The Drug Matrix is concerned with the treatment of problems related to the use of illegal drugs by adults (another deals with alcohol-related problems). It maps the treatment universe and for each sub-territory (a cell) lists the most important UK-relevant research and guidance. Across the top columns move from specific interventions through how their impacts are affected by staff, the management of the service, and the nature of the organisation, to the impact of local area treatment systems. Down the rows are the major intervention types implemented at these levels.  

What is cell C3 about?

What is this cell about? About the treatment of drug dependence in a medical context and/or involving medical care. Medications are the main distinguishing feature, but even when they are prescribed, the clinician-patient relationship influences whether they are taken and may be therapeutic in its own right. The power of being prescribed a medication in a credibly healing context should not be underestimated. Dismissed as a ‘placebo effect’ merely to be used as a baseline for evaluating active treatments, often it generates most of the overall effects.

This cell focuses on how these processes are affected by the management functions of selecting, training and managing staff, and managing the intervention programme. In highly controlled studies, it may be possible to divorce the impact of interventions from the management of the service delivering them, but in everyday practice, whether interventions (cell A3) get adopted and adequately implemented, and whether practitioners (cell B3) are able to develop and maintain recovery-generating attitudes and knowledge, depend on management and supervision.

Within this remit, the most researched treatments have been opioid substitute prescribing programmes like methadone maintenance, in which management decisions on testing for drug use, supervising the consumption of medications, dosing policy, ‘disciplinary’ rules, and duration of treatment, are critical to safety and effectiveness.