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In everyday practice at methadone maintenance clinics and with the full range of patients, does implementing clinical guidelines lead to better outcomes for patients? Two sets of US clinics selected for high versus low adherence to guidelines provided evidence that the recommended high doses and intensive psychosocial services really do make the intended difference.
STUDY 2007 HTM file
The costs and consequences of three policy options for reducing heroin dependency
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 2007 HTM file
Drug misuse in over 16s: psychosocial interventions
After examining the evidence for psychosocial therapies for problem drug use, the UK’s official health advisers recommend behavioural couples therapy and contingency management, argue against cognitive-behavioural therapies, and pose residential rehabilitation as a last resort – in some respects surprising and controversial recommendations.
STUDY 2006 PDF file 171Kb
Matching resources to needs is key to achieving 'wrap-around' care objectives
Linking treatment intake assessments to a computerised guide to local welfare and medical services transformed the assessments from redundant paperwork into a practical route to the reintegration services being advocated in Britain – and treatment completion rates doubled.
DOCUMENT 2006 PDF file 1326Kb
The Rolleston legacy
In British drug policy no document has more claim to the term 'classic' than the 1926 Rolleston report, which enshrined doctors' freedom to prescribe opiates to opiate addicts.
STUDY 2006 PDF file 106Kb
Improving continuity of care in a public addiction treatment system with clinical case management
In Philadelphia intensive case management created the kind of post-detoxification continuity of care which dramatically cut repeated admissions for detoxification, increased the numbers able to be treated, and offered patients a better chance of gaining lasting stability.
IN PRACTICE 2005 PDF file 927Kb
Barriers cleared in Endell Street
How a team in London's West End set about systematically overcoming the barriers which prevented the residents of a homelessness hostel getting the treatment they needed. The key step was simple – asking the residents just what it was which stood in the way.
STUDY 2005 PDF file 154Kb
Hepatitis C therapy cost-effective for injectors
Two new analyses agree that despite relapse to drug use and imperfect adherence to a demanding medical regime, anti-viral therapy for hepatitis C infection in drug injectors cost-effectively prolongs and improves life.
OFFCUT 2005 PDF file 151Kb
Hepatitis C is spreading more rapidly than was thought
From the early 2000s in Britain there was clear evidence from research and routine monitoring that drug policy was failing to contain hepatitis C infection among injectors, and worrying signs of a trend upwards in HIV infection.
STUDY 2005 PDF file 102Kb
More patients drop out after long waits for methadone prescribing
Combined implications of two British studies are that the longer someone waits for methadone treatment, the less likely they are to start it, and even if they do, they will have spent longer at risk from dependent heroin use.
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