You have found 50 entries after clicking the GO button or a search link in a hot topic. Starting with analyses of the most recently published documents, the list shows in orange the type of entry, year the original document was published (or if one of our own documents, the year last updated), and the type of file you will download when you click on the title. In blue is the document’s title followed by a brief description.
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How do different pathways for the treatment of problem opioid use compare under real-world conditions? For US patients with health insurance, opioid substitution therapy was associated with the greatest risk reduction. However, its protective effect may not be fully realised while federal and insurance plan restrictions continue to limit access to this treatment option.
STUDY 2019 HTM file
Efficacy and cost-effectiveness of an adjunctive personalised psychosocial intervention in treatment-resistant maintenance opioid agonist therapy: a pragmatic, open-label, randomised controlled trial
Instead of a set programme, a clinic in London tried offering methadone or buprenorphine patients still using heroin or cocaine a selection from a suite of well-supported psychological interventions tailored to the patient and then systematically re-tailored in the light of how they responded. It worked – but did it work well enough, and would the findings be replicated in more typical circumstances?
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.
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.
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.
Though set up to determine whether the public purse would gain by sending more opiate-dependent clients to residential rehabilitation, this UK government report declared itself unable to conclude one way or the other, but did judge it “highly unlikely” that these treatments’ extra expense would be offset by extra savings.
From the USA’s professional society for clinicians and allied professionals in the field of addiction medicine, comprehensive recommendations on how doctors can use medications to treat addiction to heroin and other opioids.
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.
DOCUMENT 2013 HTM file
Can we dispense with counselling, therapy, treatment as we know it, and just punish or deprive patients of rewards when they use substances in undesired ways, and reward them when they behave as we/they would wish? British services are trialling an approach about which many clinicians express major ethical concerns – contingency management.
REVIEW 2012 HTM file
Drug policy and the public good: evidence for effective interventions
Review of relevant research by an international team of leading researchers offers policymakers guidance on the interventions most likely on the evidence to achieve national policy aims in respect of illegal drug use.
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