Detoxification From Alcohol and Other Drugs Treatment Improvement Protocol (TIP) Series 19
[Front Matter]
[Title Page]
Detoxification From Alcohol and Other Drugs Treatment Improvement Protocol (TIP) Series 19
Donald R. Wesson, M.D. Consensus Panel Chair
U.S. Department of Health and Human Services Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857 DHHS Publication No. (SMA) 95-3046 Printed 1995.
This publication is part of the Substance Abuse Prevention and
Treatment Block Grant technical assistance program. All material
appearing in this volume except quoted passages from copyrighted sources
is in the public domain and may be reproduced or copied without
permission from the Center for Substance Abuse Treatment (CSAT) or the
authors. Citation of the source is appreciated.
This publication was written under contract number ADM 270-91-0007
from the Center for Substance Abuse Treatment of the Substance Abuse and
Mental Health Services Administration (SAMHSA). Sandra Clunies, M.S.,
served as the CSAT Government project officer. Dorynne Czechowicz,
M.D., served as the Government content advisor. Carolyn Davis, Betsy
Earp, Jo Lane Gregory-Thomas, Linda Harteker, Lise Markl, and Gail
Martin served as writers.
The opinions expressed herein are the views of the consensus panel
members and do not reflect the official position of CSAT or any other
part of the U.S. Department of Health and Human Services (DHHS). No
official support or endorsement of CSAT or DHHS for these opinions or
for particular instruments or software that may be described in this
document is intended or should be inferred. The guidelines proffered in
this document should not be considered as substitutes for individualized
patient care and treatment decisions.
CSAT Treatment Improvement Protocols (TIPs) are prepared by the
Quality Assurance and Evaluation Branch to facilitate the transfer of
state-of-the-art protocols and guidelines for the treatment of alcohol
and other drug (AOD) abuse from acknowledged clinical, research, and
administrative experts to the Nation's AOD abuse treatment
resources.
The dissemination of a TIP is the last step in a process that begins
with the recommendation of an AOD abuse problem area for consideration
by a panel of experts. These include clinicians, researchers, and
program managers, as well as professionals in such related fields as
social services or criminal justice.
Once a topic has been selected, CSAT creates a Federal resource
panel, with members from pertinent Federal agencies and national
organizations, to review the state of the art in treatment and program
management in the area selected. Recommendations from this Federal
panel are then transmitted to the members of a second group, which
consists of non-Federal experts who are intimately familiar with the
topic. This group, known as a non-Federal consensus panel, meets in
Washington for 5 days, makes recommendations, defines protocols, and
arrives at agreement on protocols. Its members represent AOD abuse
treatment programs, hospitals, community health centers, counseling
programs, criminal justice and child welfare agencies, and private
practitioners. A chair for the panel is charged with responsibility for
ensuring that the resulting protocol reflects true group consensus.
The next step is a review of the proposed guidelines and protocol by
a third group whose members serve as expert field reviewers. Once their
recommendations and responses have been reviewed, the chair approves the
document for publication. The result is a TIP reflecting the actual
state of the art of AOD abuse treatment in public and private programs
recognized for their provision of high-quality and innovative AOD abuse
treatment.
This TIP, Detoxification From Alcohol and Other Drugs,
describes detoxification care in a number of settings. Detoxification
and patient matching are discussed. The TIP provides clinical
guidelines for detoxification from specific classes of drugs such as
sedative-hypnotics, stimulants, and opiates. Detoxification needs of
special populations are addressed. The TIP also includes information
helpful to planners and policymakers about costs, quality improvement,
outcome criteria, health care reform, and linking
detoxification -- often the gateway to ongoing treatment -- to
the larger continuum of care in the substance abuse treatment system.
Legal and ethical issues of concern to detoxification programs are also
examined.
This TIP represents another step by CSAT toward its goal of bringing
national leadership to bear in the effort to improve AOD abuse
treatment.
Other TIPs may be ordered by contacting the National Clearinghouse
for Alcohol and Drug Information (NCADI), (800) 729-6686 or (301)
468-2600; TDD (for hearing impaired), (800) 487-4889).
Gainesville Veterans Administration Medical Center
Gainesville, Florida
1. Lovetta Smith, R.N., D.N.Sc., F.A.A.N.,
was originally cochair for this TIP but had to withdraw. Her
contributions as cochair are appreciated. Dr. Smith also served as a
field reviewer for the document.
The Treatment Improvement Protocol (TIP) series fulfills CSAT's
mission to improve alcohol and other drug (AOD) abuse and dependency
treatment by providing best practices guidance to clinicians, program
administrators, and payers. This guidance, in the form of a protocol,
results from a careful consideration of all relevant clinical and health
services research findings, demonstration experience, and implementation
requirements. A panel of non-Federal clinical researchers, clinicians,
program administrators, and patient advocates employs a consensus
process to produce the product. This panel's work is reviewed and
critiqued by field reviewers as it evolves.
The talent, dedication, and hard work that TIPs panelists and
reviewers bring to this highly participatory process have bridged the
gap between the promise of research and the needs of practicing
clinicians and administrators. We are grateful to all who have joined
with us to contribute to advance our substance abuse treatment
field.
Nelba Chavez, Ph.D.
Administrator
Substance Abuse and Mental Health Services Administration
Site Map
Help
Account
Cart
Home
