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Prescribing oral methadone to heroin addicts divides opinions, but prescribing injectable heroin elevates the controversy to another level. Fortunately we now have six randomised clinical trials involving over 1500 patients to ground us in the evidence – and this European Union review to pull it all together.
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.
Report for the EU identifies an urgent need to increase access to social reintegration interventions for problem drug users. Though unable to pin down the best approaches, it stresses that reintegration measures should be embedded into drug treatment at an early stage.
Experience in California of developing and implementing a system for assessing patients' needs and matching to appropriate services offers an unusually fully developed model for promoting recovery and judging the outcomes achieved by a service in the light of its patient profile.
In three high drug use urban areas in England, treatment staff were placed in job centres to facilitate the referral of unemployed substance users in to treatment. It worked, but not well enough to recommend a national roll out.
STUDY 2011 HTM file
The effectiveness of supported employment in people with dual disorders
Compared to more gradualist approaches, with appropriate support targeted at rapidly achieving this objective, far more mentally ill problem substance users in the USA were enabled to find competitive employment in the open labour market rather than sheltered placements.
Is regular counselling really essential to the effectiveness of methadone maintenance treatment, or are treatment entry and the power of high-dose methadone enough in themselves for many patients? At least in the first four months, this US study suggests the latter.
Opiate dependent methadone patients in Belgium give their own accounts of what for them constitutes a good quality of life. Generally they want what other people want: a meaningful, independent life and supportive relationships. Methadone creates the preconditions for such a life at the same time as it limits its achievement.
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.
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.
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