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When the English Department of Health's alcohol policy support team visited local areas, they found an improving but often muddled and uncoordinated attempt to improve public health through alcohol-related interventions which lacked consistent commitment.
UK-focused review for Britain's National Institute for Health and Clinical Excellence of what impedes or promotes the implementation of brief alcohol interventions at the level of the organisation, the staff doing the work, and the patients targeted by the programme.
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.
STUDY 2011 HTM file
Therapist effectiveness: implications for accountability and patient care
1 in 6 US therapists (mainly not specialising in substance use) typically ended up with clients whose substance use problems were significantly worse than when they started therapy, an indication perhaps that social workers and mental health counsellors find these issues especially hard to deal with.
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.
This review encapsulates the range of treatment assessment and improvement tools developed over decades by the Texas Christian University, widely recognised as the most comprehensive and systematic attempt to map the processes involved in treatment and to link these to interventions to improve outcomes for the client.
In Russia, injecting detoxified opiate addicts with long-acting naltrexone which blocks opiates for a month meant more were able to stay off the drugs, findings which helped persuade US authorities to approve it for this role. Others argue this was precipitate given the lack of evidence on overdose protection.
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.
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.
Applying a systematic and comprehensive framework to map the strategies trialled in attempts to implement screening and counselling for risky drinking primary care patients gives some clues to what it has taken to achieve a high screening rate, the essential first step in the process.
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