Effectiveness Bank bulletin 8 May 2013

Latest additions to the Effectiveness Bank. First entry asks what 'recovery' is and contrasts understandings in addiction with those in mental health. Whatever recovery is, extending remission in substance use via extended treatment is a key way to get there and the subject of the next two entries, both concerned with how to consolidate a break in substance use in to a life free of dependence. Last a study which confirms the reality of peer influence on which much drug prevention is based.

What is 'recovery'?
What is 'recovery' and what does it mean for the roles of treatment and of doctors? This analysis based on the last ten years' writings on the subject makes an intriguing comparison with mental health, where recovery in terms of a meaningful and self-directed life is reserved for persisting severe disorder resistant to 'cure' via treatment

Ways to extend cocaine treatment gains
Unusually this US study took a set of patients who had generally already initiated abstinence from cocaine use and then used abstinence incentives and/or relapse-prevention therapy to extend these gains. When the incentives were also tied to therapy attendance, there was some evidence that the combination prolonged the impact of the incentives.

Starting methadone in prison promotes treatment on release
This US randomised trial in Rhode Island among formerly opiate dependent prisoners found that starting methadone treatment in prison radically improved treatment uptake on release and reduced heroin and cocaine use over the following six months, confirming results from Baltimore. Though they probably save lives, such 'retox' programmes remain controversial and rare.

Teenage peer influence on drinking is no illusion
Is the peer influence on which many prevention programmes are based an illusion due to other factors like pupils sharing similar environments or choosing like-minded friends? Not entirely, finds this unusually rigorous US analysis; the chances of a given child drinking rise by 4% for every 10% more of their school year-mates who drink.

Sent by the Drug and Alcohol Findings Effectiveness Bank to alert you to site updates and UK-relevant evaluations and reviews of drug/alcohol interventions. Managed by DrugScope, Alcohol Concern and the National Addiction Centre. Supported by Alcohol Research UK and the J. Paul Getty Jr. Charitable Trust.