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HOT TOPIC 2016 HTM file
Individualising treatment: an obviously ‘good thing’?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Individualisation might seem an obvious and basic prerequisite to substance use treatment, but in fact services have often striven for uniformity.
Broad and sustained improvement possible for people with co-occurring borderline personality and alcohol use disorders participating in deconstructive psychotherapy.
Approaches to alcohol policy differ widely across the UK. Scottish policy appears to be most closely aligned with evidence-based recommendations, framing alcohol as a whole population issue, in contrast with UK government policy which is influenced to a greater extent by prevailing beliefs about personal responsibility for alcohol issues.
This US study found that among people with serious mental illness and a history of criminal justice involvement, an intervention intended to foster citizenship through peer mentoring, education and activities, reduced alcohol and drug use and enhanced quality of life and satisfaction with social, leisure and work activities.
The first UK evaluation of court-ordered alcohol treatment to feature an adequate comparison group finds no statistically significant reductions in recorded re-offending associated with alcohol treatment requirements imposed as part of a probation sentence.
A computer-delivered brief intervention plus booster mailings increased the alcohol abstinence rate and improved pregnancy outcomes among risky drinking pregnant women recruited at a US antenatal clinic, though in this small pilot trial the results were not statistically significant.
Long-acting injectable naltrexone blocks the effects of opiates for about a month and has also helped dependent drinkers cut back. Treatment records in the US state of Missouri showed that among the few problem substance using offenders allocated to or who chose this treatment, a much higher proportion became abstinent than those offered other kinds of addiction treatment.
After intensive coaching in parenting conducted with mother and child together, randomly selected mothers in residential treatment demonstrated more sensitive parenting than mothers not allocated to the programme, promising to intercept inter-generational transmission of poor parenting.
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.
‘Do just the minimum’ seems the message of the emergency department arm of the largest alcohol screening and brief intervention study yet conducted in Britain; the proportion of risky drinkers fell no less after a brief warning than after more sophisticated and longer interventions.
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