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NICE guidance on health and social care for substance users with severe mental illness says that rather than creating specialist ‘dual diagnosis’ services, health and social care (including substance misuse) services should adapt to this caseload, and their care should be led by the mental health service.
DOCUMENT 2012 HTM file
Quality standard for drug use disorders
Official UK quality standards on the treatment of adults for problems related to the use of illegal drugs, intended be used to plan and deliver services to provide the best possible care.
Patient interviews provide insight into low levels of engagement and retention in alcohol treatment services, hindering the effective provision of treatment for dependent drinkers. Findings suggest that treatment pathways should better reflect the capacity and capabilities of people with alcohol dependence.
Family interventions were at the heart of the UK government’s ambition to ‘turn round’ the lives of 120,000 troubled families in England. In respect of drink and drug problems, substantial remission was seen, but the featured study could not show whether this was due to the interventions, and a report on a successor programme found no significant impacts.
STUDY 2012 HTM file
Drug system change pilots evaluation: final report
Based on the yardstick of successful treatment completions, government-funded research in England offers no assurance that recovery-oriented redesigns of local treatment systems have generated more or more rapid recovery from addiction than usual arrangements. Evidence was stronger for focused attempts to improve continuity of care for offenders.
STUDY 1997 HTM file
Performance contracting for substance abuse treatment
This US study finds that performance contracting may be associated with improvements in service utilisation and treatment outcomes, but does not appear to increase engagement with under-served populations.
Evidence that in 2012 Scotland’s alcohol treatment caseload equated to about 1 in 4 of the country’s alcohol-dependent adults, over three times the 1 in 14 ratio in England, partly a consequence of extra funding accompanying Scotland’s 2009 national alcohol strategy. Evidence too of a peer-based recovery orientation taking root.
Consolidates WHO guidance on HIV prevention, diagnosis, treatment and care for key populations including prisoners and people who inject drugs. Strongly advocates universal access of injectors to needle exchange and of dependent opioid users to indefinite, high dose methadone and buprenorphine maintenance.
How can it be that incentives to therapists improve implementation of a therapy without further helping patients overcome substance use problems? In this US study of young substance users, disappointing results may reflect the inability of time-limited programmes to make an impression on the lives of youngsters subject to powerful influences, including criminal justice intervention.
DOCUMENT 2014 HTM file
Needle and syringe programmes
The UK’s health advisory body recommends high coverage and if need be, 24-hour needle exchange to combat HIV and the hepatitis C epidemic. The aim they say is for every injector to have even more sterile injecting equipment than they need for every single injection.
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