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DOCUMENT 2014 HTM file
Needle and syringe programmes
The UK’s health advisory body recommends high coverage and if need be, 24-hour needle exchange to combat HIV and the hepatitis C epidemic. The aim they say is for every injector to have even more sterile injecting equipment than they need for every single injection.
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.
STUDY 2013 HTM file
Criminal justice responses to drug related crime in Scotland
In one expert package, the recent history, results, achievements and possible drawbacks of Scotland's concerted attempt to engage drug-driven offenders in treatment at nearly every stage of the criminal justice system. Widening treatment access may have been the main plus, also widening entanglement in the criminal justice system the main minus.
From England, findings suggesting the intriguing but for the moment tentative possibility that non-conformist drug workers who value hedonism and stimulation help socially excluded clients improve most because their values match those of their clients.
DOCUMENT 2013 HTM file
Sometimes best to break the rules
Motivational interviewing’s ‘Do not dos’ like avoiding confrontation were intended to sidestep the traps which provoke clients to dig in their heels or disengage. Imagine then the upset of discovering that in certain circumstances, the opposite is the case; the explanation appeared to lie in coming across as ‘genuine’.
STUDY 1981 HTM file
Interpersonal functioning of alcoholism counselors and treatment outcome
Seminal US study which found that the therapy-related social skills of alcohol counsellors were strongly related to how many of their patients relapsed in the two years after leaving inpatient treatment.
The title speaks of long-term effects but in fact there were none from sending young US substance users to a youth therapeutic community specialising in substance use problems compared to non-specialist group homes; early gains had all eroded, an instance of the general difficulty of sustaining youth treatment outcomes.
Analysis of counselling session recordings from therapists trained in motivational interviewing suggests that the important quality of seeming 'genuine' can suffer if training mandates unnaturally withholding normal responses; however, departing from these tenets is risky unless done by a socially skilled therapist.
In Sydney in Australia an official campaign and educational efforts had the desired effect of shifting staff attitudes in methadone maintenance clinics away from achieving abstinence and withdrawal and towards long-term treatment aimed at reducing harm.
Seminal study of how to train out socially derived attitudes to methadone maintenance as a policy solution to a social problem and train in attitudes which place it within mainstream medical practice as a treatment of individuals which does not 'fix' their problems but offers the opportunity for positive change.
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