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Amalgamated findings from studies of risky drinkers identified and counselled in primary care settings indicate that compared to screening and assessment only, brief counselling lead to greater reductions in drinking, gains reflected less strongly in some indicators of health. However, it is unclear whether the generally small impacts would be sustained in routine practice.
This real-world implementation of overdose education and nasal naloxone distribution in Massachusetts illustrates the life-saving potential of these programmes.
HOT TOPIC 2016 HTM file
The therapeutic potential of patients and clients
One of our hot topics offering background and analysis on important issues which sometimes generate heated debate. The recovery agenda emphasises the transformation of problem substance users into solutions to those problems through peer support and involvement in their own care – but perhaps at a deeper level, the patient or client has always been the author of their own recovery.
HOT TOPIC 2016 HTM file
Harm reduction: what’s it for?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Opposing agendas have led to a shifting balance between seeing harm-reduction as acceptable only in the service of the greater good of reducing or eliminating drug use, versus seeing it as the overriding objective, one which should never be sacrificed to an anti-drugs agenda.
REVIEW 2016 HTM file
Preventing opioid overdose deaths with take-home naloxone
To aid policymaking, experts commissioned by the European Union’s drug misuse monitoring centre review the evidence and offer guidance on the provision of the medication naloxone, which reverses the effects of drugs like heroin, helping to prevent overdoses becoming fatal.
Injectors at risk of infection due to sharing equipment responded best to brief risk-reduction counselling based on motivational rather than educational principles, offering a way to augment the benefits of harm reduction services.
This intervention based on housing first led to significantly greater reductions in drinking problems after 14 months, but not in problems with other substances.
Thorough search for evidence uncovers 37 studies which overall suggest that by tackling sexual and injecting risk behaviours, some interventions protect against HIV in adults with a history of criminal justice involvement. Methadone maintenance emerged as the best established.
In the UK context, this study’s findings imply that to prevent new cases it is best to focus expensive new treatments for hepatitis C infection on injectors who infrequently share their injecting equipment – patients most likely to be found and recruited via needle exchanges and addiction treatment services.
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.
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