Effectiveness Bank bulletin 18 December 2013

Drugs that can cause permanent damage to eyesight and even a fatal blood disorder are being trialled for the treatment of cocaine dependence and to cut cannabis use among schizophrenics, but are the benefits worth the risks? The last two entries show that counselling and skills training do not help protect injectors from HIV and hepatitis C, so what can be done to help combat the spread of these diseases?

The alcohol and drug treatment matrices: "The documents you should read if you read nothing else".
Alcohol matrix for alcohol brief interventions and treatment
Drug matrix for harm reduction and treatment in relation to illegal drugs

Is curbing cocaine use worth risking visual defects?
Severely cocaine-dependent Mexican parolees were the test bed for an epilepsy medication known after long-term use to damage vision in a substantial proportion of patients. It seemed to help at least interrupt cocaine use and also cut drinking, but are the risks worth it?

Switching antipsychotic curbs cannabis use in schizophrenia
Heavy cannabis use is particularly troubling in patients already struggling with schizophrenia. This study provides the first evidence from a randomised controlled trial that switching such patients to the antipsychotic clozapine may help reduce their cannabis use without adverse effects on psychiatric symptoms, but the drug risks a potentially fatal blood disorder.

Extensive training little better than a leaflet for reducing HIV risk
Multiple sessions of information and skills training are little better than the most minimal educational interventions at reducing the kind of substance use and sexual behaviour which risks HIV infection in drug users who inject and/or use cocaine, according to the findings of this systematic review of 35 trials. If these interventions usually don’t protect drug users from HIV, are there other interventions which can?

Counselling not enough to contain hepatitis C virus
On their own interventions such as counselling and peer-educator training have not prevented injecting drug users becoming infected with hepatitis C, was the conclusion of this review – but are these really useless, or is it just that the research is inadequate or that even minimal ‘control’ interventions have an impact?

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.