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Matrix Row logo Drug Treatment Matrix row 3: Medical treatment

Medications most clearly mark an intervention as ‘medical’, but are never all there is to treatment. Evidence places them in the context of practitioners, the managements and organisations which determine how well they can do their jobs, and local systems through which patients access treatment and sustain their recovery.

Cell A3 Can medications make it too easy to recover?
Drug-based treatments dominate opiate addiction treatment but are far from universally accepted. The ‘bite’ commentary on this cell ends with the “curious possibility that precisely because a technology is (relatively) effortlessly effective, it is to that degree under suspicion”. Does recovery really have to “hurt and cause pain”?

Cell B3 Bridging the chasm; legal drug prescribers relating to illegal drug users
In 1960s Britain chasms of opposing agendas and social distance opened up between doctors and their drug-addicted patients. This cell examines how bridging such chasms makes treatment more effective. Asks how clinician-patient relationships might be affected by unpopular rules on supervising medication consumption and testing for drug use, and explores the impact of treating users of illegal drugs as more than ‘patients’ or ‘addicts’ – as ‘whole people’.

Cell C3 Getting the balance right
Moves up a tier to the role of management. Commentary considers how medication-based treatment can be (re)oriented to long-term recovery, the importance of the right dose, and whether we can we dispense with supervised consumption of medications like methadone and all but minimal counselling/therapy.

Cell D3 Ethos, dose, organisation
Up a further tier to the organisation. Seminal work from Australia identified ethos, dose, and organisation as the three pillars of medication-based treatments. In the recovery era, do these remain essential elements of an effective service – and are they sufficient in themselves?

Cell E3 Medical care in drug treatment systems
Top tier is formed by local, regional and national treatment systems. Commentary highlights a simple innovation which transformed detoxification recyclers into typical patients, asks if you agree with an expert group’s vision of what a good service looks like, and questions whether Britain is making progress on care for mentally ill problem drug users.