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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.
A flagship drug treatment policy initiative appears to have backfired in England, where the government’s pilot payment-by-results schemes seem to have led to fewer successful completions of treatment and more prospective patients declining treatment.
For the first time regular checkups to promote treatment re-entry have been tried with an all-female problem substance user caseload, and one leaving prison rather than community-based treatment. Over the first three months more returned to treatment more promptly. Previous studies suggest this will lead to reduced substance use, crime and HIV infections.
Testing in the UK suggested that a questionnaire assessing the ‘recovery capital’ resources which help overcome addiction might underpin more recovery-oriented assessments of services and of client progress and needs – but only a study which followed up patients could confirm this, and do some of the questions assess ability to recover, or recovery itself?
For such a widely implemented and widely supported adjunct to formal treatment, the revelation from this review is how little evidence there is for involving former problem substance users in promoting recovery from similar problems – a lack which may simply reflect the paucity of adequate research.
STUDY 2014 HTM file
Drug treatment in England 2013–14
Authority responsible for promoting addiction treatment in England cautions that the gains of recent years in reduced drug use, lower demand for treatment for heroin and crack problems, improved treatment performance, and curbing drug-related harm, have all stalled or gone in to reverse.
Evidence that in 2012 Scotland’s alcohol treatment caseload equated to about 1 in 4 of the country’s alcohol-dependent adults, over three times the 1 in 14 ratio in England, partly a consequence of extra funding accompanying Scotland’s 2009 national alcohol strategy. Evidence too of a peer-based recovery orientation taking root.
DOCUMENT 2014 HTM file
Time limiting opioid substitution therapy
Rather than being ‘parked’ on methadone, generally Britain’s heroin-addicted patients leave too soon to fully benefit, argue official government advisers on drug policy. Their report unambiguously countered concerns within the current UK government over methadone maintenance.
Opiate dependent patients in Scotland who opted for or were allocated to methadone sustained their abstinence from heroin as well as those on buprenorphine, but buprenorphine was far better at helping continuing heroin users cut back – suggestive, but the study’s constraints make the practice implications unclear.
Reprint of a 1977 presentation of one of the most influential studies of heroin addiction ever conducted, which called in to question its supposed addictive qualities, the need for prolonged treatment and abstinence to overcome addiction, and whether heroin use inevitably causes major social problems.
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