Structured Preparation for Alcohol Detoxification (SPADe)

Why we have done the study

Alcohol-related problems are widespread in England. Those most severely affected are dependent drinkers, who have lost control over drinking and need alcohol in order to function every day.  Current research tells us that rushed attempts to stop using alcohol (detoxifications) do not help patients to stay off  alcohol for the rest of their lives. It may be also harmful going through many detoxes and make future attempts to stop drinking even harder. It is important that patients get treatment before being detoxed that gives them the best chance of achieving long term abstinence .
Clinicians have developed a group programme to prepare dependent patients before detox. The aim of the programme is to stabilise drinking, to support patients to prepare for a new life without alcohol and to encourage them to attend support after the detox.

What we have done

Small studies have already been done suggesting that this programme is working and that patients are happy to take part. We plan to conduct a large trial to assess properly if this group programme is effective and suitable for widespread use. But before we do this, we want to make sure the trial will run smoothly. 

Who we have involved in the study

Alcohol dependent patients who attend NHS alcohol community services and agree to take part will be randomised (as if ‘by the throw of a dice’) to either take part in the detox preparation group programme (SPAde group) , or to carry on receiving usual care (no group preparation). The study lasted for 30 months.

What we have done

48 patients started the study and 36 were able to stay involved and complete the study (75%). About half of patients (44%) were able to complete the SPADe group. We were able to follow up more that 60% of patients at 3 and 12 months from the start of the study. Interviews with some of the patients showed that their experience of participating in the study was positive. Also positive was the experience of the SPADe group.


Next steps

The above results suggest that we can do the bigger study with small changes. To that effect we will apply for further funding.

Study partners

  • Camden and Islington NHS Foundation Trust
  • University of Leicester
  • University of East Anglia
  • University of Surrey
  • University of Sussex
  • Imperial College London 

SPADe publications so far

The published step by step guide, based on that used in the intervention, can be downloaded here.

Kouimtsidis, Christos & Houghton, Ben & Gage, Heather & Phd, Caitlin & Maskrey, Vivienne & Clark, Allan & Holland, Richard & Lingford-Hughes, Anne & Punukollu, Bhaskar & Touray, Morro & Duka, Theodora. (2020). A Feasibility Study of an Intervention for Structured Preparation Before Detoxification in Alcohol Dependence: the SPADe Trial Results.

Kouimtsidis, Christos & Houghton, Ben & Gage, Heather & Phd, Caitlin & Maskrey, Vivienne & Clark, Allan & Holland, Richard & Lingford-Hughes, Anne & Punukollu, Bhaskar & Duka, Theodora. (2019). A feasibility study of an intervention for structured preparation before detoxification in alcohol dependence: the SPADe trial protocol. Pilot and Feasibility Studies.

Kouimtsidis, Christos & Duka, Theodora & Palmer, Em & Lingford-Hughes, Anne. (2019). Prehabilitation in Alcohol Dependence as a Treatment Model for Sustainable Outcomes. A Narrative Review of Literature on the Risks Associated With Detoxification, From Animal Models to Human Translational Research. Frontiers in Psychiatry.