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English treatment systems perform at least as well as other countries on a number of measures, but have a considerably higher rate of drug-related deaths than elsewhere in Europe. As well as pursuing harm reduction and recovery, this report stresses the importance of social integration as an objective.
For the second time the annual accounting of the treatment caseload in England combines records of drug and alcohol use treatment, registering a continuing fall in total numbers and decreasing success with opiate users, while the treatment of drinkers appears to be improving.
The annual accounting of the treatment caseload in England registers a continuing fall in total numbers and decreasing success with opiate users, while success with drinkers has increased and has for the last few years remained relatively high and stable. An ageing population of opiate users is the proposed explanation for the former trend – but why hasn’t a similarly ageing alcohol caseload also eroded success rates?
Study published by UK government estimates that every £1 spent on specialist substance misuse treatment for under-18s in Britain averts social costs totalling £4.66–£8.38.
Australian study addressing an issue greatly exercising the UK: do you get greater returns per £ from residential rehabilitation or from substitute prescribing? In terms of reduction in the frequency of heroin use, prescribing was one-and-a-half to three times more cost-effective.
DOCUMENT 2010 HTM file
The Patel report: Reducing drug-related crime and rehabilitating offenders
Investigation and recommendations from an expert group on drug treatment and interventions for people in prison in England calls for a clear focus on recovery and for the commissioning and coordination measures needed to improve outcomes without extra resources.
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.
DOCUMENT 2013 HTM file
Community loses from failure to offer maintenance prescribing in prisons
An international team of experts has argued that failure to implement effective opioid maintenance programmes in prison represents an important missed opportunity to engage high-risk drug users in treatment, at possibly substantial costs to the individuals and to the community. Is Britain too losing out, and how does the future look?
Failure to find effects concentrated in the first two weeks after release persuaded analysts that widespread methadone prescribing in Scottish prisons from 2002 did not reduce the rate of drug-related deaths after release. But over 12 weeks the rate did fall substantially, and methadone treatment may have helped.
STUDY 2015 HTM file
Changing patterns of substance misuse in adult prisons and service responses
Inspection findings on individual prisons were supplemented by fieldwork in eight prisons in 2014 to generate an overall picture of drug use and responses to it in prisons and England and Wales. In the face of rapidly changing and varied drug use patterns, policy and operational responses were seen as insufficiently flexible and dynamic, though treatment had dramatically improved.
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