home detox. However, they can’t monitor your or assess your progress: This becomes a regulated activity.They can only do this if they are a general practitoner or a doctor who is on the General Medical Council’s list of addictions specialists and who has a day job in a service with CQC registration. Any healthcare professional that forms part of the treatment plan would be carrying out a regulated activity: without the activity being registered. While a nurse prescriber, such as I, can write a prescription in a private clinic for a detox, such a nurse cannot write one for treatment at home: Unless that service has registration with the CQC. This doesn’t happen. A doctor who is on the General Medical Council’s register of specialisms for addiction or a GP, who has registration for their “day job” can write a private prescription for a home detox but only if the doctor is paid directly. I told you it was complicated! However, as above, that is all they can do. If they contact, you and/or monitor you it becomes an unregulated activity. Considering the potential difficulties someone could find themselves in, no doctor who cherishes their livelihood would do this. Thus, any companies who advertise alcohol home detox who demand payment upfront, are trading illegally. Also, any such company who uses a nurse or pharmacist prescriber and does not have registration for home alcohol treatment is also trading illegally. A recent, wide ranging, investigation into a company providing such services has highlighted the regulatory framework around home detox for alcohol. If a service is provided unlawfully, not only does this mean that the person providing it is putting their registration at risk, but their professional indemnity insurance also won’t cover them. https://www.themdu.com/ Community drug and alcohol services will, where clinically appropriate, provide home alcohol detox. However, what this can’t do is provide the therapeutic treatment that is needed to achieve and maintain abstinence. From experience, the risk of relapse for home treatment clients is exceptionally high. While community services will adhere to the strict guidelines issued by NICE https://www.nice.org.uk/sharedlearning/alcohol-withdrawal-management-for-acute-admissions-to-hospital there is no assurance, whatsoever, that a home alcohol treatment company will adhere to these. The vast majority will assess someone, over the phone, and demand payment of around £1,500 before they pass you onto a clinician. They will not speak to the client's GP, arrange blood tests or be able to provide safe monitoring of clients, let alone a safe assessment. The staff, while they may have their own experience of addiction (which can be invaluable) are never clinically trained or accountable to any professional body. During my time in this sector, I have come across clinicians who will prescribe for patients on the strength of information from relatives and give very dangerous treatment advice to patients. Indeed, I have even come across a clinician who advises patients to commence medication, immediately upon receiving it: regardless of their physical state. Other serious issues have been clinicians who have had a 10–15-minute telephone conversation with a patient and simply sent out a prescription. Companies who provide home detox on the internet, the vast majority of whom do so illegally, will charge you anything from £995 to £1500, if not more. What do you get for this? Well, from my experience in this sector you will get a very quick and dirty assessment from someone who is not clinically trained. They care not if you are clinically viable but merely if you can pay and will take your payment: After all, they are working to targets. Once you have paid your money this creates another issue: You expect a prescription. A clinician will call you (nurse prescriber pharmacist prescriber or a doctor). They will assess you but, as you have paid, you expect to get your prescription. I have seen some horrendously unsafe treatment plans being drawn up and sent out to those who should not be treated at home. Companies who offer this unsafe and illegal treatment will make all sorts of promises. With my consultant psychiatrist the service only operates within nationally recognized guidelines. He will not, unlike other services, pick up a prescription pad because you have picked up a credit card.