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Part review, part ‘call to action’, the featured paper highlights the lack of awareness of evidence-based interventions for transgender people, and advocates for ‘culturally-sensitive’ approaches embedded in both general and specialised substance use programmes.
Taking a public health and human rights-based approach, the 2018 strategy from Scotland strives to improve citizens’ lives by preventing and reducing the harms of drinking and drug use.
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.
Important implications for overdose prevention policy and practice in Scotland and the UK from this qualitative study which provides the first detailed insights into how people who inject drugs experience administering naloxone rescue kits.
REVIEW 2018 HTM file
Drug consumption rooms: an overview of provision and evidence
Refreshing its overview of the use of drug consumption rooms, the European Union’s drug misuse monitoring centre says the evidence still contradicts concerns that such facilities encourage drug use, delay treatment entry, or aggravate problems arising from local drug markets – finding instead that both the users and the community stand to benefit.
Based on detailed treatment records kept by the Canadian province of British Columbia, a slow taper liberally interspersed with stabilisation periods offers the best chance of sustainably withdrawing from methadone without severe relapse, but still very few manage to avoid this risk – an argument for careful consideration and informed consent before making the attempt.
Buprenorphine may be associated with a lower risk of mortality than methadone among people engaged in opioid substitution treatment – but is the pattern of short treatment duration in the UK preventing maximal impact at a population level?
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.
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.
DOCUMENT 2017 HTM file
Commissioning impact on drug treatment: The extent to which commissioning structures, the financial environment and wider changes to health and social welfare impact on drug misuse treatment and recovery
Based on research, financial data and stakeholder surveys and testimonies, the UK government’s official drug policy advisers warn that without significant efforts to protect investment and quality, in England “loss of funding will result in the dismantling of a drug misuse treatment system that has brought huge improvement to the lives of people with drug and alcohol problems”.
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