Matrix Bite Drug Matrix row 3. Doctors and drugs
Concerned with the treatment of drug dependence in a medical context or involving medical care. Clinical staff are responsible for medications, so their centrality most clearly marks an intervention as medical. But medications are never all there is to medical care. The evidence places them in the context of practitioners, the managements and organisations which shape how well they can do their jobs, and local systems through which patients access treatment and sustain their recovery.

Return to the Matrix, click on cells in row 3 and unfold bites by clicking the Matrix Bite link at the bottom or go to your chosen cell and bite below.
The five cells

A3. Interventions: Can medications make it too easy?
Ends with “the curious possibility that precisely because a [treatment] technology is (relatively) effortlessly effective, it is to that degree under suspicion”. Does recovery have to be hard?

B3. Practitioners: Even in medication-based treatments, relationships matter
A methadone clinic in Philadelphia hosted one of those invaluable accidents which expose hidden influences – in this case, the surprisingly substantial impact of the keyworker. If relationships matter, what matters in the forging of relationships?

C3. Management: Key issues in managing medical treatments
Focuses on the treatment where evidence and controversy are concentrated – methadone maintenance. Issues include ‘parking’, dose, whether patients should choose their doses, supervised consumption, and the need for counselling/therapy.

D3. Organisations: Ethos, dose, being organised
Seminal work from Australia identified ethos, dose, and being organised as the three pillars of medication-based interventions. In the recovery era, do these remain essential – and are they sufficient in themselves?

E3. Whole systems: How can commissioners recognise a good quality service?
Asks if you agree with an expert group’s vision for commissioners of what a good quality service looks like and highlights a simple innovation which transformed detoxification recyclers in to typical patients.

More ways to appreciate the matrices
Visit the matrices page of the Effectiveness Bank web site for articles, presentations, and a video explaining their genesis and construction.