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In Australia the first trial to randomly allocate prisoners seeking this treatment to methadone maintenance found substantial reductions in heroin use, injecting and syringe sharing, promising to avert infections and preserve lives.
A large scale Australian study which approximated recommended clinical procedures found buprenorphine roughly equivalent to methadone as a maintenance treatment for opiate dependence and also roughly as cost-effective.
Being motivated enough to cut drug use before treatment entry leads to better outcomes, but even after taking this in to account, this huge US study found outcomes improved the longer patients stayed in residential or non-residential programmes.
REVIEW 2003 Role Reversal 925Kb PDF file
Controversial, expensive, yet promising so much, interest is increasing in prescribing heroin to heroin addicts. Just five studies hold what answers there are to whether this can work, including a probably unrepeatable early British study.
How a patient assesses their own well-being can be poorly related to conventional outcomes such as substance use. Using quality of life as a benchmark would often give a different impression of whether one treatment or service is better than another.
In Australia a home-based child welfare intervention for methadone-maintained parents improved parenting and decreased the risks of child abuse or neglect, offering one way to address current concerns about the children of dependent drug users.
From the Netherlands, the first large-scale, randomised trial found that for patients previously failed by oral methadone, prescribing injectable or smokable heroin instead greatly reduces crime and improves health and social functioning.
US drug treatment was under fire, over-stretched and facing the new challenge of crack cocaine when the huge DATOS study set out to test whether it was still delivering benefits, how it worked, and how it could be made better. Truly essential reading.
A team led by one of the most respected authorities in the world on drug-based treatments for opiate dependence assesses the evidence for a drug emerging as the most promising alternative to methadone.
US study shows that methadone maintenance patients allowed to set their own doses do not escalate excessively. Benefits may include improved patient-therapist relations and reduced illicit drug use. Extended text reviews other relevant studies.
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