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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.
An expert committee responds to the Scottish government’s concerns over the role of methadone prescribing in helping patients along the Road to Recovery signposted in the national strategy. On the ground, that road was often barely constructed but methadone was not the problem, rather the failure to optimise programmes for recovery.
DOCUMENT 2012 HTM file
Medications in recovery: re-orientating drug dependence treatment
On behalf of the UK government an expert group has developed and documented a clinical consensus on how prescribing-based treatment for heroin addiction can be made more recovery-oriented in line with national strategy. Their report will be the main reference point in tussles over what recovery means for methadone services and patients.
STUDY 2013 HTM file
Drug treatment in England 2012–13
Agency responsible for addiction treatment in England argues that efforts to put recovery at its heart are paying off in the form of patients successfully completing treatment and not having to return, but warns that the older caseload is getting harder to move on. One concern: is treatment being de-individualised to generate a 'good news' story?
REVIEW 2013 HTM file
Quitting drugs: quantitative and qualitative features
Innovative re-analysis of US national surveys reveals that no matter how long ago someone became dependent on an illegal drug or alcohol, their chances of achieving remission remain the same. The findings challenge models which assume that progressive neural, lifestyle or psychological changes increasingly lock someone in to addiction.
STUDY 2011 HTM file
Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions
The largest recent US national survey of drink and drug problems shows that outside the addiction treatment clinic, remission is the norm and recovery common. After 14 years half the people at some time dependent on alcohol were in remission, a milestone reached for cannabis after six years, and for cocaine after just five.
Positive message of this compendious synthesis of hundreds of studies is that "Recovery is not an aberration achieved by a small and morally enlightened minority of addicted people. If there is a natural developmental momentum within the course of [these] problems, it is toward remission and recovery."
STUDY 2011 HTM file
Recovery innovations in Yorkshire and Humberside
The enthusiastic shoots of a recovery orientation emerging in treatment systems and services in northern England faced considerable challenges in gaining sufficient coverage to transform the established landscape – literally in the case of a plan to communally build an Iron Age roundhouse village.
Detailed examination of how differing welfare and treatment systems and understandings of dependence affect the alcohol caseloads of substance use treatment services in Sweden and the USA and how they fare in the year after starting treatment; reveals differences and similarities in what 'success' consists of and what seems to promote it.
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