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Practitioner-friendly review from the British Association for Psychopharmacology on drug-based treatments for substance dependence offer authoritative, evidence-based guidance to prescribers and others; they also demonstrate the limitations of trying to cure over-use of drugs with drugs.
REVIEW 2010 HTM file
Testing for cannabis in the work-place: a review of the evidence
A review of 20 years of research on cannabis testing at work found that the patchy evidence permitted few strong conclusions about effectiveness. Given the lack of evidence, it seems wise for UK guidance to limit workplace testing to those who really warrant it because of their jobs, rather than advocating widespread testing as a deterrent.
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?
Heavy cannabis use is particularly troubling in patients already struggling with schizophrenia. This study provides the first evidence from a randomised controlled trial that switching such patients to the antipsychotic clozapine may help reduce their cannabis use, but is this worth the extra risk of clozapine compared to the alternatives?
DOCUMENT 2013 HTM file
Can we dispense with counselling, therapy, treatment as we know it, and just punish or deprive patients of rewards when they use substances in undesired ways, and reward them when they behave as we/they would wish? British services are trialling an approach about which many clinicians express major ethical concerns – contingency management.
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.
STUDY 2012 HTM file
A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries
Orchestrated by WHO, across all four countries this rare attempt at screening and brief intervention for problems arising from illegal drug use identified at front-line health care centres found modest reductions in use/risks, but there was a puzzling opposition between particularly positive results from Australia and seemingly negative ones from the USA.
STUDY 2008 HTM file
The effectiveness of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary health care settings: a technical report of phase III findings of the WHO ASSIST randomized controlled trial
Rare attempt at screening and brief intervention for actual or potential problems arising from illegal drug use among primary care patients suggests that screening itself reduces use levels and that further intervention might be worthwhile among high-risk populations.
Aged 16 and smoking cannabis or drinking coming up to one day in three, US youngsters identified as substance users by their schools substantially cut back in response to just two motivational counselling sessions, and even more when a third session addressed the parents at home.
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