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Substance use treatment commissioned on a payment-by-results basis in England has been linked to higher rates of in-treatment abstinence and non-injecting than other commissioning models, but lower rates of treatment initiation and completion. Is this enough to support the policy?
HOT TOPIC 2017 HTM file
Focus on the families
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Both as a treatment resource for the patient and a group needing support in their own right, a UK report described families affected by substance use as the “forgotten” carers. Here we turn the focus on the “unheard and unseen victims when a loved one uses drugs or alcohol”.
STUDY 2017 HTM file
Impact of financial incentives on alcohol consumption recording in primary health care among adults with schizophrenia and other psychoses: a cross-sectional and retrospective cohort study
UK study of how Quality and Outcomes Framework incentives for primary care boosted alcohol screening among patients with severe mental illness shows what could have happened had the incentives been extended across the entire primary care caseload.
MATRIX CELL 2017 HTM file
Drug Treatment Matrix cell E1: Local and national systems; Reducing harm
Seminal and key studies relating to local, regional and national systems for effectively and cost-effectively reducing harm.
Coinciding with a ‘refresh’ of Scotland’s alcohol strategy, evidence that financial incentives in primary care can affect delivery of brief alcohol interventions.
DOCUMENT 2017 HTM file
Drug misuse and dependence: UK guidelines on clinical management
Last published in 2007, there is no more important document for UK clinicians involved in treating problem drug use than the so-called ‘Orange guidelines’. This major update offers detailed guidance on the range of problems, settings and patients clinicians encounter, substantially informing judgements of what constitutes good medical practice.
This impressive assessment of what evaluation research means for alcohol dependence treatment in Britain is distinguished by reviews of the latest literature on the sub-topics it covers; in some cases these starkly reveal the inadequacies of the evidence base.
STUDY 2015 HTM file
Changing patterns of substance misuse in adult prisons and service responses
Inspection findings on individual prisons were supplemented by fieldwork in eight prisons in 2014 to generate an overall picture of drug use and responses to it in prisons and England and Wales. In the face of rapidly changing and varied drug use patterns, policy and operational responses were seen as insufficiently flexible and dynamic, though treatment had dramatically improved.
DOCUMENT 2017 HTM file
2017 Drug Strategy
Continuing in the vein of its precursor, the UK Government’s new drug strategy pledges to tackle drug use and dependence through reducing demand, restricting supply, and building recovery, and adds to this a further ambition to drive global action.
Interventions delivered by nurses did lead to a reduction in excessive drinking in their patients, but there seemed to be no advantage of a structured brief intervention over standard advice.
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