Hopes telehealth detox service could be a ‘game-changer’

For anyone with concerns about alcohol use, the pandemic has been a troubling time.
 
While the Australian Institute of Health and Welfare is circumspect about whether consumption has increased during COVID-19, alcohol retail sales certainly spiked when the pandemic began.
 
Good news for liquor store owners, not so much for health practitioners such as Dr Chris Davis, a Darlinghurst GP with a passion for treating addiction.
 
However, the limitations of lockdown may also have spurred a project that could have an enduring positive impact.
 
Dr Davis, who treated alcohol dependency in London before moving to Sydney in 2014, has the experience; he set up Clean Slate Clinic in Blacktown to treat mild-to-moderate alcohol dependency after being surprised there was no GP-led home detox service on offer in Australia.
 
Now, working with Hello Sunday Morning and health strategist Pia Tarestad, he has launched a telehealth service drawing on the same scheme that has allowed many of his patients in Sydney and in the UK to withdraw from alcohol use.
 
Dr Davis believes the pandemic has served as a catalyst for the program, sweeping away previous hesitancy about telehealth.
 
‘I think there would have just been a lot more hesitancy or mistrust of telehealth before the pandemic,’ he told newsGP.
 
‘So far, it’s been overwhelmingly positive. Our first client just said that he wouldn’t have been able to do it without the support of the online service.’
 
His enthusiasm for the project – and his hopes for its use – seems to know no bounds.
 
‘It’s been a dream come true,’ he said. ‘Now when I get emails from patients in Perth, or Alice Springs or Adelaide asking if there’s a place at a Clean Slate Clinic near them, instead of saying “no, I’m sorry”, I can now say, “Well, yes, there is a service that you can access”.’
 
The telehealth service offers access to psychologists, alcohol counsellors, dietitians and nurses, with patients able to sign themselves up and enlist a family member and local GP for support.
 
‘Even as a private offering, it’s 10 times cheaper than what inpatient care would cost them,’ Dr Davis said.
 
‘We prepare them, we have a resource pack, a full assessment, we send them out a care package with a breathalyser and a vitamins regime. We do the daily check-in and the medicated detox and we follow them for up to a year as well.’
 
As a practising GP, Dr Davis says he is ‘fully aware’ what time-stretched practitioners will need from the service.
 
‘We’ll do the work,’ he said. ‘And the GP will get the big-ticket item at the end.
 
‘They’ll get some education along the way. We’ll do the tricky bit, and they get their patient back fully worked up with an MBS [item] 721 and a recovery plan.’
 
As it is still in its early days, Clean Slate Clinic’s telehealth service is undergoing an evaluation process, led by experts at the University of Sydney.
 
‘We already know that community home alcohol detox is safe and successful and effective,’ Dr Davis said.
 
‘That’s well researched and evidence-based, and that’s the model I’ve been doing from East Sydney doctors [Dr Davis’ current practice].
 
‘But what we haven’t proven is that telehealth home detox is feasible. We’re very confident that it is. The first five patients we’ve taken through have proven that it is completely feasible.’
 
As well as being available privately, there are now three Primary Health Networks (PHNs) in New South Wales supporting the service as a pilot scheme.
 
Talks with other PHNs around the country are ongoing, while Dr Davis says he is hopeful the program will one day be eligible for Medicare billing.
 
Dr Davis is also already thinking in ambitious terms about what comes next. He describes it as ‘his mission’ to improve access for patients across Australia who would not otherwise go to inpatient or specialist services and hopes the telehealth program can reach a much wider audience.
 
‘Really, we want this to be as big as it can get and open as many doors for as many Australians as possible,’ he said.

‘We definitely want it nationwide. And once we’ve done that, then we can look to Southeast Asia where there’s a huge need for this, but we’ll stick to Australia for now.
 
‘And again, it’s early days [but] once we’ve done that we’ll probably scale to other substances. Methamphetamine and cannabis would fit this model really nicely as well.’
 
So what impact has this had on his day-to-day job? Having toyed with the idea of becoming an addiction specialist, Dr Davis has decided to stay with general practice due to the changes he can help bring about.
 
‘It really became a passion of mine because of the difference that I can make as a GP to somebody who has come to me dependent upon alcohol,’ he said.
 
‘In a very short period of time – a matter of weeks – we could detox them and remove that from their lives. Seeing the improvements in mental health and their physical health and their relationships with their families and their workmates, it’s just hugely rewarding.
 
‘You compare that to pretty much any other chronic disease that I manage. I don’t do anything as impactful as helping someone through a detox.’
 
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