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In pubs and clubs, especially for young patrons, out-of-control intoxication is sometimes the aim rather than an undesirable outcome to be prevented. How in these circumstances to reduce use and harm has been investigated in the 17 studies analysed in this review.
In the first study of its kind opiate-dependent prisoners in Norway were randomly allocated to a six-month implant which blocks the effects of heroin or to methadone which substitutes for heroin as a way of bridging the period after release. Among the few interested in either option, they led to equivalent reductions in opiate use and crime.
Intriguing suggestion from a Norwegian study that taking measures to effectively reduce bullying in schools (including improving the social climate and setting clear and consistently enforced boundaries) also curbs the development of forms of substance use most associated with disturbed child development.
STUDY 2011 HTM file
The NTA overdose and naloxone training programme for families and carers
Up to 18 lives were known (and more perhaps unrecorded) to have been saved after the National Treatment Agency in England piloted training for the carers of opiate users on how to administer the overdose-reversing drug naloxone. But how does catering for relapse in this way square with the optimism of the recovery movement?
As concern mounts about Britain's failure to reverse the recent growth in drug-related deaths, the first large-scale UK follow-up study has assessed the impact of training in overdose recognition and management featuring the opiate blocking drug naloxone.
Survey responses from clinicians prescribing methadone at Scottish addiction treatment clinics show how the requirement that patients be observed taking the medication involves striking a balance between safety, individualising treatment, and attracting and retaining patients.
STUDY 2010 HTM file
An evaluation of a heroin overdose prevention and education campaign
Faced with rapidly increasing heroin overdose deaths, the Australian state of Victoria mounted a media campaign targeted at drug users via treatment and needle exchange services. The results illuminate the limitations of such campaigns as much as their plus points.
STUDY 2011 HTM file
What is the role of harm reduction when drug users say they want abstinence?
A team including one of the researchers responsible for the original finding have queried the interpretation of the highly influential report from a national Scottish study that most drug users starting treatment wanted to become abstinent. On the basis of in-depth interviews, they caution that it is just not that simple.
From Baltimore in the USA, evidence that encouraging syringe exchange participants to enter treatment will reduce their drug use, crime and injecting more than syringe exchange alone.
The safer injecting facility in Vancouver prevented overdose deaths but only in areas nearest the service, suggesting that often several facilities will be needed to make a city-wide impact.
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