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Placing staff in the clients' shoes was the key tactic in this national US treatment improvement programme which more than halved waiting times and increased retention without limiting patient numbers.
A UK-based project placed a dedicated full-time hepatitis C nurse into a drug and alcohol treatment service. The experiences of people who inject drugs and attended the service reveal the degree to which this strategy can remove barriers to the infection treatment so crucial to containing the virus.
Methadone maintained heroin-dependent patients in Birmingham (UK) randomised to inpatient v. outpatient lofexidine-based detoxification rarely sustained long-term opioid abstinence; return to maintenance was the typical outcome.
DOCUMENT 2014 HTM file
Time limiting opioid substitution therapy
Rather than being ‘parked’ on methadone, generally Britain’s heroin-addicted patients leave too soon to fully benefit, argue official government advisers on drug policy. Their report unambiguously countered concerns within the current UK government over methadone maintenance.
Compared to methadone, buprenorphine is more often chosen in a make-or-break attempt to divorce oneself from illicit opiates found the first large-scale study to compare the drugs in real-life conditions at a British opiate addiction maintenance treatment programme.
STUDY 2010 HTM file
Treatment research in prison: problems and solutions in a randomized trial
In the first study of its kind, as a way of bridging the period after release opiate-dependent prisoners in Norway were randomly allocated to a six-month implant which blocks the effects of heroin or to methadone which substitutes for heroin. Many prisoners rejected treatment, wrongly believing they would sustain abstinence on release.
For such a widely implemented and widely supported adjunct to formal treatment, the revelation from this review is how little evidence there is for involving former problem substance users in promoting recovery from similar problems – a lack which may simply reflect the paucity of adequate research.
STUDY 2004 PDF file 140Kb
Crack: making and sustaining the break
The first UK follow-up study of service use by crack users revealed that after residential crisis intervention practically none avoided relapse without the aid of follow-on treatment, especially residential rehabilitation and attending mutual aid groups.
From France the first study to randomly allocate patients to start methadone maintenance either in primary care or at a specialist centre found primary care more attractive to patients, and no less effective at reducing street-opioid use and promoting engagement and retention.
STUDY 2000 PDF file 117Kb
Sympathetic ear helps clients overcome dependence on amphetamine
A British study highlights the role of the counselling relationship in the treatment of amphetamine dependence, a drug whose use and transition to non-use seems intimately bound up with social relationships.
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