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Failure to find effects concentrated in the first two weeks after release persuaded analysts that widespread methadone prescribing in Scottish prisons from 2002 did not reduce the rate of drug-related deaths after release. But over 12 weeks the rate did fall substantially, and methadone treatment may have helped.
HOT TOPIC 2016 HTM file
What do the patients want?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Focus is the apparently iconoclastic finding from a Scottish national treatment study that abstinence is the sole drug-focused goal for most patients in drug treatment: “At best these extrapolations were sloppy, at worst, deliberately misleading.”
HOT TOPIC 2015 HTM file
Prescribing opiate-type drugs to opiate addicts: good sense or nonsense?
One of our hot topics offering background and analysis on important issues which sometimes generate heated debate. For decades deeply felt and at times intemperate debate has surrounded a treatment which achieves unparalleled success by going with the grain of addiction, prescribing the same type of drug which opiate-dependent patients used illegally – a substitution castigated as surrender or hailed as an enlightened lifesaver.
A study exploring the challenges of defining and measuring ‘outcomes’ and ‘success’ in substance use treatment environments, from the perspective of staff and participants in two different US harm-reduction counselling programmes.
This US study found that among people with serious mental illness and a history of criminal justice involvement, an intervention intended to foster citizenship through peer mentoring, education and activities, reduced alcohol and drug use and enhanced quality of life and satisfaction with social, leisure and work activities.
Testing in the UK suggested that a questionnaire assessing the ‘recovery capital’ resources which help overcome addiction might underpin more recovery-oriented assessments of services and of client progress and needs – but only a study which followed up patients could confirm this, and do some of the questions assess ability to recover, or recovery itself?
STUDY 2014 HTM file
Drug treatment in England 2013–14
Authority responsible for promoting addiction treatment in England cautions that the gains of recent years in reduced drug use, lower demand for treatment for heroin and crack problems, improved treatment performance, and curbing drug-related harm, have all stalled or gone in to reverse.
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.
STUDY 1995 HTM file
An evaluation of private methadone clinics
Comparison of three Australian clinics highlights the importance of good organisation and an ethos of individualised treatment and care for patients, rather than acting as a more or less efficient ‘methadone dispensary’.
Opiate dependent patients in Scotland who opted for or were allocated to methadone sustained their abstinence from heroin as well as those on buprenorphine, but buprenorphine was far better at helping continuing heroin users cut back – suggestive, but the study’s constraints make the practice implications unclear.
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