The new abstentionists - burning questions about drug treatment
Around Bonfire Night, a rocket was fired at the heart of England's drug treatment structure - someone asked how many patients ended up drug-free. Clothless as the fabled emperor, '3%' came the reply. Bullish engagement and crime reduction claims were dismissed as irrelevant. Scotland had already suffered a similar attack. The new abstentionists were on the march and the statistics seemed to be with them. But their attacks and the defences put up against them were based on questionable assumptions and misinterpreted or just plain mistaken figures. This forensic examination of the claims examines the good and not-so-good to emerge from this episode and finds some inspiration for the future.
Download: Ashton M., The New Abstentionists (PDF 163.5KB)
Key reading:
Guidelines for the evaluation of treatment in the field of problem drug use
EMCDDA, 2007.
The main objective of these guidelines is to provide a European audience with basic information on the options, elements and procedures of drug-related treatment evaluation. The target readership includes professionals working in treatment services for substance use and dependence, administrators and officials in social and health authorities, researchers dealing with treatment of substance dependence, and those who professionally or politically may have an interest in evidence from treatment evaluation.
Download: Full report (PDF 544KB)
The impact of violence and abuse on engagement and retention rates for women in substance use treatment
NTA, 2007
This document describes the available evidence and includes professional opinion from key informants on the impact of domestic violence and abuse on women’s capacity to access, engage and benefit from drug treatment
Download: Full report (PDF 535KB)
Harm reduction findings from the NTA’s 2006 survey of user satisfaction in England
NTA, 2006.
This report investigates the harm reduction support received by the users of drug services, as well as pharmacy-based needle exchange services. Data was collected as part of The NTA’s 2006 Survey of User Satisfaction in England (NTA, 2007), which included a section on harm reduction. Self-completion questionnaires were distributed in August 2006 to the clients of Tier 3 and 4 drug treatment services in England, as well as the users of Tier 2 drug services. In addition, a shorter questionnaire – consisting of the harm reduction questions only – was distributed in October 2006 to the clients of pharmacy-based needle exchange services.This document reports on data on harm reduction from 10,070 respondents to the combined.
Download: http://www.nta.nhs.uk/publications/documents/
nta_2006_harm_reduction_survey.pdf (PDF 616KB)
Treating drug misuse problems: evidence of effectiveness
Gossop M., National Addiction Centre, 2006.
This report reviews evidence of the effectiveness of a wide range of drug treatments, including; pharmacotherapies, psychological treatments, twelve step programs, brief interventions, needle exchange schemes and combined treatments.
Download: http://www.nta.nhs.uk/publications/documents/
nta_treat_drug_misuse_evidence_effectiveness_2006_rb5.pdf (PDF 811KB)
Findings of a survey of needle exchanges in England
Abdulrahim D.,Gordon D., Best D., NTA., 2006.
The National Treatment Agency conducted a Department of Health funded survey using three separate questionnaires that were sent to joint commisioners, specialist needle exchange services and pharmacy related services. The survey found that there were many examples of good practice in needle exchange provision however substantial areas and groups are being denied access.
Download: Full report (PDF 2.9MB) Warning: large file
Needle exchange provision in Scotland: a report of the National Needle Exchange Survey
Griesbach D., Abdulrahim D., Gordon D., Dowell K. UK. Scotland. Scottish Executive. Substance Misuse Division. Substance Misuse Research Team, SMRT, 2006.
The National Needle Exchange Survey aimed to: map needle exchange service provision; investigate the nature of that service provision; identify areas of good and innovative practice; identify problems and impediments in delivering needle exchange services. This report covers Scotland.
Web: http://www.scotland.gov.uk/Publications/2006/06/16110001/0
Improvement review into substance misuse services
NTA, Healthcare Commission, 2006.
The NTA and the Healthcare Commission have agreed to work in partnership to review substance misuse services to bring about improvements in drug treatment services. The first of a series of these national reviews focussed on two key aspects of drug treatment for 2005/2006, whether drug treatment services are prescribing drugs safely and appropriately and whether there is good treatment planning and coordination of services. The national review covered 149 drug action teams (DATs). Drug action teams are partnerships responsible for drug treatment services in England and are made up of representatives from NHS trusts, social services, the police, the probation service and the voluntary sector. Fifty six mental health trusts and 303 primary care trusts (PCTs) within those drug action teams have also been given a rating.
Web: http://www.healthcarecommission.org.uk/serviceproviderinformation/
reviewsandinspections/improvementreviews/substancemisuse.cfm
Roles and responsibilities of doctors in the provision of treatment for drug and alcohol misusers
NTA, 2005.
All organisations employing doctors need a robust clinical governance structure that addresses issues of education and supervision. This report recommends that appraisal must be carried out by a trained appraiser with experience of the clinical area. Supervision could be carried across different employing and specialty areas, so for example a consultant addiction psychiatrist could supervise a GP with special clinical interest working in their geographical area.
Web: http://www.nta.nhs.uk/publications/
documents/nta_doctors_roles_and_responsibilities_sept_2005.pdf
Service provision for drug users in rural and remote areas of Scotland: a qualitative study: summary report
UK. Scotland. Scottish Executive. Substance Misuse Division. Effective Interventions Unit, 2005.
There are almost 1 million people living in rural Scotland. This accounts for almost 20% of the population. Of there, around 6% live in remote rural areas with the remainder living in accessible rural areas. In August 2004, the Effective Interventions Unit commissioned qualitative research into the issues that influence the effective planning, design and delivery of integrated care for drug users in rural and remote areas from the perspectives of service commissioners, service providers and service users. It found that the lower level and number of services in rural and remote areas and the possibility of drug users being supported by extended families and close-knit communities without recourse to services suggest an unmeasured level of under-reporting in these areas.
Web: http://www.drugmisuse.isdscotland.org/eiu/pubs/eiu_090.htm
Cannabis and mental health: responses to the emerging evidence
Hunt N., Lenton S., Witton J. Beckley Foundation, KCA, 2005.
There is increasing apprehension about cannabis's possible role in triggering or exacerbating mental health problems, or of inhibiting young people’s emotional or social development. This paper discusses the policy issues.
Download: http://www.internationaldrugpolicy.net/reports/BeckleyFoundation_Report_08.pdf (PDF)
How many people are receiving methadone hydrochloride mixture for opiate dependence in Scotland and what are the prescribing costs per person?
UK. Scotland. Scottish Executive. Information and Statistics Division.Publisher: ISD, 2005.
There is no national routine information which reports the number of people in Scotland who are receiving Methadone Hydrochloride mixture, nor information on the cost per person to the NHS. This report describes a study carried out with the aim of calculating these indicators, to enhance understanding of drug misuse treatment in Scotland.
Download: http://www.drugmisuse.isdscotland.org/publications/local/isd_methadone.pdf (PDF 127KB)
A national survey of inpatient drug services in England
Best D., O'Grady A., Charalampous I., Gordon D. UK. National Health Service. National Treatment Agency for Substance Misuse, 2005.
This briefing reviews inpatient services, evaluating detoxification provision across specialist units, residential rehabilitation services that offer an initial detoxification and generic medical and psychiatric wards that provide detoxification from drug misuse.
Download: http://www.nta.nhs.uk/publications/documents
/nta_national_survey_of_inpatient_drug_services_in_england_rb12.pdf (PDF 829KB)
National needs assessment for Tier 4 drugs services in England
Day E., Ison J. UK. National Health Service. National Treatment Agency for Substance Misuse. NTA, 2005.
This briefing assesses regional and national levels of Tier 4 provision for primary drug users and to estimate future levels of need for both inpatient detoxification and residential rehabilitation. It is part of a wider work programme, aiming to increase effectiveness and improve capacity for Tier 4
Download: http://www.nta.nhs.uk/publications/documents/
nta_national_needs_assessment_of_tier4_drug_services_in_england_2005_rb16.pdf (PDF 1.8MB)
