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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.
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.
From the USA a rare randomised controlled trial of prison-based substance use treatment for women finds substantial benefits from replacing a standard prison therapeutic community programme with one based on extensive trauma-informed and gender-responsive elements delivered in an entirely woman-only environment.
This first major multi-modality test of a treatment engagement indicator widely used as a quality control yardstick in the USA found it was only very weakly related to patient improvement seven months after starting treatment, confirmation that simple measures of what happens during treatment struggle to capture what really makes treatment effective.
REVIEW 2008 HTM file
Offender coercion in treatment: a meta-analysis of effectiveness
This comprehensive synthesis of 129 studies of offender treatment for problems such as substance use found increasing treatment impact as the degree to which the offender was free to choose the treatment increased. At the bottom end, mandated treatment in custody appeared a waste of time and money.
Seeking Safety is a prominent therapy for the common combination of substance dependence and post-traumatic stress disorder, yet in this study of imprisoned women in the USA it did not significantly augment outcomes from the prison's own substance use treatment. Asking 'Why not?' generates interesting explanations.
In Norway, long-term continuity of care by the same adults in a family-like setting outside the home (a specially funded foster home or residential centre) was the key to a better later life for severely troubled young teenage substance users.
This US-focused review calls for parents with substance use problems in the child welfare system to receive integrated services which comprehensively assess health and social problems and systematically match needs to problems in the context of a positive client-provider relationship.
DOCUMENT 2010 HTM file
Drug misuse statistics Scotland 2010
Statistical picture of drug misuse in Scotland in 2009 and 2010 including treatment and criminal justice caseloads and health impacts, plus trends over recent years.
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