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In the Canadian province of British Columbia there was a rapid rise in overdose deaths from 2015, leading to the declaration of a public health emergency in 2016. The response rested on three key interventions: take-home naloxone, opioid substitution therapy, and drug consumption rooms. The province’s highly detailed surveillance data offered an opportunity to estimate their collective and individual impacts on opioid overdose deaths.
STUDY 2012 HTM file
Housing first for severely mentally ill homeless methadone patients
Homelessness is a significant obstacle to regular participation in methadone maintenance treatment, particularly among people leaving prison. This study in a major US city examines whether a ‘housing first’ programme could improve outcomes among this cohort.
Key studies on the how the characteristics and functioning of treatment organisations affect implementation and effectiveness. Learn to see organisational context as part of treatment and about two evidence-based US quality improvement resources, and consider what makes treatment services engaging and how they could extend engagement into long-term continuing care. See the remaining four cells in row 2 of the matrix for more on generic features of medical and psychosocial therapies.
‘A minute makes a difference in primary care consultations’, was the finding of a 1992 study about improving the capacity of general practitioners to screen for problems such as heavy drinking, smoking, and high blood pressure. But is extra time on the clock enough to secure routine (as opposed to more frequent) delivery of health promotion and brief intervention?
MATRIX CELL 2020 HTM file
Alcohol Treatment Matrix cell C2: Management/supervision; Generic and cross-cutting issues
Key studies on management and supervision across psychosocial and medical treatments of problem drinking. Highlights that “Manners Matter”, focuses on staff recruitment, queries the ubiquitous stages of change model, and details the fascinating history of the most controversial issue in alcohol treatment: whether to insist dependent drinkers try for abstinence. See the rest of row 2 of the matrix for more on features common to psychosocial and medical treatments.
DOCUMENT 2020 HTM file
Guidance on contingency planning for people who use drugs and COVID-19 (v1.0)
How can needle exchange services and opioid substitution therapy be safeguarded in the midst of a novel viral outbreak? Scottish Guidance considers potential disruptions to delivery, and suggests ways of ensuring continuity of services when best practice or ‘service as usual’ might be out of the question.
What do primary care clinicians think would help them bridge the ‘implementation gap’ in screening for risky drinking and brief advice, and extend the potential benefits to a greater proportion of the population? A European trial found the answer differed depending on distinctive national circumstances.
Has enough high-quality evidence accumulated over the past five years to improve confidence in the effectiveness of residential treatment?
Could combinations of three strategies – training and support, financial reimbursement, and the opportunity to refer patients to a website – cost-effectively boost delivery of brief interventions in European primary care? The important aim was to find the best way to narrow the ‘implementation gap’ between the number of patients who could benefit from these interventions and those who receive them.
Simulation study calculated health care cost savings and benefits for patients in England which make routine GP-based screening and brief advice for excessive drinking look an unmissable bargain, but the key assumptions derived from studies divorced from how interventions would routinely be implemented.
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