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In the context of current UK policy, this is a key study, testing the ambition to extend recovery beyond formal treatment by systematically linking patients to mutual aid groups, the main way it is being suggested commissioners can square the circle of doing more (recovery is seen as a whole-life transformation) with less.
From Germany the first trial to rigorously test high doses of the muscle-relaxant baclofen for the treatment of dependent drinking found post-detoxification drinking reductions of a magnitude rarely seen. Other trials have been less positive, and serious safety concerns may limit the drug’s use.
HOT TOPIC 2018 HTM file
Cycle of Change: change promoter or benevolent fiction?
One of our hot topics – essays on important issues which sometimes generate heated debate over the facts or their interpretation. Its simplicity is beguiling, but does the ubiquitous cycle of change model simply describe the change process, or help predict and accelerate it?
A review commissioned by the American Psychological Association found that patients who enter psychotherapy with positive expectations about outcomes tend to actually have better outcomes, suggesting therapists should regularly assess expectations and if indicated take steps to enhance them.
DOCUMENT 2017 HTM file
Commissioning impact on drug treatment: The extent to which commissioning structures, the financial environment and wider changes to health and social welfare impact on drug misuse treatment and recovery
Based on research, financial data and stakeholder surveys and testimonies, the UK government’s official drug policy advisers warn that without significant efforts to protect investment and quality, in England “loss of funding will result in the dismantling of a drug misuse treatment system that has brought huge improvement to the lives of people with drug and alcohol problems”.
The annual accounting of the treatment caseload in England registers a continuing fall in total numbers and decreasing success with opiate users, while success with drinkers has increased and has for the last few years remained relatively high and stable. An ageing population of opiate users is the proposed explanation for the former trend – but why hasn’t a similarly ageing alcohol caseload also eroded success rates?
HOT TOPIC 2017 HTM file
Focus on the families
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Both as a treatment resource for the patient and a group needing support in their own right, a UK report described families affected by substance use as the “forgotten” carers. Here we turn the focus on the “unheard and unseen victims when a loved one uses drugs or alcohol”.
STUDY 2014 HTM file
A ‘symptom-triggered’ approach to alcohol withdrawal management
Providing medication in response to symptoms of alcohol withdrawal instead of routinely improved the outcomes of patients in acute hospital settings – reducing the duration of treatment and the amount of medication used.
This impressive assessment of what evaluation research means for alcohol dependence treatment in Britain is distinguished by reviews of the latest literature on the sub-topics it covers; in some cases these starkly reveal the inadequacies of the evidence base.
Systematically applying simple prompts and motivators can improve aftercare attendance and help sustain progress made during initial residential treatment, offering a way to preserve the benefits of the investment made by patients, services and funders.
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