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An ambitious attempt to use research to understand the most effective and cost-effective set of policies for reducing alcohol-related harm in the English context, from taxation and price regulation to managing the drinking environment.
This impressive assessment of what evaluation research means for alcohol dependence treatment in Britain is distinguished by reviews of the latest literature on the sub-topics it covers; in some cases these starkly reveal the inadequacies of the evidence base.
Can a brief intervention delivered by trained GPs impact on young patients’ excessive drinking and cannabis use? Set in French-speaking Switzerland, this study examines outcomes over a 12-month period.
Naltrexone and acamprosate both modestly curtail drinking among alcohol-dependent patients, but which is best in which circumstances and for which treatment goals? To find out this review compared the medications’ performance when separately benchmarked against a placebo, bringing to bear much more data than is available from the few trials which directly compared the two drugs.
Patient interviews provide insight into low levels of engagement and retention in alcohol treatment services, hindering the effective provision of treatment for dependent drinkers. Findings suggest that treatment pathways should better reflect the capacity and capabilities of people with alcohol dependence.
Amalgamated findings from studies of risky drinkers identified and counselled in primary care settings indicate that compared to screening and assessment only, brief counselling lead to greater reductions in drinking, gains reflected less strongly in some indicators of health. However, it is unclear whether the generally small impacts would be sustained in routine practice.
REVIEW 2015 HTM file
Risks and benefits of nalmefene in the treatment of adult alcohol dependence: a systematic literature review and meta-analysis of published and unpublished double-blind randomized controlled trials
‘A pill for every ill’ is the gist of the attacks levelled at nalmefene in the form of Selincro, a drug expected to extend the benefits of pharmacotherapy to drinkers not physically dependent or in need of detoxification – or for critics, to medicalise psychosocial dependence on shaky scientific grounds.
Whether differences between the patients mean impacts of the alcohol treatment medications acamprosate and naltrexone vary between Europe and the USA was the issue which motivated this fresh analysis of randomised trials. It confirmed the medications’ efficacy and found no evidence that this differed in European trials versus those conducted elsewhere.
STUDY 1997 HTM file
Performance contracting for substance abuse treatment
This US study finds that performance contracting may be associated with improvements in service utilisation and treatment outcomes, but does not appear to increase engagement with under-served populations.
In the Netherlands an intensive cognitive-behavioural treatment programme for problem drinkers based on messages sent via a web site between therapist and patient achieved substantial remission in drinking and improvements in health – promising results undermined somewhat by how few patients were followed up.
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