Outpatient Versus Inpatient Detoxification Program for Alcohol Dependent Patients Seeking Abstinence: The IN/OUT Study

• ClinicalTrials.gov Identifier: NCT00226720
• Recruitment Status: Completed
• First Posted: September 27, 2005
• Last Update Posted: May 6, 2008
• Sponsor: Assistance Publique - Hôpitaux de Paris
• Collaborator: Direction Générale de la Santé, France
• Information provided by: Assistance Publique - Hôpitaux de Paris

Study Description

Brief Summary:

Detoxification, in an inpatient or outpatient program, is the primary and essential step for managing alcohol dependence. The superiority of one or other method of detoxification has never been proved in several previous randomized clinical trials (RCT). The aim of this multicenter RCT was to compare efficiency, on the abstinence rate as the primary outcome, at 1 and 3 months follow-up of two alcohol detoxification programs (a 5/7-days inpatient detox vs. an ambulatory detox).

Condition or disease	Intervention/treatment	Phase
Alcoholism; Alcohol Dependence	Procedure: Outpatient detoxification program	Not Applicable

Detailed Description:

Among patients consulting in 4 alcohol treatment centers in France seeking treatment for withdrawal, we included those who met criteria for current alcohol-dependence (DSM IV) and having drinking during the past three days before randomization. Exclusion criteria were: patients' refusal of one or other method, contraindication for outpatient detoxification method (history of DELIRIUM TREMENS or withdrawal seizures), homelessness, Major Depressive Episode assessed by MADRS > 25, current Substance Abuse Disorder (except nicotine), indication for hospitalization (severe somatic disorder), judicial injunction, family crisis, patients seeking antabuse treatment.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 500 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Official Title: Comparison of Efficacy of an Outpatient vs Inpatient Detoxification Program for Alcohol Dependent Patients Seeking Abstinence. A Prospective Randomized Clinical Trial.
• Study Start Date: September 2002
• Actual Primary Completion Date: November 2004
• Actual Study Completion Date: November 2004

Arms and Interventions

Arm	Intervention/treatment
Experimental: 1; at the hospital	Procedure: Outpatient detoxification program; Outpatient detoxification program
Active Comparator: 2; out of the hospital	Procedure: Outpatient detoxification program; Outpatient detoxification program

Outcome Measures

Primary Outcome Measures :

1. Abstinence rate at 3 Months & 6 Months follow-up. Abstinence is defined as no alcohol drinking during the period between the last day of the detoxification program and the evaluation. [ Time Frame: at 3 Months & 6 Months ]

Secondary Outcome Measures :

1. Relapse rate. Relapse is defined as drinking more than 4 Units per occasion (3 for women) and more than one occasion per week during the 6 months follow-up after the last day of detoxification program. [ Time Frame: during the 6 months follow-up ]

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Alcohol dependence according to DSM IV
• Detoxification program requested by patients

Exclusion Criteria:

• Refusal of the patient for the hospitalization or ambulant weaning alcoholic
• contraindication in ambulant weaning
• The state of the patient requires a hospitalization
• Ask of the patient for a treatment by the ESPERAL

Contacts and Locations

Locations

France

BEAUJON Hospital

Clichy, France, 92110

Sponsors and Collaborators

Assistance Publique - Hôpitaux de Paris

Direction Générale de la Santé, France

Investigators

• Principal Investigator: Philippe M. BATEL, MD; Assistance Publique - Hôpitaux de Paris

More Information

Publications:

Limosin F, Romo L, Batel P, Adès J, Boni C, Gorwood P. Association between dopamine receptor D3 gene BalI polymorphism and cognitive impulsiveness in alcohol-dependent men. Eur Psychiatry. 2005 May;20(3):304-6.

Batel P, Reynaud-Maurupt C, Lavignasse P, Constant MV, Kopp P, Jourdain JJ, Videau B, Mucchielli A, Riff B, Lowenstein W. [Risk factors of early drop-out during induction of high-dose buprenorphine substitution therapy. A study of 1085 opiate addicts]. Presse Med. 2004 Oct 23;33(18 Suppl):5-9. French.

Batel P, Balester-Mouret S. [Care network in addictive pathologies: where is it?]. Rev Prat. 2003 Jun 15;53(12):1335-9. French.

Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B, Valla DC. Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence. Liver Int. 2003 Feb;23(1):45-53.

Gorwood P, Limosin F, Batel P, Hamon M, Adès J, Boni C. The A9 allele of the dopamine transporter gene is associated with delirium tremens and alcohol-withdrawal seizure. Biol Psychiatry. 2003 Jan 1;53(1):85-92.

Lavignasse P, Lowenstein W, Batel P, Constant MV, Jourdain JJ, Kopp P, Reynaud-Maurupt C, Riff B, Videau B, Mucchielli A. Economic and social effects of high-dose buprenorphine substitution therapy. Six-month results. Ann Med Interne (Paris). 2002 May;153(3 Suppl):1S20-6.

Batel P, Michaud P. [Risky alcohol drinking or problems and brief interventions]. Gastroenterol Clin Biol. 2002 May;26(5 Suppl):B158-62. Review. French.

Gorwood P, Aissi F, Batel P, Adès J, Cohen-Salmon C, Hamon M, Boni C, Lanfumey L. Reappraisal of the serotonin 5-HT(1B) receptor gene in alcoholism: of mice and men. Brain Res Bull. 2002 Jan 1;57(1):103-7.

Gorwood P, Limosin F, Batel P, Duaux E, Gouya L, Adès J. The genetics of addiction: alcohol-dependence and D3 dopamine receptor gene. Pathol Biol (Paris). 2001 Nov;49(9):710-7.

Batel P, Larivière P. [Late-onset alcohol withdrawal syndrome]. Ann Med Interne (Paris). 2000 Oct;151 Suppl B:B27-9. French.

Gorwood P, Batel P, Adès J, Hamon M, Boni C. Serotonin transporter gene polymorphisms, alcoholism, and suicidal behavior. Biol Psychiatry. 2000 Aug 15;48(4):259-64.

Batel P. Addiction and schizophrenia. Eur Psychiatry. 2000 Mar;15(2):115-22. Review.

Gorwood P, Batel P, Gouya L, Courtois F, Feingold J, Adès J. Reappraisal of the association between the DRD2 gene, alcoholism and addiction. Eur Psychiatry. 2000 Mar;15(2):90-6.

Batel P. [Alcohol withdrawal syndrome in the hospital]. Rev Prat. 1999 Feb 15;49(4):387-90. Review. French.

Quiñones-Jenab V, Batel P, Schlussman SD, Ho A, Kreek MJ. Cocaine impairs maternal nest building in pregnant rats. Pharmacol Biochem Behav. 1997 Dec;58(4):1009-13.

Batel-Copel LM, Kornblith AB, Batel PC, Holland JC. Do oncologists have an increasing interest in the quality of life of their patients? A literature review of the last 15 years. Eur J Cancer. 1997 Jan;33(1):29-32. Review.

Batel P. A critique of chapter 3: "Individual drinking and degree of risk". Addiction. 1995 Nov;90(11):1450-1.

Batel P. The treatment of alcoholism in France. Drug Alcohol Depend. 1995 Sep;39 Suppl 1:S15-21.

Batel P, Pessione F, Maître C, Rueff B. Relationship between alcohol and tobacco dependencies among alcoholics who smoke. Addiction. 1995 Jul;90(7):977-80.

Batel P, Pessione F, Bouvier AM, Rueff B. Prompting alcoholics to be referred to an alcohol clinic: the effectiveness of a simple letter. Addiction. 1995 Jun;90(6):811-4.

• Responsible Party: Myriem TOUHAMI-CARRIER, Department Clinical Research of the Developpement
• ClinicalTrials.gov Identifier: NCT00226720
• Other Study ID Numbers: P000807; AOM98176
• First Posted: September 27, 2005
• Last Update Posted: May 6, 2008
• Last Verified: April 2007

Keywords provided by Assistance Publique - Hôpitaux de Paris:

alcoholism; Alcohol dependence; Detoxification; Abstinence maintain; Efficacy; Ambulatory detoxification

Additional relevant MeSH terms:

Alcoholism; Alcohol-Related Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders