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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.
HOT TOPIC 2020 HTM file
What about evidence-based commissioning?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. In the UK the landscape of drug and alcohol service commissioning to meet need in an area has radically altered – a leap in the dark illuminated only dimly by prior evidence and current evaluations.
COLLECTION 2020 HTM file
Focus on women
‘Collections’ are customised Effectiveness Bank searches not available via the standard options in the search pages. How do women’s substance use problems, needs and outcomes differ from those of men? Marking International Women’s Day 2020, this collection search mainly retrieves treatment research but includes some prevention analyses.
MATRIX CELL 2019 HTM file
Alcohol Treatment Matrix cell C1: Management/supervision; Screening and brief intervention
Seminal and key studies on management and supervision in screening and brief interventions for risky drinking. Highlights UK guidance which insists health service managers “must” support this work and the quandary over whether to insist on these procedures (taking time which could have been used in other ways) or to let practitioners and patients decide their priorities. See the rest of row 1 of the matrix for more on screening and brief interventions.
STUDY 1962 HTM file
The abstinent alcoholic
Classic description of the patient who has sustained abstinence after treatment but is still unhappy, unfulfilled and/or nervously hanging on – in other words, not really ‘recovered’. They formed the majority of patients seen at Connecticut’s alcohol clinics in the 1950s who were not drinking at follow-up.
People with co-occurring mental health and substance use problems are often unable to access the care they need. This 2017 guide from Public Health England describes what better care would look like, underpinned by the principles that there is ‘no wrong door’ for accessing support, and it is ‘everyone’s job’ the other side of the door to help.
STUDY 2019 HTM file
“We have to put the fire out first before we start rebuilding the house”: practitioners’ experiences of supporting women with histories of substance use, interpersonal abuse and symptoms of post-traumatic stress disorder
Within treatment systems that have tended to underestimate or overlook the importance of ‘trauma-informed’ practice, this study explores how practitioners in England respond to the needs of women with substance use problems, histories of abuse, and symptoms of post-traumatic stress disorder.
In these UK national prevention guidelines, experts prioritised population-wide changes like price rises and outlet restrictions which affect everyone, independent of the choices they make. But in England government prefers to target what they see as the troublesome minority, not the responsible majority.
How do drug recovery wings in women’s prisons compare with best practice in Baroness Corston’s 2007 report to the Home Office?
Heavy drinking is clearly problematic for homeless populations, but is the best way to tackle it to aim for abstinence, or to accept the reality of life on the streets and aim to reduce harm and improve lives in ways which make sense to the patient? This US study supports the latter, but without conclusively deciding the issue.
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