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Opiate dependent patients in Scotland who opted for or were allocated to methadone sustained their abstinence from heroin as well as those on buprenorphine, but buprenorphine was far better at helping continuing heroin users cut back – suggestive, but the study’s constraints make the practice implications unclear.
Review of studies of interventions for heavy drinkers identified among general hospital inpatients concluded that multi-session brief interventions could reduce drinking. “Could” is an important qualifier: yet to be pinned down is why though sometimes they work, brief interventions often fail to produce significant effects.
The primary care 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.
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.
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.
DOCUMENT 2012 HTM file
The government's alcohol strategy
The UK government alcohol strategy for England and Wales claims to signal a radical change to turn the tide against irresponsible drinking. After resisting the policy, headline is the commitment to setting a minimum per unit price for alcohol.
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.
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.
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.
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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