Effectiveness Bank bulletin 18 March 2013

First two additions to the Effectiveness Bank probe the differences and similarities in treatment processes and outcomes for men and women. The second of these concerns the prescribing of injectable heroin, but next in the list is a less radical alternative for patients who do not settle on oral methadone – slow-release morphine. Finally, text messaging finds its way in to the brief alcohol interventions armoury in a study with an intriguing twist in the findings.

Therapeutic relationships and meeting needs at heart of treatment process
From the comprehensive treatment process data collected by a major national US study emerges the important lesson that retention in itself is not an active ingredient in post-treatment outcomes but reflects influences such having needs met (especially important for women) and developing a good relationship with the service and your key worker.
Findings were foreshadowed by an analysis from the same study focused on receipt of services matched to needs.

Prescribing injectable heroin benefits women as well as men
From Canada the first study to show that among long-term, severely opiate dependent patients who have not responded well to prior treatment, women as well as men benefit more from being prescribed injectable heroin than oral methadone.

Slow-release morphine offers alternative for methadone-intolerant heroin addicts
Slow-release capsules of morphine – the closest drug to heroin – might offer acceptable and effective treatment to addicts who cannot settle on methadone. In England a dozen also being prescribed heroin switched their supplementary methadone to morphine, generally experiencing the benefits they expected and cutting their average dose of heroin.

Post-emergency visit text message advice moderates drinking
For the first time this US study tried mobile phone text messaging as a way to monitor and moderate the hazardous drinking of young adults screened at emergency departments. Compared to merely monitoring, text-based advice did cut drinking – but why did monitoring-only patients actually start to drink more?

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.