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Slow-release capsules of morphine – the closest drug to heroin – might offer acceptable and effective treatment to addicts who cannot settle on methadone. In England a dozen also being prescribed heroin switched their supplementary methadone to morphine, generally experiencing the benefits they expected and cutting their average dose of heroin.
This US randomised trial in Rhode Island among formerly opiate dependent prisoners found that starting methadone treatment in prison radically improved treatment uptake on release and reduced heroin and cocaine use over the following six months, confirming results from Baltimore.
The first systematic review of whether integrated substance use/parenting programmes improve the parenting of problem substance using mothers found remarkably few quality studies, but enough to suggest that such programmes can improve the prospects of often highly at-risk children.
Up to a year after starting methadone treatment US patients offered virtually no counselling for the first four months were still doing as well as those offered regular counselling. But there is a hint that intensive and high quality counselling enabled more to safely leave treatment.
In the context of current UK policy, this is a key study, testing the ambition to extend recovery beyond formal treatment by systematically linking patients to mutual aid groups, the main way it is being suggested commissioners can square the circle of doing more (recovery is seen as a whole-life transformation) with less.
DOCUMENT 2012 HTM file
Practice standards for young people with substance misuse problems
Practice standards developed by the UK’s Royal College of Psychiatrists on working with young people aged 18 or under with substance misuse problems, intended (if followed) to promote high quality screening, assessment and treatment for these young people.
STUDY 2012 HTM file
Alcohol screening and brief intervention in emergency departments
The emergency department 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.
DOCUMENT 2012 HTM file
Quality standard for drug use disorders
Official UK quality standards on the treatment of adults for problems related to the use of illegal drugs, intended be used to plan and deliver services to provide the best possible care.
DOCUMENT 2011 HTM file
Alcohol dependence and harmful alcohol use quality standard
From the UK health service standard-setting agency, a concise statement of 13 practices which constitute high quality health care for problem drinkers and good practice in identifying and advising hazardous drinkers - standards which may be used to assess and reward providers and health service commissioning authorities.
Despite the challenges, review confirms that hepatitis C infection can be prevented among injectors, but it takes multi-component strategies with elements such as substitute prescribing to reduce or eliminate drug injection, treatment of infection, and enabling safe injection practices by providing sterile injecting equipment and behaviour-change counselling.
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