What are the outcomes for assessing drug treatment? A review of long-term observational studies on the treatment of opioid dependence
|
|
|
- Neil Watson
- 8 years ago
- Views:
Transcription
1 What are the outcomes for assessing drug treatment? A review of long-term observational studies on the treatment of opioid dependence Lucas Wiessing & Marica Ferri, EMCDDA
2 Background Drug use and addiction, notably to opioids, are important public health problems with high costs to individual and society Continuing discussion about treatment effectiveness, chronicity complicates Lack of clear overview of studies and outcomes, although specific outcomes have been reviewed (e.g. abstinence, injecting, HIV) and specific interventions (methadone, buprenorphine, heroin..) To our knowledge no review to date has provided an overview of the outcomes being assessed in the major treatment outcome studies of opioid dependence (regardless of the intervention offered) We aimed to assess what outcomes are being used in the largest prospective treatment studies to understand gaps, needs and areas for further research 2
3 Objectives General background questions underlying our study and for future analysis: Are treatment outcomes consistent with the objectives of treatment? Are treatment outcomes comparable? Are data available to replicate those evaluations? Specific objective of this presentation: Discuss the outcomes reported in the literature of observational prospective studies on the treatment of opioid users 3
4 Methods search strategy We searched Pubmed and Cochrane databases for substance-related disorders AND observational study No publication date or language limitations Prospective cohort studies In addition: Searched related citations to 12 known large studies Free text search for the known study acronyms Checked websites of the known studies Registered protocol in Prospero database (Ferri et al. 2014) 4
5 Methods inclusion / exclusion criteria Inclusion criteria: Population = sample of opioid users Intervention = any drug treatment Outcomes = any outcome at follow-up (base-line data or covariates of outcomes excluded) Study design = non-experimental observational prospective cohort studies (efficacy studies / RCTs excluded) Data reporting quality e.g. loss to follow-up (LTFU) 5
6 Search strategy results Pubmed; Cochrane; Google; website of observational studies N=1974 Titles screening N=1604 Abstract screening N=370 Countries N=11 Eligible for inclusion N=135 publications Studies identified N=21 6
7 Methods data extraction Study acronym Author Publ year Treatment objective: end of Tx / mainten. / both Study method Data coll. period Setting / sample Eligibility criteria Sampling Main outcomes Secondary outcomes Measures used Main outcome re abstinence Measures abstinence N baseline Follow-up interval (months) N at end of FU LTFU % Factors LTFU Abstinence rates (n, %) Covariates of abstinence Epidemiological phase heroin use available Time since initiation available Results regarding retention available Reference 7
8 Results Preliminarily analysis here presented includes data from 9 of the 12 known studies: ALIVE, ATOS, DATOS, DORIS, DTORS, NDTMS, NTORS, ROSIE, VEDETTE Five countries: Australia, Ireland, Italy, UK (4x, of which 1 from Scotland), USA (2x), one national sample each (not Au) Data collection (publication date 2001-) Median FU 25.5 months (range 5-144, IQR 12-36) N = 16,801 at end of FU % LTFU median 32.7 (range 31-56, IQR 32-44) 8
9 Results main outcome domains Drug use (8/9 studies) Abstinence (6/9) Crime (6..) Harm (4) Health (3) Mortality (3) Treatment / study aspects (3) Social functioning (3) Cost-effectiveness / economic issues (2) Recovery (1) Needs of treatment providers & seekers (1) 9
10 Results Drug use (8/9 studies) Heroin use in last 3 months / last year (DATOS, DORIS) Days heroin use in the four weeks preceding interview / zero days of use in last 28 days (ATOS, NDTMS) Drug type, Frequency, Quantity (ROSIE) Classes of injection patterns /transitions (ALIVE) Regular (weekly or +) use for all six illicit drugs, Daily use of opiates, Injecting behaviour, Alcohol (NTORS) Being currently drug free, being currently drug free excluding cannabis, severity of dependence (DORIS) Abstinence (DTORS) (VEDETTE)? (cocaine use as covariate of retention) 10
11 Results Abstinence (6/9 studies) Not using any illicit drug / Not using any illicit drug excluding cannabis (ROSIE) Stopped using the drugs that they reported using at baseline, Stopped the regular use of all drugs, Levels of drug consumption (mean value of all drugs used in the seven days prior to interview) (DTORS) Ceased injection over 12 year FU period (stopped injecting and reported no injection at subsequent visits) (ALIVE) Treatment retention / abstinence therapy had lowest retention (VEDETTE) Been totally drug free (excluding possible alcohol and tobacco use) for a 90-day period in advance of being interviewed (self-reported drug use and service usage), also excluding cannabis (DORIS) Abstinence from heroin use, crack use or both; Reduction in days used at group level; "Reliable improvement" (12 days or more reduction in last 28 days) (NDTMS) 11
12 Results Crime / Legal (6/9 studies) Crime: selling/supplying drugs, handling stolen goods. Legal problems: being arrested, other (eight legal problem categories) (ROSIE) Offending (levels of acquisitive offending [burglary of a business or dwelling, theft of vehicle, bag snatching or robbery], high-cost offending, committing an acquisitive crime in the past four weeks) (DTORS) Ever arrested, arrested over the last 17 months, having committed any crime and any acquisitive crime over the last 17 months (DORIS) Crime / Criminality / Illegal activity / Arrests (ATOS, DATOS, NTORS) 12
![or dwelling, theft of vehicle, bag snatching or robbery], high-cost offending, committing an acquisitive crime in the past four weeks) (DTORS)](/docs-images/57/6348347/images/page_12.jpg "Ever arrested, arrested over the last 17 months, having committed any crime and any acquisitive crime over the last 17 months (DORIS) Crime /")
13 Results Harm (4/9) / Health (3/9) / Death (3/9) Injecting risks (DATOS, DTORS, ROSIE) Overdose (DTORS, ROSIE, VEDETTE) Mental health (ATOS, NTORS, ROSIE) Suicidal ideation (NTORS) Physical health (poor appetite, tiredness etc.) (ROSIE) Injection related health problems (ATOS) Mortality (ATOS, NTORS, VEDETTE) 13
14 Results Treatment / Study aspects (3/9 studies) Retention (NDTMS, ROSIE, VEDETTE) Discussing a care plan and being happy with it (DTORS) Intake completion (for detox and abstinence modalities as indicator for improved outcomes) (ROSIE) 14
15 Results Social functioning (3/9 studies) Employment (DATOS, ROSIE) Accommodation (DTORS, ROSIE) (Family) relations (DTORS, ROSIE) Recovery self-perceptions include Able to socialise and relate etc. (DATOS) 15
16 Results cost-effectiveness / economic (2/9) Cost-effectiveness of services: net saving of 6,500 per person for drug treatment, compared to no treatment, net gain in health as measured by QALYs, drug treatment ~ 80% chance of being cost-effective for the individual (DTORS) Economic issues: social costs incurred by the cohort included crime costs, health and welfare service use, the use of drug misuse services and criminal justice costs (NTORS) 16
17 Results Other outcomes (1 study each) Recovery: evidence of any opioid or cocaine use, any daily alcohol use, and illegal activity before treatment (urine, hair test, interview), nine recovery perception areas at follow-up (DATOS) Needs of treatment providers & seekers (DTORS) 17
18 Limitations These are preliminary findings, not yet validated Not all studies identified have yet been included (9 out of 21) This is a global explorative analysis, not permitting full detail on the different outcomes, a meta-analysis on specific outcomes might improve understanding of definitions and comparability To some extent results may be dependent on the specificity of the wording used in the publications e.g. economic issues and costeffectiveness can be similar or actually indicate very different outcomes (but we show some detail on definitions), some studies mention social functioning others recovery perceptions that include a social variable Outcomes may have been missed in data extraction (still to validate) Outcomes may have been measured but not (yet) reported (publication bias), although then perhaps not relevant 18
19 Limitations cont. Search for observational studies is unreliable (not indexed as for RCTs) Protocols (with originally planned outcomes) are not systematically registered as for the RCTs Additional publications on the same study may have been missed (no unique study number as for RCTs) Although all studies included reported outcomes for a separate sample of opioid users, not all outcomes were always reported separately for opioid users Some outcomes mentioned here were reported in a qualitative format, complicating potential meta-analysis Some studies included reported additional variables as co-variates of the outcome investigated (they were then not included as outcome) 19
20 Conclusions In preliminary analysis, the range of outcomes in nine large observational prospective studies of opioid users suggests variation in measures of treatment success (treatment objectives?) Where the same outcome domains are covered, measures of treatment success seem to vary There appears to be a need for developing further consensus on what are the main outcomes to assess the successful treatment of opioid users 20
21 Discussion and way forward Can studies based on registries (National Drug Treatment Monitoring System (NDTMS)) and prospective cohort studies be analysed jointly? outcomes collected from registries records outcomes collected through special study forms (protocols) Look at (consistency and comparability of) instruments used to measure outcomes. Separate by treatment modality (maintenance vs. abstinence) Be more restrictive i.e. only include quantitative outcomes reported separately for opioid users? (meta-analysis) 21
22 Publications assessed in preliminary analysis ALIVE: Galai N, Safaeian M, Vlahov D, Bolotin A, Celentano DD; ALIVE Study. Longitudinal patterns of drug injection behavior in the ALIVE Study cohort, : description and determinants. Am J Epidemiol Oct 1;158(7): ATOS: Darke S, Mills KL, Ross J, Teesson M. Rates and correlates of mortality amongst heroin users: Findings from the Australian Treatment Outcome Study (ATOS), Drug Alcohol Depend Dec 2. DATOS: Flynn PM, Joe GW, Broome KM, Simpson DD, Brown BS. Recovery from opioid addiction in DATOS. J Subst Abuse Treat Oct;25(3): DATOS: Hubbard, R. L., Craddock, S. G., & Anderson, J. (2003). Overview of 5-year follow-up outcomes in the Drug Abuse Treatment Outcome Studies (DATOS). Journal of Substance Abuse Treatment, 25(3), (abstract only) DATOS: Murphy DA, Brecht ML, Herbeck D, Evans E, Huang D, Hser YI. Longitudinal HIV risk behavior among the Drug Abuse Treatment Outcome Studies (DATOS) adult sample. Eval Rev Feb;32(1): (abstract only) DATOS: Rao SR, Broome KM, Simpson DD. Depression and hostility as predictors of long-term outcomes among opiate users. Addiction May;99(5): (abstract only) DORIS: McKeganey N, Bloor M, McIntosh J (2008). Drug Outcome Research in Scotland (DORIS) Scotland Key findings from the Drug Outcome Research in Scotland (DORIS) study. University of Glasgow Centre for Drug Misuse Research (link not working) DORIS: McKeganey, N. P., Bloor, M., Robertson, M. and Neale, J. (2006) Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study. Drugs: Education, Prevention & Policy, 13(6), pp DTORS: Donmall M, Jones A, Davies L, Barnard M. Summary of key findings from the Drug Treatment Outcomes Research Study (DTORS). Research Report 23 (summary). [UK] Home Office, NDTMS: Marsden J, Eastwood B, Bradbury C, Dale-Perera A, Farrell M, Hammond P, Knight J, Randhawa K, Wright C; National Drug Treatment Monitoring System Outcomes Study Group. Effectiveness of community treatments for heroin and crack cocaine addiction in England: a prospective, in-treatment cohort study. Lancet Oct 10;374(9697): doi: /S (09) Epub 2009 Oct 1. PMID: [PubMed - indexed for MEDLINE] NTORS: Gossop M, Marsden J, Stewart D. NTORS After Five Years. The National Treatment Outcome Research Study Changes in substance use, health and criminal behaviour during the five years after intake. National Addiction Centre, London, ROSIE: Comiskey CM, Kelly P, Leckey Y, McCulloch L, O Duill B, Stapleton RD, White E. The ROSIE Study Drug Treatment Outcomes in Ireland - A Report for the National Advisory Committee on Drugs Dublin, VEDETTE: Davoli M, Bargagli AM, Perucci CA, Schifano P, Belleudi V, Hickman M, Salamina G, Diecidue R, Vigna-Taglianti F, Faggiano F; VEdeTTE Study Group. Risk of fatal overdose during and after specialist drug treatment: the VEdeTTE study, a national multi-site prospective cohort study. Addiction Dec;102(12): (abstract only) VEDETTE: Salamina G, Diecidue R, Vigna-Taglianti F, Jarre P, Schifano P, Bargagli AM, Davoli M, Amato L, Perucci CA, Faggiano F; VEdeTTE Study Group. Effectiveness of therapies for heroin addiction in retaining patients in treatment: results from the VEdeTTE study. Subst Use Misuse Oct;45(12): doi: /
Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study
Drugs: education, prevention and policy, December 2006; 13(6): 537 550 Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study NEIL MCKEGANEY 1, MICHAEL BLOOR 1, MICHELE
The Drug Treatment Outcomes Research Study (DTORS): Research Design and Baseline Data
The Open Addiction Journal, 2012, 5, 1-11 1 Open Access The Drug Treatment Outcomes Research Study (DTORS): Research Design and Baseline Data Michael Donmall 1, Andrew Jones 1, Samantha Weston 2, Linda
The Drug Treatment Outcomes Research Study (DTORS): Final outcomes report 3rd Edition
Research Report 24 Key Implications The Drug Treatment Outcomes Research Study (DTORS): Final outcomes report 3rd Edition Andrew Jones, Michael Donmall, Tim Millar, Alison Moody, Samantha Weston, Tracy
The treatment of heroin dependence presents
Residential Rehabilitation for the Treatment of Heroin Dependence: Sustained Heroin Abstinence and Drug-Related Problems 2 Years After Treatment Entrance Shane Darke, PhD, Anna Williamson, BPsych Hons,
London: boom or bust
Treatment systems at a city level Planning, implementing and evaluating London: boom or bust Annette Dale-Perera Strategic Director of Addiction & Offender Care Effective treatment, changing lives London
Trends in deaths related to drug misuse in England and Wales, 1993 2004
Trends in deaths related to drug misuse in, 1993 24 Oliver Morgan, Office for National Statistics and Imperial College London, Clare Griffiths, Barbara Toson and Cleo Rooney, Office for, Azeem Majeed,
LONG-TERM TREATMENT OUTCOME: WHAT ARE THE 11 YEAR OUTCOMES OF TREATMENT FOR HEROIN DEPENDENCE?
AUSTRALIAN T R E A T M E N T OU T C O M E STUDY - N S W Funded by the National Health and Medical Research Council and the Australian Government Department of Health. ATOS NSW is a project of the Centre
POWDER COCAINE: HOW THE TREATMENT SYSTEM IS RESPONDING TO A GROWING PROBLEM
Effective treatment is available for people who have a powder-cocaine problem seven in ten of those who come into treatment either stop using or reduce their use substantially within six months POWDER
NTORS After Five Years
NTORS After Five Years The National Treatment Outcome Research Study Changes in substance use, health and criminal behaviour during the five years after intake Michael Gossop, John Marsden and Duncan Stewart
Specialist drug and alcohol services for young people a cost benefit analysis
Research Report DFE-RR087 Specialist drug and alcohol services for young people a cost benefit analysis Frontier Economics This research report was commissioned before the new UK Government took office
The National Community Detoxification Pilot
The National Community Detoxification Pilot Aoife Dermody, Progression Routes Initiative NDCI, 2011 Community Detoxification Protocols Guidelines for outpatient detoxification from methadone or benzodiazepines
A LONG-TERM STUDY OF THE OUTCOMES OF DRUG USERS LEAVING TREATMENT SEPTEMBER 2010
National Treatment Agency for Substance Misuse Long-term results for those who have been treated in one year found that nearly half who leave neither need further treatment nor were found to be involved
To detox or not to detox: whose choice is it anyway? Dr Ed Day Senior Lecturer in Addiction Psychiatry University of Birmingham
To detox or not to detox: whose choice is it anyway? Dr Ed Day Senior Lecturer in Addiction Psychiatry University of Birmingham What do people say they want? Luty J (2004) 104 people attending a community
Costing report. Drug misuse: psychosocial interventions and opioid detoxification. Implementing NICE guidance. July 2007
Drug misuse: psychosocial interventions and opioid detoxification Costing report Implementing NICE guidance July 2007 NICE clinical guidelines 51 and 52 National costing report: Drug misuse guidelines
estimating the crime reduction benefits of drug treatment and recovery
Reducing drug-related crime is one of the main objectives of the government s drug strategy. This recognises that good quality drug treatment can prevent high-volume acquisitive offending estimating the
THE STORY OF DRUG TREATMENT
THE STORY OF DRUG TREATMENT EFFECTIVE TREATMENT CHANGING LIVES The story of drug treatment The goal of all treatment is for drug users to achieve abstinence from their drug or drugs of dependency. For
Substance Misuse. See the Data Factsheets for more data and analysis: http://www.rbkc.gov.uk/voluntaryandpartnerships/jsna/2010datafactsheets.
Substance Misuse See the Data Factsheets for more data and analysis: http://www.rbkc.gov.uk/voluntaryandpartnerships/jsna/2010datafactsheets.aspx Problematic drug use Kensington and Chelsea has a similar
drug treatment in england: the road to recovery
The use of illegal drugs in England is declining; people who need help to overcome drug dependency are getting it quicker; and more are completing their treatment and recovering drug treatment in ENGlaND:
The natural history of opiate dependence; findings from longterm follow-up studies. Jack Leach
The natural history of opiate dependence; findings from longterm follow-up studies Jack Leach Value of long- term follow-up studies Methodological problems Review of studies What they seem to tell us Value?
NTORS and the 3 for 1 bargain
NTORS and the 3 for 1 bargain The best known and most influential finding in British addiction treatment 3 savings to society for every spent on treatment. From the mid-'90s NTORS study, this finding underpinned
INTRODUCTION. a. Value of merchandise stolen. b. Costs of medical care for crime victims. c. Productivity losses. d. Cost for police protection.
Presented by: James A. Pitts, M.A. Chief Executive Officer Odyssey House McGrath Foundation ABSTRACT Therapeutic communities for the treatment of alcohol and other drugs misuse have been in operation throughout
Effectiveness of Treatment The Evidence
Effectiveness of Treatment The Evidence The treatment programme at Castle Craig is based on the 12 Step abstinence model. This document describes the evidence for residential and 12 Step treatment programmes.
Joint Committee on Health and Children
Houses of the Oireachtas Joint Committee on Health and Children A Submission From Homeless & Drugs Services Homeless & Drugs Services September 15 th 2011 1 CONTENTS Page no. 0.1 Introduction 3 0.2 Structure
REVIEW OF DRUG TREATMENT AND REHABILITATION SERVICES: SUMMARY AND ACTIONS
REVIEW OF DRUG TREATMENT AND REHABILITATION SERVICES: SUMMARY AND ACTIONS 1. INTRODUCTION 1.1 Review Process A Partnership for a Better Scotland committed the Scottish Executive to reviewing and investing
The story of drug treatment
EFFECTIVE TREATMENT CHANGING LIVES www.nta.nhs.uk www.nta.nhs.uk 1 The story of drug treatment The use of illicit drugs is declining in England; more and more people who need help with drug dependency
Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment Outcome Research Study
Drug and Alcohol Dependence 62 (2001) 255 264 www.elsevier.com/locate/drugalcdep Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment
Key findings from the Drug Outcome Research in Scotland (DORIS) study
Key findings from the Drug Outcome Research in Scotland (DORIS) study Neil McKeganey Michael Bloor James McIntosh *Joanne Neale Centre for Drug Misuse Research occasional paper ISSN 1759-6270 (Print) 0
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre, UNSW 2
Maree Teesson 1, Christina Marel 1, Katherine Mills 1, Shane Darke 2, Joanne Ross 1, Tim Slade 1, Jo White 1, Sonja Memedovic 1, Michael Lynskey 2 and Lucinda Burns 3 1 NHMRC Centre of Research Excellence
FRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma
FRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma Background A growing opiate abuse epidemic has highlighted the need for effective treatment options. This study documents
Drug addic+on is a complex but treatable condi+on Addicts use drugs compulsively, damaging themselves and those around them
Drug addic+on is a complex but treatable condi+on Addicts use drugs compulsively, damaging themselves and those around them Na#onal Ins#tute on Drug Abuse (2009) Principles of Drug Addic#on Treatment:
A copy can be downloaded for personal non-commercial research or study, without prior permission or charge
McKeganey, N. (2010) Rediscovering recovery in drug and alcohol treatment services. In: Brown, J. and Campbell, E.A. (eds.) Cambridge Handbook of Forensic Psychology. University of Cambridge. ISBN 9780521701815
Why invest? How drug treatment and recovery services work for individuals, communities and society
Why invest? How drug treatment and recovery services work for individuals, communities and society What is drug addiction? Drug addiction is a complex but treatable condition Those affected use drugs compulsively,
FALLING DRUG USE: THE IMPACT OF TREATMENT
We have a policy which actually is working in Britain. Drugs use is coming down, the emphasis on treatment is absolutely right, and we need to continue with that to make sure we can really make a difference.
Foundations Recovery Network (FRN) Announces Groundbreaking Opiate Research Study Which Yields Compelling Results
Foundations Recovery Network (FRN) Announces Groundbreaking Opiate Research Study Which Yields Compelling Results Results validate FRN s system of care approach through patient satisfaction Siobhan A.
Treatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call 1-800-662-HELP(4357)
Specialist drug and alcohol services for young people a cost benefit analysis
DFE-RB087 ISBN 978-1-84775-862-0 February 2011 Specialist drug and alcohol services for young people a cost benefit analysis Frontier Economics This report looks at the costs and benefits associated with
Adult drug treatment plan 2009/10. Part 1: Strategic summary, needs assessment and key priorities
Birmingham Drug and Alcohol Action Team Adult drug treatment plan 2009/10 Part 1: Strategic summary, needs assessment and key priorities The strategic summary incorporating the findings of the needs assessment,
Treatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction [NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call
Reshaping Drug and Alcohol Treatment in Westminster. Public Consultation
Reshaping Drug and Alcohol Treatment in Westminster Public Consultation We want to hear your views Please respond to the questionnaire by March 31 st 2009 (You can click on the below to go directly to
Adults who misuse drugs and alcohol
West of England ESF BIG Lottery - Breaking down the barriers to employment Adults who misuse drugs and alcohol Bath and North East Somerset Baseline data Current local provision Gaps /added Prevalence
How To Understand The Atop
The Australian Treatment Outcomes Profile (ATOP): Clinical Outcome Monitoring for the Drug & Alcohol Sector Jennifer Holmes and Kristie Mammen Drug and Alcohol Services, South Eastern Sydney Local Health
Minimum Insurance Benefits for Patients with Opioid Use Disorder The Opioid Use Disorder Epidemic: The Evidence for Opioid Treatment:
Minimum Insurance Benefits for Patients with Opioid Use Disorder By David Kan, MD and Tauheed Zaman, MD Adopted by the California Society of Addiction Medicine Committee on Opioids and the California Society
The Government's Drug Strategy
Report by the Comptroller and Auditor General HC 297 SesSIon 2009 2010 march 2010 Tackling problem drug use Report by the Comptroller and Auditor General Tackling problem drug use HC 297 Session 2009-2010
Mapping routes to recovery and the role of recovery groups and communities
Mapping routes to recovery and the role of recovery groups and communities Dr David Best Reader in Criminal Justice University of the West of Scotland Research pathway The myth of addiction attributions
Jennifer Sharpe Potter, PhD, MPH Associate Professor Division of Alcohol and Drug Addiction Department of Psychiatry
Buprenorphine/Naloxone and Methadone Maintenance Treatment Outcomes for Opioid Analgesic, Heroin, and Combined Users: Findings From Starting Treatment With Agonist Replacement Therapies (START) Jennifer
Topic Area - Dual Diagnosis
Topic Area - Dual Diagnosis Dual Diagnosis is a challenging problem for both mental health and substance misuse services. People with mental health problems, who also suffer from substance misuse are at
Q6: Should non-specialist health care providers refer alcohol dependent patients and their family members to mutual help groups such as AA?
Q6: Should non-specialist health care providers refer alcohol dependent patients and their family members to mutual help groups such as AA? Background Self help groups such as Alcoholics Anonymous (AA)
The impact of smoking cessation on drug abuse treatment outcome
Addictive Behaviors 28 (2003) 1323 1331 Short Communication The impact of smoking cessation on drug abuse treatment outcome Stephenie C. Lemon, Peter D. Friedmann*, Michael D. Stein Division of General
Dual Diagnosis. Dual Diagnosis Good Practice Guidance, Dept of Health (2002);
Dual Diagnosis Dual Diagnosis is a challenging problem for both mental health and substance misuse services. People with mental health problems, who also suffer from substance misuse are at an increased
Krystyna Kowalski, Maia Lindstrøm, Pernille Skovbo Rasmussen, Trine Filges, Anne-Marie Klint Jørgensen
Title registration for a review proposal: Functional Family Therapy (FFT) for young people in treatment for illicit nonopioid drug use Krystyna Kowalski, Maia Lindstrøm, Pernille Skovbo Rasmussen, Trine
Title registration for a review proposal: 12-step programmes for reducing abuse of illicit drugs
Title registration for a review proposal: 12-step programmes for reducing abuse of illicit drugs Submitted to the Coordinating Group of: Social Welfare TITLE OF THE REVIEW 12-step programmes for reducing
HIGH SUCCESS RATE OF BUTTERY REHABILITATION PROGRAMS
HIGH SUCCESS RATE OF BUTTERY REHABILITATION PROGRAMS By treating addiction and helping people live productive, fulfilling lives, The Buttery addresses a major social and economic problem facing our society.
Developing the Guernsey treatment system for substance misusers: Phases One and Two. Helen Baldwin Linda Prickett Adam Marr Jim McVeigh
Developing the Guernsey treatment system for substance misusers: Phases One and Two Helen Baldwin Linda Prickett Adam Marr Jim McVeigh Roles and responsibilities of the LJMU research team Helen Baldwin
The Criminal Justice Intervention Programme & Primary Care.
The Criminal Justice Intervention Programme & Primary Care. Edward Ward Deputy Regional Manager, CJIP. June 2004 1 What's the Criminal Justice Intervention Programme? Aims to reduce drug related crime
Testimony of The New York City Department of Health and Mental Hygiene. before the
Testimony of The New York City Department of Health and Mental Hygiene before the New York City State Assembly Committee on Alcoholism and Drug Abuse on Programs and Services for the Treatment of Opioid
Predictors of Substance Abuse Treatment Engagement among Rural Appalachian Prescription Drug Users
Predictors of Substance Abuse Treatment Engagement among Rural Appalachian Prescription Drug Users Jennifer R. Havens, PhD, MPH Carrie B. Oser, PhD Carl G. Leukefeld, PhD Study Objective The objective
The ROSIE Study Drug Treatment Outcomes in Ireland
The ROSIE Study Drug Treatment Outcomes in Ireland The ROSIE Study Drug Treatment Outcomes in Ireland Dublin Published by the Stationery Office To be purchased directly from the Government Publications
Abstinence versus agonist maintenance treatment: an outdated debate?
Abstinence versus agonist maintenance treatment: an outdated debate? Ambros Uchtenhagen After two decades of increasing acceptance and availability of agonist maintenance therapies, we hear more about
Executive Summary. 1. What is the temporal relationship between problem gambling and other co-occurring disorders?
Executive Summary The issue of ascertaining the temporal relationship between problem gambling and cooccurring disorders is an important one. By understanding the connection between problem gambling and
Client Characteristics
Client Characteristics As Predictors of Retention and Outcomes in an Australian Residential Alcohol and Other Drug (AOD) Treatment Program for Adolescents Michael Wicks The Ted Noffs Foundation ATCA Conference
Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence
bs_bs_banner FOR DEBATE doi:10.1111/j.1360-0443.2012.04075.x Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence Petra K. Staiger 1, Ben Richardson 1, Caroline
Assessing the impact of drug law enforcement activities in one London borough
Assessing the impact of drug law enforcement activities in one London borough Tim McSweeney Senior Research Fellow Institute for Criminal Policy Research Birkbeck, University of London 6 th ISSDP Conference
7.11 Substance misuse
7.11 Substance misuse Substance misuse is defined by NICE as intoxication by or regular excessive consumption of and/or dependence on psychoactive substances, leading to social, psychological, physical
Brief Strategic Family Therapy (BSFT) for young people in treatment for illicit nonopioid
Title registration for a review proposal: Brief Strategic Family Therapy (BSFT) for young people in treatment for illicit nonopioid drug use Maia Lindstrøm, Pernille Skovbo Rasmussen, Krystyna Kowalski,
National Addiction Centre, Maudsley Hospital/Institute of Psychiatry, King s College London, London, UK
RESEARCH REPORT doi:10.1111/j.1360-0443.2007.02050.x Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment
DMRI Drug Misuse Research Initiative
DMRI Drug Misuse Research Initiative Executive Summary Dexamphetamine Substitution as a Treatment of Amphetamine Dependence: a Two-Centre Randomised Controlled Trial Final Report submitted to the Department
Treatment of Opioid Dependence: A Randomized Controlled Trial. Karen L. Sees, DO, Kevin L. Delucchi, PhD, Carmen Masson, PhD, Amy
Category: Heroin Title: Methadone Maintenance vs 180-Day psychosocially Enriched Detoxification for Treatment of Opioid Dependence: A Randomized Controlled Trial Authors: Karen L. Sees, DO, Kevin L. Delucchi,
Clinical profiles of cannabis-dependent adolescents in residential substance use treatment
bulletin Clinical profiles of cannabis-dependent adolescents in residential substance use treatment Anthony Arcuri, Jan Copeland and John Howard Key points Young people are most likely to present to residential
THE JOURNAL OF GLOBAL DRUG POUCY AND PRACTICE
THE JOURNAL OF GLOBAL DRUG POUCY AND PRACTICE The UK's Treatment War on Drugs: A Lesson in Unintended Consequences and Perverse Outcomes Kathy Gyngell Abstract From 1998 to 2011 the bulk (some two-thirds)
Research Note RN 00/91 1 November 2000 DRUG COURTS
Research Note RN 00/91 1 November 2000 DRUG COURTS There will be a Scottish National Party debate on Drug Courts on Thursday 2 November 2000. This brief research note gives information on the background
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SPECIAL HEALTH AUTHORITY TENTH WAVE WORK PROGRAMME DRUG MISUSE. Psychosocial interventions in drug misuse
Attachment B NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SPECIAL HEALTH AUTHORITY TENTH WAVE WORK PROGRAMME DRUG MISUSE Psychosocial interventions in drug misuse On 16 th June 2004 the Department of Health
EPIDEMIOLOGY OF OPIATE USE
Opiate Dependence EPIDEMIOLOGY OF OPIATE USE Difficult to estimate true extent of opiate dependence Based on National Survey of Health and Mental Well Being: 1.2% sample used opiates in last 12 months
The NJSAMS Report. Heroin Admissions to Substance Abuse Treatment in New Jersey. In Brief. New Jersey Substance Abuse Monitoring System.
New Jersey Substance Abuse Monitoring System The NJSAMS Report May 2011 Admissions to Substance Abuse Treatment in New Jersey eroin is a semi-synthetic opioid drug derived from morphine. It has a high
ORGANIZATION OF AMERICAN STATES
ORGANIZATION OF AMERICAN STATES INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION FIRST INTER-REGIONAL FORUM OF EU-LAC CITIES: PUBLIC POLICIES IN DRUG TREATMENT April 2 5, 2008 Santo Domingo, Dominican Republic
A 10-year follow-up study of drug users in treatment. Grethe Lauritzen, SIRUS
A 10-year follow-up study of drug users in treatment Grethe Lauritzen, SIRUS A prospective co-hort study 10-year observation period (1998-2009) 481 clients interviewed in 20 treatment facilities in and
2 Evidence for the effectiveness of OST
Report 3.3 The impact of opioid substitution treatment (OST) on the European heroin market Tim McSweeney and Oonagh Skrine Abstract Using a combination of existing and primary data sources, we sought to
How To Treat A Drug Addiction
1 About drugs Drugs are substances that change a person s physical or mental state. The vast majority of drugs are used to treat medical conditions, both physical and mental. Some, however, are used outside
The Vermont Legislative Research Shop. Methadone
The Vermont Legislative Research Shop Methadone Heroin use statistics in Vermont Heroin treatment admissions in Vermont have risen from around 200 patients in 1994 to 833 patients in 2002 (see Figure 1).
Effectiveness of Case Management in Treating Substance Abusers Selected Results from a Metaanalysis Richard C. Rapp, M.S.W. Center for Interventions, Treatment, and Addictions Research Boonshoft School
MORTALITY AMONGST ILLICIT DRUG USERS
MORTALITY AMONGST ILLICIT DRUG USERS Over the past 40 years the rate of illicit drug use worldwide has risen dramatically, and with it the number of deaths reported among drug-using populations. What are
EXPERT PLATFORM ON CRIMINAL JUSTICE. Quasi-coerced treatment of adult drug-dependent offenders. Guidelines on the application of QCT
Strasbourg, 30 November 2007 P-PG-CJ(2007)21_en EXPERT PLATFORM ON CRIMINAL JUSTICE Quasi-coerced treatment of adult drug-dependent offenders Guidelines on the application of QCT drawn up by Tim McSweeney
PRESCRIPTION DRUG ABUSE: THE NATIONAL PERSPECTIVE
PRESCRIPTION DRUG ABUSE: THE NATIONAL PERSPECTIVE May 19, 2012 National Association Boards of Pharmacy Annual Meeting Gil Kerlikowske, Director White House Office of National Drug Control Policy ONDCP
Nadine Ezard 1,2, Brian Francis 2, Amanda Brown 3,4, Bill Robertson 4, Rohan Holland 4, Adrian Dunlop 3,4
What do we know about dexamphetamine in the treatment of methamphetamine dependence? 8 years of the NSW Stimulant Treatment Program, Newcastle and Sydney Nadine Ezard 1,2, Brian Francis 2, Amanda Brown
Title Registration Form Campbell Collaboration Social Welfare Coordinating Group
1. Title of review Title Registration Form Campbell Collaboration Social Welfare Coordinating Group Cognitive-behavioural therapies for young people in outpatient treatment for illicit non-opioid drug
Treatment System 101
Treatment System 101 A brief overview for courtroom decision-makers and people working in criminal justice sectors March 11, 2015 West Toronto Human Services & Justice Coordinating Cttee. Agenda Introduction
Statistics from the National Drug Treatment Monitoring System (NDTMS) Statistics relating to young people England, 1 April 2010 31 March 2011
Statistics from the National Drug Treatment Monitoring System (NDTMS) Statistics relating to young people England, 1 April 2010 31 March 2011 8 December 2011 Executive Summary 21,955 young people accessed
Non medical use of prescription medicines existing WHO advice
Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations
THE DRUG DETOX UNIT AT MOUNTJOY PRISON A REVIEW
1 THE DRUG DETOX UNIT AT MOUNTJOY PRISON A REVIEW By Dr. Des Crowley, General Practitioner INTRODUCTION The Drug Detox Unit was opened in July 1996 at Mountjoy Prison in response to the escalating drug
1. Youth Drug Use More than 40% of Maryland high school seniors used an illicit drug in the past year.
1. Youth Drug Use More than 4% of Maryland high school seniors used an illicit drug in the past year. Any Illicit Drug Alcohol Marijuana Ecstasy Cocaine Percentage of Maryland and U.S. high school seniors
A Review of the Impacts of Opiate Use in Ontario: Summary Report
A Review of the Impacts of Opiate Use in Ontario: Summary Report A Provincial Summary Report of the Impacts of the Discontinuation of Oxycontin in Ontario: January to August 2013 December 2013 This report
Universities of Leeds, Sheffield and York http://eprints.whiterose.ac.uk/
promoting access to White Rose research papers Universities of Leeds, Sheffield and York http://eprints.whiterose.ac.uk/ This is an author produced version of a paper published in Journal of Substance
Dual Diagnosis: Models of Care and Local Pathways AGENDA. Part one: Part two:
Slide 1 Dual Diagnosis: Models of Care and Local Pathways St. Anne s Community Services Dual Diagnosis Project Slide 2 AGENDA Part one: Models of Care. Clinical Guidelines & Evidence Base Local Care Pathways
Alcohol and drugs prevention, treatment and recovery: why invest?
Alcohol and drugs prevention, treatment and recovery: why invest? 1 Alcohol problems are widespread 9 million adults drink at levels that increase the risk of harm to their health 1.6 million adults show
RESEARCH. Survival and cessation in injecting drug users: prospective observational study of outcomes and effect of opiate substitution treatment
Survival and cessation in injecting drug users: prospective observational study of outcomes and effect of opiate substitution treatment Jo Kimber, NHMRC postdoctoral fellow, 1,2 Lorraine Copeland, researcher,
The VEdeTTE cohort study: Effectiveness of treatments for heroin addiction in retaining patients and reducing mortality
The VEdeTTE cohort study: Effectiveness of treatments for heroin addiction in retaining patients and reducing mortality Federica Vigna-Taglianti www.oed.piemonte.it Piedmont Centre for Drug Addiction Epidemiology
NEDS A NALYTIC SUMMARY
N ATIONAL E VALUATION D ATA SERVICES NEDS A NALYTIC SUMMARY Summary #21 July 2001 Highlights Effectiveness of Women s Substance Abuse Treatment Programs: A Meta-analysis The meta-analysis revealed few
Using Drugs to Treat Drug Addiction How it works and why it makes sense
Using Drugs to Treat Drug Addiction How it works and why it makes sense Jeff Baxter, MD University of Massachusetts Medical School May 17, 2011 Objectives Biological basis of addiction Is addiction a chronic
Implementation in Community
Medication-Assisted i t d Treatment t Implementation in Community Correctional Environments (MATICCE) CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA. What is Medication-Assisted Treatment
FRN Research Report March 2011: Correlation between Patient Relapse and Mental Illness Post-Treatment
FRN Research Report March 2011: Correlation between Patient Relapse and Mental Illness Post-Treatment Background Studies show that more than 50% of patients who have been diagnosed with substance abuse
Mothers on the Opioid Treatment Program and their involvement with the child protection system. Stephanie Taplin and Richard Mattick
Mothers on the Opioid Treatment Program and their involvement with the child protection system Stephanie Taplin and Richard Mattick Background to the study Three year study: Child protection and women