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IN PRACTICE 2005 PDF file 813Kb
Wet day centres in Britain part 2: Care Control Challenge
Part 2 of our mini-series on wet day centres in Britain will ring bells not just for alcohol workers but also for drug workers in needle exchanges and drop-in services. Maureen Crane and Tony Warnes analyse what it takes to work productively in one of the most challenging of settings.
SERIES OF ARTICLES 2005 PDF file 1935Kb
Wet day centres in Britain
In drug and alcohol services, it doesn't get more difficult than this – offering street drinkers a place where they can start to reverse years of deterioration, without having first to stop drinking.
STUDY 2001 PDF file 99Kb
Naltrexone prevents return to heavy drinking
The British study which provided the largest test to date of naltrexone in the treatment of alcohol dependence. In conditions typical of NHS alcohol treatment centres, it confirmed that taken as directed, the drug reduces alcohol consumption.
REVIEW 2002 PDF file 174Kb
Convincing evidence that acamprosate and naltrexone help prevent alcohol relapse
Despite patchy results in individual studies, two meta-analyses which combined findings from rigorous trials have confirmed that acamprosate and naltrexone help prevent relapse after detoxification from alcohol. See extended text for further studies.
STUDY 2003 PDF file 188Kb
Naltrexone helps heavy drinkers gain control
In Spain naltrexone helped young regular binge drinkers cut back, potentially extending its role from alcoholics seeking treatment at specialist clinics to problem drinkers identified in other settings such as primary care.
STUDY 2005 PDF file 170Kb
'Real-world' studies show that medications do suppress heavy drinking
Three trials found that drugs commonly used to treat alcohol dependence improve outcomes for an appreciable minority of patients, even under conditions close to normal practice. Together they offer clues to who benefits most from each medication.
Could a single LSD trip precipitate such a radical re-evaluation of their lives that it proves a turning point for dependent drinkers? According to this synthesis of the research, across six randomised trials it can and it has, and the results rival approved medications. Nevertheless, LSD seems unlikely to be welcomed in to the alcohol treatment pharmacopeia.
The first comprehensive analysis of whether acamprosate treatment works as well for alcohol-dependent women as for men definitively concludes that across 22 mainly European trials it has had a virtually identical impact. The analysis also reports the drug's overall impact, finding that it helps prevent heavy drinking as well as fostering abstinence.
Reanalysis of the largest US study of medication-based alcoholism treatment confirms that either naltrexone or psychological therapy improved outcomes more than medical care and placebos, while the two in combination or acamprosate added little. It also revealed previously invisible benefits when certain types of patients received certain treatments.
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.
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