Effectiveness Bank bulletin 24 November 2014

Twin planks of drug harm reduction feature among latest additions to the Effectiveness Bank. Methadone maintenance – UK advisers clash with government minister over keeping patients in treatment; from Norway, why retention is so important. Needle exchange – how misinterpreted early findings from Vancouver clouded its reputation. Final entry compellingly describes the real world challenges of introducing a new therapy.

The Alcohol and Drug Treatment Matrices: “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
‘Parking’ not the issue with methadone in the UK
Government advisers uncover evidence that rather than being ‘parked’ on methadone, patients leave too soon to fully benefit. Their report unambiguously countered concerns in the UK government over methadone maintenance, but within days a minister had accused them of “providing cover for perpetuating drug addiction”.
Also see hot topic on the methadone controversy in the UK.

Strive to retain ‘difficult’ methadone patients
From Norway, strong evidence that being in a methadone or buprenorphine maintenance programme protects patients from life-threatening overdoses and infections, even if illegal drug use continues, and that discharging patients dramatically escalates risk.

How restricted syringe/needle supply let HIV spread in Vancouver
The apparently risk-generating record of Vancouver’s needle exchange in the 1990s seemed to justify antipathy to such programmes, but this review of 15 years of research in the city concludes the problem was not supplying injecting equipment, but failing to supply enough and imposing counterproductive restrictions.
Also see Findings analysis of needle exchange in Vancouver and other cities.

New therapy implementation will fail unless tailored to the organisation
Frank and compelling account of what it takes in the real world to introduce a new therapy programme. Key lesson is that each organisation is different; experiencing and taking that unique context in to account are needed to give implementation a chance.
Sent by Drug and Alcohol Findings Effectiveness Bank to alert you to site updates and UK-relevant evaluations of drug/alcohol interventions. Managed by DrugScope, Alcohol Concern, the National Addiction Centre and Alcohol Research UK. Supported by Alcohol Research UK, Society for the Study of Addiction, and J. Paul Getty Jr. Charitable Trust.