Just Accepted

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An In-Home Withdrawal Service (IHWS) for individuals with Low to Moderate Substance Dependence: Implementation and program evaluation

James Mussared, Helen Oni, Taylah Gregory, Andrew Fernandes, Anna Mazzacano, Debby Kadarusman, Sarah Fraser

Abstract

Background. Sonder’s In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multi-disciplinary, wraparound withdrawal option for people with low to moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service’s overall impact on reducing substance use amongst clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder and staff perspectives. Methods. A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys was analysed thematically. Results. 1,166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their AOD use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service’s home-based setting, multi-disciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions. The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post- withdrawal support and the inclusion of multi-disciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers.

PY23231  Accepted 17 July 2024

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