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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.
Around the world, programmes which take a spiritual or overtly religious route to overcoming substance use problems are extremely common and in some countries dominant – but do they work any better than the alternatives? This review systematically sifted the evidence from the past 30 years.
STUDY 2019 HTM file
Efficacy and cost-effectiveness of an adjunctive personalised psychosocial intervention in treatment-resistant maintenance opioid agonist therapy: a pragmatic, open-label, randomised controlled trial
Instead of a set programme, a clinic in London tried offering methadone or buprenorphine patients still using heroin or cocaine a selection from a suite of well-supported psychological interventions tailored to the patient and then systematically re-tailored in the light of how they responded. It worked – but did it work well enough, and would the findings be replicated in more typical circumstances?
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.
MATRIX CELL 2018 HTM file
Drug Treatment Matrix cell A4: Interventions; Psychosocial therapies
Seminal and key studies shedding light on the general principles underpinning psychosocial therapies and the effectiveness specific approaches. ’Individualise,’ is the overarching theme … and the consequent dangers of inflexibly following guidelines and research findings.
HOT TOPIC 2018 HTM file
Can 12-step mutual aid bridge recovery resources deficit?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Can mutual aid groups based on AA’s 12 steps help bridge the gap between heightened ambition for recovery from addiction and diminished public resources. That largely depends on whether the worldwide popularity of the steps is matched by evidence of effectiveness.
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.
Strongest support for ‘therapeutic community’ approach to incarceration-based drug treatment according to robust review of evidence – with consistent reductions found in both drug relapse and recidivism.
12-step fellowships offer a way to reconcile shrunken resources with the desire to get more patients safely out of treatment. Accounting for the self-selection bias which has obscured AA’s impacts, this synthesis of US trials finds that attending more meetings after treatment boosts abstinence. Why then is research equivocal on whether promoting attendance improves drink-related outcomes?
Patient interviews provide insight into low levels of engagement and retention in alcohol treatment services, hindering the effective provision of treatment for dependent drinkers. Findings suggest that treatment pathways should better reflect the capacity and capabilities of people with alcohol dependence.
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