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This thorough review formed the evidential basis for recent guidance from England's National Institute for Health and Clinical Excellence on how best to distribute sterile syringes. Maximising the proportion of injections done with sterile equipment is the key objective.
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.
From the USA, the first randomised trial of a post-prison therapeutic community designed for psychologically disturbed problem substance using offenders found it halved the numbers reimprisoned and did even better when preceded by similar in-prison treatment, confirmation that what happens when people leave prison can be critical.
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.
DOCUMENT 2009 HTM file
Management of cannabis use disorder and related issues: a clinician’s guide
Guidance funded by the Australian government and systematically based on the evidence. Covers the range of cannabis use interventions from brief advice for users identified by screening through to managing withdrawal and treating dependence.
DOCUMENT 2013 HTM file
Sometimes best to break the rules
Motivational interviewing’s ‘Do not dos’ like avoiding confrontation were intended to sidestep the traps which provoke clients to dig in their heels or disengage. Imagine then the upset of discovering that in certain circumstances, the opposite is the case; the explanation appeared to lie in coming across as ‘genuine’.
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.
Sets out the structure and objectives of the public health system for England effective from April 2013 and how progress against these objectives will be measured, including addiction treatment completions, alcohol-related hospital admissions, and prisoners identified as needing treatment for alcohol/drug problems.
From Canada the first study to show that among long-term, severely opiate dependent patients who have not responded well to prior treatment, women as well as men benefit more from being prescribed injectable heroin than oral methadone.
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.
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