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REVIEW 2011 HTM file
Implementing evidence-based psychosocial treatment in specialty substance use disorder care

Does implementing evidence-based psychosocial therapies actually lead to the intended practice changes and do these make things better for the clients? From this review, most clearly when the whole organisation is enrolled in the effort and training is bolstered by systematic and expert continuing supervision.

STUDY 1970 HTM file
Frontiers of alcoholism

Later to become founding director of the US National Institute on Alcohol Abuse and Alcoholism, in the late 1950s Dr Morris Chafetz of the Massachusetts General Hospital conducted a remarkable series of studies which proved that an alcohol clinic's intake and performance can be transformed by the simple application of empathy and organisation.

STUDY 1980 HTM file
The attitudes of helping agents toward the alcoholic client: the influence of experience, support, training and self-esteem

Seminal English study which turned the spotlight on organisational factors in the development of a positive attitude to working with problem drinkers, in particular the availability of experience in working with these patients and the support of experienced colleagues. Without these the effects of training are less and less well sustained.

DOCUMENT 2012 HTM file
Improving outcomes and supporting transparency part 1: A public health outcomes framework for England, 2013–2016

Sets out the structure and objectives of the public health system for England effective from April 2013 and how progress against these objectives will be measured, including addiction treatment completions, alcohol-related hospital admissions, and prisoners identified as needing treatment for alcohol/drug problems.

STUDY 2011 HTM file
Quality concerns with routine alcohol screening in VA clinical settings

In the US health care service for ex-military personnel, 61% of patients who screened positive when sent a postal survey did not do so when the same questions were asked by their clinics, casting doubt on the validity of the test in routine practice in a service where the emphasis was more on the quantity than the quality of screening.

STUDY 2012 HTM file
A pilot randomised controlled trial of brief versus twice weekly versus standard supervised consumption in patients on opiate maintenance treatment

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.

STUDY 2011 HTM file
An evaluation to assess the implementation of NHS delivered alcohol brief interventions: final report

In three years from 2008 Scottish national policy drove delivery of nearly 175,000 brief alcohol interventions, testament to what can be done when policy is backed by funding and infrastructure and incentive payments contingent on implementation. Leverage and acceptance were greatest in primary care, where the vast majority of the work took place.

DOCUMENT 2012 HTM file
Cost-of-alcohol studies as a research programme

Prominent alcohol expert argues that estimates that drinking imposes billions of pounds of costs on society are so value-laden and imprecise that their main value is as propaganda. Policies like increasing the price of drink may be justified on other grounds, but not by a misleadingly appealing total cost or cost reduction figure.

STUDY 2012 HTM file
Advancing recovery: implementing evidence-based treatment for substance use disorders at the systems level

In the US homeland of competition and private health care, it was cooperation and coordination which led to the introduction of new medications and innovations to promote continuing care – plus the exercise of regulatory and financial muscle and the salutary experience of senior staff who placed themselves in the patient's shoes.

STUDY 2011 HTM file
Performance-based contracting within a state substance abuse treatment system: a preliminary exploration of differences in client access and client outcomes

In 2007–08 the US state of Maine introduced a new scheme directly linking funding for outpatient treatment services to performance in terms of waiting times and retention, but financial and service delivery impacts were negligible. Were the incentives too weak, or were services already doing as well as they could?

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