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Comprehensive and thoughtful review of the UK-relevant literature warns that services which impose rigid and unrealistic expectations of abstinence or independent living on homeless addicts would deny treatment and housing to vulnerable adults with complex needs.
This unique randomised trial tested what would happen if detoxified opiate addicts were then maintained on a substitute drug, on an opiate-blocking medication, or simply counselled. The results led to the introduction of methadone prescribing programmes in Malaysia.
US figures show that testing needle exchange users for hepatitis B and at the same time starting a short course of vaccinations (the UK model) saves lives and thousands of health service dollars, but UK exchanges have lagged behind in offering these services.
After needle exchanges started distributing crack smoking equipment, drug injectors in Ottawa shifted from injecting to smoking the drug and less often shared their smoking equipment. The result was safer drug use and greater service contact by crack smokers.
European and US studies show that methadone patients stick with therapy for hepatitis C disease and do as well as other patients, bolstering the case for drug services to encourage clients to consider diagnostic testing and therapy.
Limited access to opiate substitute prescribing in Norway opened a window on its powerful lifesaving potential, a view obscured in countries where barriers create a confounding selection effect or where everyone who needs and wants this treatment can quickly get it.
STUDY 2005 PDF file 115Kb
Simple interventions cut hepatitis C risk
In Australia a detailed assessment of an injector's risk of becoming infected with hepatitis C was followed by substantial risk reductions not improved on by individualised advice.
OFFCUT 2005 PDF file 151Kb
Hepatitis C is spreading more rapidly than was thought
From the early 2000s in Britain there was clear evidence from research and routine monitoring that drug policy was failing to contain hepatitis C infection among injectors, and worrying signs of a trend upwards in HIV infection.
STUDY 2005 PDF file 180Kb
Environmental gains from injecting room
Reducing offence and alarm caused by public injecting and related litter is a key motivation for establishing supervised injecting facilities, but one rarely subject to scientific scrutiny. This Canadian study established that these benefits really can materialise.
STUDY 2005 PDF file 154Kb
Hepatitis C therapy cost-effective for injectors
Two new analyses agree that despite relapse to drug use and imperfect adherence to a demanding medical regime, anti-viral therapy for hepatitis C infection in drug injectors cost-effectively prolongs and improves life.
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