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With an ‘alarmingly scarce’ evidence base to go on, the researchers draw parallels with the broader alcohol treatment literature, finding some support for interventions with motivational components among cohorts of gay and bisexual men, for whom heavy drinking is associated with more severe and chronic consequences.
Scant research into brief interventions targeting harmful drug use in emergency departments prevents firm conclusions being drawn about their effectiveness. But, recognised benefits for alcohol, and likely cost-effectiveness, suggest that brief interventions may be appropriate within emergency care settings.
Conclusions supportive of cognitive-behavioural therapy for problem cannabis use from this authoritative UK assessment seem to conflict with earlier UK guidelines, though both query whether extended cognitive-behavioural therapy offers added value compared to briefer approaches.
STUDY 2015 HTM file
Maintenance check-ups following treatment for cannabis dependence
Arranging aftercare check-ups to see how cannabis-dependent patients were doing and whether they needed to return to treatment helped sustain cannabis use reductions – but why did this advantage emerge even before the first check-up?
A computer-delivered brief intervention plus booster mailings increased the alcohol abstinence rate and improved pregnancy outcomes among risky drinking pregnant women recruited at a US antenatal clinic, though in this small pilot trial the results were not statistically significant.
Analysis of the only four randomised trials of brief alcohol interventions among 18–24-years-olds seen at emergency departments after getting drunk tentatively suggested that booster sessions or later advice are needed to reduce drinking.
REVIEW 2015 HTM file
Prevention of addictive behaviours
Based largely on existing reviews, this report for the German Federal Centre for Health Education comprehensively assesses substance use prevention approaches. Among its many conclusions are that approaches based solely on information provision are ineffective, in contrast to the more positive evidence for lifeskills and multi-component community programmes.
In the Netherlands an intensive cognitive-behavioural treatment programme for problem drinkers based on messages sent via a web site between therapist and patient achieved substantial remission in drinking and improvements in health – promising results undermined somewhat by how few patients were followed up.
Injectors at risk of infection due to sharing equipment responded best to brief risk-reduction counselling based on motivational rather than educational principles, offering a way to augment the benefits of harm reduction services.
Despite a clear rationale for embedding brief interventions in community pharmacies, this UK trial found no evidence that they would reduce hazardous or harmful drinking.
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