Views & Reviews Personal View

Private alcohol detox clinics should be regulated

BMJ 2011; 342 doi: (Published 20 April 2011) Cite this as: BMJ 2011;342:d2399

There exists a proliferation of establishments that purport to “detoxify” and “rehabilitate” extremely vulnerable people from dependency on alcohol and other substances. There are worrying absences of an evidence base, qualified staff, ethical standards, and ongoing support—and an even more worrying tendency to concentrate more on securing fees than on achieving success in overcoming these life threatening conditions. As a result, alcohol misusers are in danger of haemorrhaging as briskly from their bank balances as from their guts. Some of the residents in these facilities are funded either by the NHS or by their local authority, which makes the apparent lack of regulation a matter of public concern.

Treatment by the NHS of the most serious complications of chronic alcohol misuse, notably liver failure, is superb. NHS management of the underlying conditions of alcohol dependency, however, is abysmal. In the case of my son, there was, as so often, a potentially lethal mixture of alcoholism, depression, anxiety, and adverse social circumstances contributing to a pattern of recurrent drinking. To be fair, he underwent a period of 10 days’ detoxification …

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