The entries below summarise documents collected by Drug and Alcohol Findings. Citation here does not imply that these documents are particularly relevant to Britain and of particular merit, though they may well be both. The original documents were not published by Findings; click on the Titles to obtain copies. Free reprints may also be available from the authors; if displayed, click Request reprint to send or adapt the pre-prepared e-mail message. The Summary is intended to convey the findings and views expressed in the study. Below may be comments from Drug and Alcohol Findings. Links to source documents are in blue. Hover mouse over orange text for explanatory notes.
Influential US researchers (see first entry in bulletin) believe that three US programmes show that many seriously dependent individuals stop using if non-use is enforced through intensive monitoring and swift, certain but not necessarily severe consequences. A distinctive feature of these programmes is the strong leverage used to sanction substance use and to reward abstinence: in physician health programmes, removal from practice and ultimately the loss of medical license versus continuing to practice in a prestigious and well paid profession; in the HOPE programme for offenders on probation and the 24/7 Sobriety programme for drink-drive defendants, immediate brief imprisonment versus freedom. Results are said to challenge the view that relapse is an essential feature of substance dependence and to demonstrate that the key to long-term success lies in sustained changes in the environment in which decisions to use and not use are made: if this rewards substance use, use is likely to continue, but the drinking and drug use of many seriously dependent individuals stops if the environment not only prohibits use, but enforces this through intensive monitoring with meaningful consequences attached to compliance and non-compliance. All the entries in this bulletin relate to the three programmes said in the first entry to exemplify a new paradigm for long-term recovery.