(71) High Completion and Patient Satisfaction in a Virtual Ambulatory Alcohol Detox Program

Background & Introduction: Alcohol use disorder (AUD) is a major public health concern, with U.S. deaths attributable to excessive alcohol use increasing over the past two decades. Excessive alcohol use accounted for an average of 178,307 deaths annually from 2020–2021 (Esser et al., 2024). Despite this burden, treatment engagement remains low; in 2023, only 7.8% of U.S. adults with AUD received treatment (National Survey on Drug Use and Health, 2024).
Existing literature supports the safety and effectiveness of outpatient detoxification for appropriately selected patients with AUD, demonstrating outcomes comparable to inpatient treatment when adequate monitoring and clinical oversight are provided (ASAM, 2020). Telehealth delivery of behavioral health and addiction services has expanded since the COVID-19 pandemic, with evidence of improved access, engagement, and patient satisfaction, particularly among underserved populations (Lin et al., 2019).
However, review of qualitative, feasibility, pilot, mixed-methods, and program evaluation literature, as well as guidance from ASAM, reveals limited evaluation of fully virtual ambulatory detoxification programs. This program evaluation assessed program completion, patient satisfaction, and short-term sobriety outcomes in a fully virtual ambulatory detoxification model, addressing a gap in the current literature.

Methods: Participants: This study included all 151 patients admitted to the Virtual Ambulatory Detox program with a primary diagnosis of alcohol use disorder between September 2024 and December 4, 2025. No patients meeting these inclusion criteria during this period were excluded.
Data Collection:
Patient satisfaction data were collected using a PatientIQ survey distributed to all patients upon program completion and discharge between February 2025 and December 2025. The survey utilized validated scoring methods, including a 0–10 Likert scale assessing the likelihood of recommending the program (0 = extremely unlikely, 10 = extremely likely).
A retrospective chart review was conducted to evaluate program completion rates and 30-day sobriety outcomes for patients admitted between September 2024 and January 2026. Program completion was defined as successful discharge without transferring to an emergency department or referral to a higher level of care.
Thirty-day sobriety post detox was assessed using three data sources: laboratory-based urine drug screening (UDS) completed by the patients, Clinical Laboratory Improvement Amendments (CLIA) waived UDS testing performed by the care team, and patient self-report documented in the medical record when urine drug screening was unavailable.
Deidentified survey and chart review data were extracted into a secure Microsoft Excel spreadsheet for analysis.

Results: This program evaluation reviewed patient demographics, program completion data, patient-reported satisfaction, and 30-day post-detox sobriety outcomes among patients enrolled in a virtual ambulatory alcohol detox program between September 10, 2024, and December 9, 2025. During this period, 151 patients were admitted (78 males, 73 females), with a mean age of 44.4 years (range 25–63). Program completion was high, with 147 patients (97.4%) completing detox; four did not complete treatment, including two referred to a higher level of care and two who disengaged from the program prior to completion. Following completion, 121 patients transitioned to other service lines in the program, while 30 were discharged to home. Patient satisfaction surveys using a 0-10 Likert scale were sent to all patients beginning February 1, 2025 (total 102), with 40 completed surveys returned (39.2% response rate), yielding a mean satisfaction score of 9.4. Sobriety thirty days post-detox was confirmed for 65 patients, including 42 verified by urine drug screen (UDS) or laboratory testing and 23 by patient self-report. Forty patients did not maintain sobriety at 30 days (12 confirmed via UDS, 28 self-reported). Sobriety status could not be determined for 46 patients due to discharge from services or loss to follow-up.

Conclusion & Discussion: This program evaluation demonstrates that a virtual ambulatory detoxification model for adults with alcohol use disorder is both feasible and effective for appropriately selected patients. High program completion rates (97.4%) and strong patient satisfaction (mean score 9.4/10) suggest that virtual detoxification can deliver safe, acceptable care while reducing barriers associated with traditional inpatient treatment. A substantial proportion of patients maintained sobriety at 30 days post-detox, supporting the clinical efficacy of this model in the early recovery period.
These findings align with existing evidence supporting outpatient detoxification (Ngoy, 2024) and expand the literature by demonstrating the viability of a fully virtual, structured detoxification program. Limitations include reliance on self-reported sobriety for some participants, incomplete follow-up data, and a modest survey response rate. Future evaluation should focus on longer-term outcomes, predictors of sustained engagement, and comparative effectiveness versus inpatient models.
Overall, virtual ambulatory detoxification represents a promising, scalable approach to addressing treatment gaps in alcohol use disorder, particularly for patients facing geographic, logistical, or stigma-related barriers to care.

References: ASAM. (2020, January 23). The ASAM clinical practice guideline on alcohol withdrawal management. American Society of Addiction Medicine. https://www.asam.org/quality-care/clinical-guidelines/alcohol-withdrawal-management-guideline

Esser, M. B., Sherk, A., Liu, Y., & Naimi, T. S. (2024). Deaths from excessive alcohol use — United States, 2016–2021. MMWR. Morbidity and Mortality Weekly Report, 73(8), 154–161. https://doi.org/10.15585/mmwr.mm7308a1

Lin, L., Casteel, D., Shigekawa, E., Weyrich, M., Roby, D. H., & McMenamin, S. B. (2019). Telemedicine-delivered treatment interventions for substance use disorders: A systematic review. Journal of Substance Abuse Treatment, 101, 38–49. https://doi.org/10.1016/j.jsat.2019.03.007

National survey on drug use and health. (2024, July). NSDUH. Retrieved May 16, 2025, from https://nsduhweb.rti.org/respweb/homepage.cfm

Ngoy, A. B. (2024). Remote Treatment of Alcohol Withdrawal: A Pilot Study (Order No. 31562541). Available from ProQuest Dissertations & Theses Global. (3128449395). https://proxy.library.vanderbilt.edu/login?url=https://www.proquest.com/dissertations-theses/remote-treatment-alcohol-withdrawal-pilot-study/docview/3128449395/se-2