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MATRIX CELL 2020 HTM file
Drug Treatment Matrix cell E4: Treatment systems; Psychosocial therapies
Seminal and key studies on local, regional and national systems for effectively and cost-effectively providing psychosocial therapies and the place of those therapies within these systems. Asks whether mutual aid groups can bridge the widening gap between resources and recovery ambitions, whether residential rehabilitation should be a last resort, and how tightly commissioners should specify services.
MATRIX CELL 2020 HTM file
Drug Treatment Matrix cell E3: Treatment systems; Medical treatment
Seminal and key studies relating to local, regional and national systems for effectively and cost-effectively providing medical interventions and treatment in medical settings. Highlights a simple innovation which transformed detoxification recyclers into typical patients, asks if you agree with an expert group’s vision of what a good quality service looks like, and questions whether Britain is making progress on organising care for mentally ill problem drug users.
In the Canadian province of British Columbia there was a rapid rise in overdose deaths from 2015, leading to the declaration of a public health emergency in 2016. The response rested on three key interventions: take-home naloxone, opioid substitution therapy, and drug consumption rooms. The province’s highly detailed surveillance data offered an opportunity to estimate their collective and individual impacts on opioid overdose deaths.
Strong evidence from two US cities that moving from a blanket prohibition on possession of equipment for injecting illegal drugs to providing this equipment via legal needle and syringe programmes prevented thousands of HIV infections, resulting in large savings in the treatment of these infections.
The UK has a long history of prescribing heroin for the treatment of heroin dependence. What has research from six countries concluded about this intensive intervention intended for patients who would otherwise be considered ‘unresponsive’ to treatment?
REVIEW 2019 HTM file
Supervised consumption sites: a nuanced assessment of the causal evidence
How high should the evidence bar be set when deciding whether to endorse drug consumption rooms?
STUDY 2019 HTM file
Efficacy and cost-effectiveness of an adjunctive personalised psychosocial intervention in treatment-resistant maintenance opioid agonist therapy: a pragmatic, open-label, randomised controlled trial
Instead of a set programme, a clinic in London tried offering methadone or buprenorphine patients still using heroin or cocaine a selection from a suite of well-supported psychological interventions tailored to the patient and then systematically re-tailored in the light of how they responded. It worked – but did it work well enough, and would the findings be replicated in more typical circumstances?
DOCUMENT 1987 HTM file
High time for harm reduction
Impelled by the injecting-related AIDS crisis, Merseyside was where harm reduction in the UK first took root. From there in 1987 came this groundbreaking call for a turn away from what was seen as a failed attempt to prevent use to mitigating the harm. Expressed modestly as a “prudent” suggestion, with Russell Newcombe’s essay, “harm reduction” had come of age.
What would happen to rates of infection with hepatitis C if we closed down all the needle exchanges? In three UK municipalities, the answers were predicted to be more infections, lost low-cost opportunities to improve and save lives, and in two of the areas, greater health-related costs overall. Conclusion was that these services are among the best investments UK health services can make. town
STUDY 2018 HTM file
Impact of current and scaled-up levels of hepatitis C prevention and treatment interventions for people who inject drugs in three UK settings – what is required to achieve the WHO’s HCV elimination targets?
What would it take for the UK to meet the World Health Organization’s target of a 90% reduction in hepatitis C by 2030? According to projections in three diverse areas, current levels of harm reduction services are averting a great deal of transmission, and adding only moderate rates of treatment for hepatitis C would put Britain on course to achieve the elimination target.
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