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DOCUMENT 2017 HTM file
Drug misuse and dependence: UK guidelines on clinical management
Last published in 2007, there is no more important document for UK clinicians involved in treating problem drug use than the so-called ‘Orange guidelines’. This major update offers detailed guidance on the range of problems, settings and patients clinicians encounter, substantially informing judgements of what constitutes good medical practice.
MATRIX CELL 2017 HTM file
Drug Matrix cell A1: Interventions; Reducing harm
Seminal and key studies on the effectiveness of harm reduction interventions such as needle exchanges.
REVIEW 2016 HTM file
Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria
How confident can we be that take-home naloxone programmes are effective without the ‘gold standard’ randomised trial? Judged against nine criteria for establishing the presumption of causality, evidence that the provision of naloxone reduces overdose-related deaths among opioid users.
STUDY 2017 HTM file
The evaluation of the Drug Recovery Wing pilots: Final report
The final piece of the Drug Recovery Wing evaluation jigsaw, focusing on the process and impact of implementing the model in eight men’s and two women’s prisons in England and Wales.
REVIEW 2017 HTM file
Supervised dosing with a long-acting opioid medication in the management of opioid dependence
Trials challenge the need for the widely accepted policy of making opioid-dependent patients take their methadone or other opioid substitutes at the clinic or pharmacy, but ‘no difference’ findings may be due to the limitations of the research.
A randomised trial conducted in England found that the (at the time) recommended three months of supervised consumption of prescribed opioid substitutes like methadone conferred no significant advantages over supervising only for up to the first four weeks of treatment, but the findings applied only to the minority of patients for whom random allocation was thought feasible and safe.
STUDY 2017 HTM file
Effectiveness of injectable extended-release naltrexone vs daily buprenorphine–naloxone for opioid dependence: A randomized clinical noninferiority trial
Can monthly injections of extended-release naltrexone be considered on a par with the standard daily opioid substitute in Norway for people wanting to maintain abstinence from heroin?
MATRIX CELL 2018 HTM file
Drug Treatment Matrix cell A3: Interventions; Medical treatment
Key studies on the effectiveness of medical interventions and treatment in medical settings.
STUDY 2018 HTM file
A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: findings at 12 months post-release
From the USA, a rare randomised trial found in favour of continuing methadone maintenance when patients entered prison rather than compulsory withdrawal. The potential benefits were most apparent in the near-100% continuation of protective treatment during the highly overdose-prone weeks after leaving prison.
STUDY 2014 HTM file
Methadone induction in primary care for opioid dependence: a pragmatic randomized trial (ANRS Methaville)
From France the first study to randomly allocate patients to start methadone maintenance either in primary care or at a specialist centre found primary care more attractive to patients, and no less effective at reducing street-opioid use and promoting engagement and retention.
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