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HOT TOPIC 2017 HTM file
Overdose deaths in the UK: crisis and response
One of our selection of hot topics – important issues which sometimes generate heated debate. Why did the fall in UK drug overdose deaths in 2009 to 2012 so decisively reverse in the following years? A life-threatening turn away from harm reduction, or simply an ageing population of heroin users?
STUDY 2016 HTM file
Reducing opioid-related deaths in the UK
The UK’s official drug policy advisers conclude that the ageing profile of heroin users with increasingly complex health needs has contributed to recent increases in drug-related deaths, and that to hold down the increases government must maintain investment in substitute prescribing programmes like methadone maintenance.
English treatment systems perform at least as well as other countries on a number of measures, but have a considerably higher rate of drug-related deaths than elsewhere in Europe. As well as pursuing harm reduction and recovery, this report stresses the importance of social integration as an objective.
Implication of this English study is that to save the lives of people dependent on heroin or similar drugs, they should be engaged and retained in substitute prescribing programmes like methadone maintenance until there is little risk of their relapsing after leaving. Shortly after leaving residential/inpatient settings was the highest risk period.
HOT TOPIC 2016 HTM file
Are the drugs enough? Counselling and therapy in substitute prescribing programmes
One of our hot topics offering background and analysis on important issues which sometimes generate heated debate. Explore the somewhat heretical proposition that the counsellor can virtually be dispensed with in opiate substitute prescribing programmes with little loss of impact. The gain would be that methadone could be spread ‘thin and wide’, reaching more potential patients.
HOT TOPIC 2016 HTM file
Prizes for not using drugs?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Contingency management programmes reward patients for complying with treatment or not engaging in undesired substance use. It works, but often only temporarily – and perhaps at the cost of eroding the patient’s confidence and motivation.
Failure to find effects concentrated in the first two weeks after release persuaded analysts that widespread methadone prescribing in Scottish prisons from 2002 did not reduce the rate of drug-related deaths after release. But over 12 weeks the rate did fall substantially, and methadone treatment may have helped.
HOT TOPIC 2016 HTM file
What do the patients want?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Focus is the apparently iconoclastic finding from a Scottish national treatment study that abstinence is the sole drug-focused goal for most patients in drug treatment: “At best these extrapolations were sloppy, at worst, deliberately misleading.”
HOT TOPIC 2015 HTM file
Prescribing opiate-type drugs to opiate addicts: good sense or nonsense?
One of our hot topics offering background and analysis on important issues which sometimes generate heated debate. For decades deeply felt and at times intemperate debate has surrounded a treatment which achieves unparalleled success by going with the grain of addiction, prescribing the same type of drug which opiate-dependent patients used illegally – a substitution castigated as surrender or hailed as an enlightened lifesaver.
STUDY 2012 HTM file
Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland
National survey of injectors attending services supplying injecting equipment suggests methadone maintenance plus an abundant supply of needles and syringes help protect Scottish injectors from infection by hepatitis C.
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