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Training for addiction treatment staff in managing overdose using naloxone, seeded in London by the National Addiction Centre, 'cascaded' to other staff and to patients at a disappointingly slow pace; on average each clinician trainee trained one drug user every 11 months.
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?
REVIEW 2011 HTM file
Heroin maintenance for chronic heroin-dependent individuals
Update of the first authoritative review to combine results from all trials to date of long-term heroin prescribing for the management of heroin addiction finds important advantages for seemingly intractable patients previously failed by methadone, including reduced illegal drug use.
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.
DOCUMENT 2011 HTM file
Prevention and control of infectious diseases among people who inject drugs
European Union drug misuse and disease control agencies have come together to offer guidance on how to prevent injection-related disease spread in Europe. Towards the top of the list are widespread injecting equipment supply and heroin substitute prescribing, but neither chime well with the UK's recovery-focused addiction policies.
REVIEW 2011 HTM file
Substitution treatment of injecting opioid users for prevention of HIV infection
Updated review conducted for the respected Cochrane collaboration finds that methadone maintenance and allied treatments for opioid dependence consistently and significantly reduce the risk of transmission of blood-borne viruses and curb the spread of HIV.
Together studies recently conducted across the UK suggest that consistent participation in methadone maintenance treatment plus adequate access to fresh injecting equipment has prevented many hepatitis C infections, supporting calls for needle exchange to be expanded and methadone treatment sustained.
From New York, a success story of the reversal of a serious epidemic of HIV among injectors, with mass needle exchange in the starring role. It adds weight to studies which collectively indicate that multi-strand approaches featuring high-coverage syringe provision can curb the spread of HIV.
This British study concluded that it takes extended opiate substitute prescribing to realise the treatment's life-saving potential. The implication is that the current push to get people off methadone sooner could cost lives.
NOTES 2010 PDF file 239Kb
Preventing unauthorised use of medications prescribed for the treatment of opiate addiction
Detailed and fully referenced notes on preventing the diversion of maintenance medications like methadone on to the illicit market, with an emphasis on the pros and cons of supervised consumption.
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