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In Sydney in Australia an official campaign and educational efforts had the desired effect of shifting staff attitudes in methadone maintenance clinics away from achieving abstinence and withdrawal and towards long-term treatment aimed at reducing harm.
DOCUMENT 2011 HTM file
Prevention and control of infectious diseases among people who inject drugs
European Union drug misuse and disease control agencies have come together to offer guidance on how to prevent injection-related disease spread in Europe. Towards the top of the list are widespread injecting equipment supply and heroin substitute prescribing, but neither chime well with the UK's recovery-focused addiction policies.
DOCUMENT 2012 HTM file
Drug misuse statistics Scotland 2011
Statistical picture of drug misuse in Scotland in 2010/11 including treatment and criminal justice caseloads and health impacts, plus trends over recent years.
STUDY 2011 HTM file
Quality concerns with routine alcohol screening in VA clinical settings
In the US health care service for ex-military personnel, 61% of patients who screened positive when sent a postal survey did not do so when the same questions were asked by their clinics, casting doubt on the validity of the test in routine practice in a service where the emphasis was more on the quantity than the quality of screening.
Unequivocal backing from UN agencies for methadone and other forms of long term maintenance treatments as the prime modality for the treatment of dependence on heroin and allied drugs. In contrast say the experts, detoxification results in poor long term outcomes.
What happens when opiate-addicted patients are suddenly no longer required to take their methadone under supervision but can take it away from the pharmacy? In Scotland this was tried in the first UK randomised trial; patients stayed longer in treatment and there was no dramatic escalation in heroin use.
Heroin addicts in Baltimore who still used drugs heavily despite being on methadone were sent to a special clinic for intensified care reinforced by sanctions and incentives and eventual discharge if still they failed to comply. Tough love perhaps, but does it really make sense to intensify compliance requirements on patients already not complying?
In the US homeland of competition and private health care, it was cooperation and coordination which led to the introduction of new medications and innovations to promote continuing care – plus the exercise of regulatory and financial muscle and the salutary experience of senior staff who placed themselves in the patient's shoes.
STUDY 2012 HTM file
Audit of alcohol detoxification at Leeds Addiction Unit
In a specialist hospital unit in Leeds, virtually all the alcohol dependent outpatients completed detoxification and all but a few went on to try to sustain their drinking reductions using the aversive medication disulfiram, indicative of what can be achieved in these settings.
STUDY 2012 HTM file
Alcohol screening and brief intervention in primary health care
The primary health arm of the largest alcohol screening and brief intervention study yet conducted in Britain found that the proportion of risky drinkers fell just as much after the most minimal of screening and intervention methods as after more sophisticated and longer (but still brief) alternatives.
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