Feasibility and safety of home-based alcohol detoxification via teleconsultation in India

Access to medically supervised alcohol withdrawal management is limited in low-resource settings. We implemented a structured, home-based alcohol withdrawal program using telemedicine-Telemedicine-Assisted Ambulatory Management of Alcohol withdrawal (TAMAL).

This study aimed to evaluate the feasibility, safety, and acceptability of TAMAL using retrospective clinical records.

This was a retrospective observational study conducted at an addiction treatment center in North India. Records of 20 adult male patients diagnosed with alcohol dependence syndrome (ICD-10) and enrolled in the TAMAL program between October 2023 and June 2024 were reviewed. All patients underwent an in-person clinical assessment on Day 1, followed by daily teleconsultations (Days 2-6) for symptom-guided chlordiazepoxide titration using the CIWA-Ar scale. Sociodemographic and clinical variables, CIWA-Ar scores, medication use, adherence, adverse events, and patient satisfaction were extracted from clinical records.

The mean CIWA-Ar score decreased from 8.5 (SD = 3.22) on Day 1 to 0 by Day 4. Sixteen patients (80%) were classified as quick responders with rapid dose tapering; three required extended benzodiazepine support. No seizures or delirium occurred. One patient was lost to follow-up. Satisfaction was high in 74% of participants. Three (15%) reported alcohol use during the follow-up period, and 19 (95%) patients returned on the seventh day for in-person follow-up.

This preliminary retrospective review suggests that telemedicine-assisted ambulatory alcohol withdrawal management is feasible and safe in carefully selected patients. Structured protocols and family support may enable the delivery of detoxification services in home settings where access to inpatient care is limited.