"eprintid","rev_number","eprint_status","userid","importid","source","dir","datestamp","lastmod","status_changed","type","succeeds","commentary","metadata_visibility","contact_email","latitude","longitude","relation_type","relation_uri","item_issues_id","item_issues_type","item_issues_description","item_issues_timestamp","item_issues_status","item_issues_reported_by","item_issues_resolved_by","item_issues_comment","item_issues_count","sword_depositor","sword_slug","creators_name.family","creators_name.given","creators_name.lineage","creators_name.honourific","creators_id","browse_creators","contributors_type","contributors_name.family","contributors_name.given","contributors_name.lineage","contributors_name.honourific","contributors_id","corp_creators","title","ispublished","subjects","divisions","full_text_status","research_status","monograph_type","pres_type","keywords","research_method_note","note","suggestions","abstract","date","date_type","series","browse_by","rel_username_id","rel_username","rel_userid","username_browse_by","publication","volume","numeric_volume","number","publisher","place_of_pub","pagerange","pages","event_title","event_location","event_dates","event_type","id_number","patent_applicant","institution","department","thesis_type","refereed","publication_type","intervention_type","drug_type","isbn","issn","nsid","table_name","edition","item_source","date_start","date_end","organisations_organisation","organisations_role","accession_number","accession_comment","accession_status","copyright_holder","copyright_permission","copyright_granted","copyright_renewal","copyright_fee","toc_html","body_html","call_number","date_received","date_ordered","season_month","issue_title","book_title","editors_name.family","editors_name.given","editors_name.lineage","editors_name.honourific","editors_id","official_url","related_url_url","related_url_type","referencetext","funders","projects","output_media","exhibitors_name.family","exhibitors_name.given","exhibitors_name.lineage","exhibitors_name.honourific","exhibitors_id","num_pieces","composition_type","producers_name.family","producers_name.given","producers_name.lineage","producers_name.honourific","producers_id","conductors_name.family","conductors_name.given","conductors_name.lineage","conductors_name.honourific","conductors_id","lyricists_name.family","lyricists_name.given","lyricists_name.lineage","lyricists_name.honourific","lyricists_id","accompaniment","data_type","pedagogic_type","completion_time","task_purpose","skill_areas","copyright_holders","learning_level","research_dissemination","research_quantitative","research_qualitative","request_form","visible_until","doc_order_by","jv_volume","jv_pub","vol_subject_list","vol_subject_list_words","vol_subject_list_geo_words","vol_subject_list_words_last","vol_subject_list_geo_words_last","ace_words","sticky","home_hide" "28007","20","archive","1684",,,"disk0/00/02/80/07","2017-10-17 11:36:21","2017-10-17 12:45:07","2017-10-17 11:36:21","article",,,"show",,,,"","","","","","","","","","",,,,"Yoder","Ruth","","","","Yoder:Ruth::","",,,,,"","","How do individuals develop alcohol use disorder after bariatric surgery? A grounded theory exploration.","pub","BB","","none",,,,,,,,"BACKGROUND: Bariatric surgery is the most effective treatment for severe obesity. However, following Roux-en-Y gastric bypass (RYGB) surgery, a small minority of patients develop new-onset alcohol use disorder (AUD), the aetiology of which is poorly understood. AIM: The aim is to construct a theory to explain the development of AUD among a sample of individuals who reported problematic drinking following RYGB. METHOD: Semi-structured interviews were conducted with eight RYGB patients diagnosed with AUD attending a multi-disciplinary outpatient weight management service at a public hospital in the Republic of Ireland. A constructivist grounded theory methodology was used to analyse interview transcripts. RESULTS: Participants' main concern was identified as 'unresolved psychological issues' which were managed by 'external coping mechanisms', namely, 'eating to cope'. After RYGB, comfort eating was no longer possible to the same extent. Following a 'honeymoon period', participants' need for an external coping mechanism resurfaced. 'Filling the void' provides a framework to explain how participants managed the symptoms of their unresolved psychological issues through 'behavioural substitution', that is, drinking alcohol instead of eating. CONCLUSION: The theoretical framework of 'filling the void' adds to contemporary research that conceptualises AUD behavioural substitution as 'addiction transfer' by describing the process by which the phenomenon occurs as well as the characteristics of participants. The clinical implication of this research is to advocate for a reshaping of treatment of RYGB patients, with increased psychological input following surgery.","2017-10-14","published",,"Yoder Ruth",,"","",,"Obesity Surgery","Early online",,,"Springer",,,,,,,,,,,,,"TRUE","","","",,"1708-0428",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"https://link.springer.com/article/10.1007%2Fs11695-017-2936-7","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_in_all_cases",,"1","Early online","Obesity Surgery","BB , FE10-4-6 , FN , FP , FR , GA2-2 , GC16 , JM , JQ6-4 , JQ6-8 , VH4-2","B Drugs and alcohol substances > Alcohol -- F Concepts in psychology > Skills > Coping skills -- F Concepts in psychology > Motivation -- F Concepts in psychology > Emotion -- F Concepts in psychology > Attitude and behaviour -- G Health and disease > State of health > Physical health -- G Health and disease > Drugs and alcohol disorder > Alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Medical care -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care","VA Geographic area > Europe > Ireland","Alcohol -- Skills - Coping skills -- Motivation -- Emotion -- Attitude and behaviour -- State of health - Physical health -- Drugs and alcohol disorder - Alcohol use -- Patient care management -- Care by type of problem - Medical care -- Care by type of problem - Mental health care","Europe - Ireland","Yoder Ruth , MacNeela Padraig , Conway Ronan , Heary Caroline","0","yes" "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MacNeela","Padraig","","",,,,,,,,,,,,"FE10-4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Conway","Ronan","","",,,,,,,,,,,,"FN",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Heary","Caroline","","",,,,,,,,,,,,"FP",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"FR",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28007",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28035","12","archive","5",,,"disk0/00/02/80/35","2017-10-23 09:22:22","2017-10-23 09:22:22","2017-10-23 09:22:22","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Substance use treatment as part of a ‘wrap-around’ package of care.","pub","AH18","","public",,,,,,,,"In the ‘austere’ UK financial climate, it seems unclear whether treatment services will be forced to bunker down and focus on substance use objectives, or instead be supported to expand into holistic providers of, or gateways to, the range of psychosocial services demanded by government reintegration and recovery agendas. Given the typically multiple, severe, and overlapping problems presented by treatment caseloads, it seems obvious that a holistic approach would help get patients back on a stable (recovery) footing, and similarly obvious that just focusing on substance use objectives would be setting some patients up to fail. Could ‘wrap-around’ care be the answer, and should treatment services have the flexibility to determine the extent to which this would be implemented in practice, or would this risk a lottery of comprehensive care?","2017-10-03","published",,"Drug and Alcohol Findings",,"","",,"Drug and Alcohol Findings Hot Topic",,"October-December 2017","October-December 2017","Drug and Alcohol Findings","London",,"3 p.",,,,,,,,,,,"","rehabilitation","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,,,,,,,,,,,,"","http://findings.org.uk/hot_topics.php?s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","unspecified","Drug and Alcohol Findings Hot Topic","AH18 , JM , JP10 , JS , TT2","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Drug or health care worker",,"Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Patient care management -- Treatment and maintenance - treatment factors -- Health care delivery -- Drug or health care worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "28035",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28035",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28035",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28035",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467","23","archive","5",,,"disk0/00/02/24/67","2014-08-13 10:29:09","2017-10-04 07:36:30","2014-08-13 10:29:09","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix cell C1: management/supervision - reducing harm.","pub","JB2-4","","public",,,,,,,,,"2017-10","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,"4 p.",,,,,,,,,,,"other","aod_disorder","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

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 C1 about?

As described more fully in cell A1’s bite, about reducing the harms experienced by the user as a result of their drug use, without necessarily reducing use or seeking to overcome dependence. Common interventions include needle exchanges, overdose prevention programmes, and substituting a legally prescribed drug of the same type for the original (and usually illegally obtained) substance, also considered as a treatment for addiction in row 3 of the matrix. This cell is not about the effectiveness of the intervention itself (for which see cell A1), but how implementation and effectiveness are influenced by the management functions of selecting, training and managing staff, and managing the intervention programme – less commonly researched topics.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/C1.htm&format=open&s=dy","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JB2-4 , JH10-6 , JH10-6-4 , JM , JS , JU , MP18-2-8-16 , MQ6-2","J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control > Needle distribution and exchange -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration -- MP-MR Policy, planning, economics, work and social services > Policy > Policy on drugs and alcohol > Harm reduction policy -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training",,"Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Health-related prevention - Health information and education - Communicable disease control -- Health-related prevention - Health information and education - Communicable disease control - Needle distribution and exchange -- Patient care management -- Health care delivery -- Health care administration -- Policy - Policy on drugs and alcohol - Harm reduction policy -- Organisational development - Workforce / staff skills and training",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MP18-2-8-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22467",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973","20","archive","5",,,"disk0/00/02/79/73","2017-10-18 08:28:43","2017-10-18 08:28:44","2017-10-18 08:28:43","article",,,"show",,,,"","","","","","","","","","",,,,"O'Driscoll","Colin","","","","O'Driscoll:Colin::","",,,,,"","","Working with clients with addiction: what psychologists need to know.","pub","GD2","","none",,,,,,,,"Addiction is a common problem that practitioner psychologists face with their clients. It is however, the view and experience of the authors that specialised training in addiction treatment for psychologists is sparse, inconsistent and incomprehensive. As a consequence, psychologists may feel unskilled in this regard, referring clients onto specialist community based services where they may or may not be seen, or specialist residential (tier 4) services where they may or may not be accepted, or be able to afford (in time or cost). This article aims to give some context to the nature of these issues and the challenges facing practitioners, offer an overview of evidence in the treatment of addiction, and finally conclude with some guidance to psychologists in the treatment of these issues in the psychotherapeutic context.","2017-10","published",,"O'Driscoll Colin",,"","",,"The Irish Psychologist","43","12","12","Psychological Society of Ireland",,"16-20",,,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_in_all_cases",,"1","43","The Irish Psychologist","GD2 , HH2 , HZ , JM , JQ6-8 , MQ6-2 , TT2-12 , TT4-4 , VH4-2","G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder -- HA Screening, identification, and diagnostic method > Psychological assessment -- HJ Treatment method > Psychosocial treatment method -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Doctor -- T Demographic characteristics > Counsellor / Therapist","VA Geographic area > Europe > Ireland","Drugs and alcohol related disorder - Drugs and alcohol related mental disorder -- Psychological assessment -- Psychosocial treatment method -- Patient care management -- Care by type of problem - Mental health care -- Organisational development - Workforce / staff skills and training -- Doctor -- Counsellor / Therapist","Europe - Ireland","O'Driscoll Colin , Foy Sean","0","yes" "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Foy","Sean","","",,,,,,,,,,,,"HH2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27973",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951","13","archive","5",,,"disk0/00/02/79/51","2017-10-05 08:11:02","2017-10-05 08:11:02","2017-10-05 08:11:02","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Public Health England","Health Matters: preventing ill health from alcohol and tobacco use.","pub","BB","","none",,,,,,,,,"2017-10",,,"Public Health England",,"","",,,,,,"Public Health England","London",,,,,,,,,,,,,"report","aod_disorder","alcohol",,,,,,"Public Health England",,,"","","","","","","","","","",,"

This professional resource from the UK focuses on preventing ill health caused by alcohol and tobacco use and makes the case for why NHS providers should implement the ‘preventing ill health by risky behaviours – alcohol and tobacco CQUIN’.

",,,,,,,,,,,"","https://www.gov.uk/government/publications/health-matters-preventing-ill-health-from-alcohol-and-tobacco/health-matters-preventing-ill-health-from-alcohol-and-tobacco-use","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , GC16 , JM , JS , TT2 , TT2-14 , TT6 , VH4-4","B Drugs and alcohol substances > Alcohol -- G Health and disease > Drugs and alcohol disorder > Alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Nurse -- T Demographic characteristics > Prevention worker","VA Geographic area > Europe > United Kingdom","Alcohol -- Drugs and alcohol disorder - Alcohol use -- Patient care management -- Health care delivery -- Drug or health care worker -- Nurse -- Prevention worker","Europe - United Kingdom","Public Health England Public Health England","0","yes" "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method","tobacco",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27951",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903","16","archive","5",,,"disk0/00/02/79/03","2017-09-26 07:03:01","2017-09-26 07:03:01","2017-09-26 07:03:01","guideline",,,"show",,,,"","","","","","","","","","",,,,"Ryan","Sara","","","","Ryan:Sara::","",,,,,"","","Do we all agree what ""good health care"" looks like? Views from those who are ""seldom heard"" in health research, policy and service improvement.","pub","JM","","none",,,,,,,,"Context: The aim of this study was to ask whether there are shared ideas about what good health care looks like that apply across different populations and conditions. Do priorities among ""seldom heard"" groups differ from mainstream views and, if so, how might we understand these differences? Design: Focus groups were recruited with the help of our study patient representatives. Participants discussed and prioritized a set of eight ""core components"" of good care. We recorded and transcribed the data for thematic analysis. Setting and participants: We recruited people who are seldom heard in health and policy research for separate focus group discussions (one each with illegal drug users, Irish Travellers, migrant workers, young men and learning disabled people). We also ran a reference group of educated, older adults and an online group with people with long-term conditions. Results: There were few differences in what participants thought was important in health care but considerable differences in their expectations that they might personally receive good care. Differences related to participants' previous experiences. The drug users group reported particularly poor experiences and low expectations of good care. Discussion: Differences in what is regarded as an entitlement or privilege in health care underline the persistence of structural and relational differences in how services are experienced. While we can be reassured that core aspects of care are similarly prioritized across different patient groups, including those who are seldom heard, a more intractable challenge remains: how to provide equitable health care for marginalized groups in an unequal society.","2017-10","published",,"Ryan Sara",,"","",,"Health Expectations","20","5","5","Wiley",,"878-885",,,,,,,,,,,"TRUE","","aod_disorder","alcohol_drugs_in_general",,"1369-7625",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/doi/10.1111/hex.12528/abstract;jsessionid=F0C14E92E7A6908BBA3C4527757C9CAD.f03t03?systemMessage=Wiley+Online+Library+will+be+unavailable+on+Saturday+7th+Oct+from+03.00+EDT+%2F+08%3A00+BST+%2F+12%3A30+IST+%2F+15.00+SGT+to+08.","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","20","Health Expectations","JM , JP10_2_2 , JQ6-8 , JS , JU10 , TL4 , TT2 , TT2-12 , TT2-14 , VH4-4","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- T Demographic characteristics > Drug user -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > United Kingdom","Patient care management -- Treatment and maintenance - patient attitude toward treatment -- Care by type of problem - Mental health care -- Health care delivery -- Health care administration - Health care quality control -- Drug user -- Drug or health care worker -- Doctor -- Nurse","Europe - United Kingdom","Ryan Sara , Hislop Jenny , Ziebland Sue","0","yes" "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hislop","Jenny","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ziebland","Sue","","",,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27903",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029","19","archive","5",,,"disk0/00/02/80/29","2017-10-23 07:34:50","2017-10-23 07:34:50","2017-10-23 07:34:50","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","WHO Regional Office for Europe","WHO alcohol brief intervention training manual for primary care.","pub","BB","","public",,,,,,,,"Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions. Unit 1. Introduction, course overview and group agreement p.22 Unit 2. Attitudes to alcohol p.26 Unit 3. Impact, consumption and harms of alcohol p.34 Unit 4. ABIs: goals, skills and practice change .p.44 Unit 5. Beginning a conversation about alcohol p.53 Unit 6. Screening and feedback using AUDIT p.57 Unit 7. Brief intervention core skills .p.68 Unit 8. Brief interventions – practice session p.77 Post training materials - Evaluation and monitoring p.93","2017-10",,,"WHO",,"","",,,,,,"WHO Regional Office for Europe","Copenhagan",,"117 p.",,,,,,,,,,,"report","aod_disorder_treatment_method","alcohol",,,,,,"WHO",,,"","","","","","","","","","",,,,,,,,,,,,,"","http://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/publications/2017/who-alcohol-brief-intervention-training-manual-for-primary-care-2017","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , GC16-6 , HZ , HZ2-2-2 , JG26_2_4_2 , JM , JT8_8_2 , TT2 , TT2-12 , TT2-14 , TT6 , TT8-2","B Drugs and alcohol substances > Alcohol -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Prevention worker -- T Demographic characteristics > Social worker",,"Alcohol -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Psychosocial treatment method -- Psychosocial treatment method - Individual therapy - Brief intervention -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Health care programme or facility - Community-based treatment (primary care) -- Drug or health care worker -- Doctor -- Nurse -- Prevention worker -- Social worker",,"WHO Regional Office for Europe WHO Regional Office for Europe","0","no" "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "28029",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911","13","archive","5",,,"disk0/00/02/79/11","2017-09-26 11:43:16","2017-09-26 11:43:16","2017-09-26 11:43:16","article",,,"show",,,,"","","","","","","","","","",,,,"Ivers","Jo-Hanna","","","","Ivers:Jo-Hanna::","",,,,,"","","A naturalistic longitudinal analysis of post-detoxification outcomes in opioid-dependent patients.","pub","BL","","none",,,,,,,,"Introduction and aims: To provide an assessment of outcomes in a cohort of opioid-dependent patients post-detoxification. Design and methods: This study employed an observational longitudinal cohort design. Patients who completed detoxification in the three major Drug Dependency Units in Ireland during a 14-month period were included in the study (n = 143). Patients opting for one of the three pathways post-detoxification (inpatient aftercare, outpatient aftercare or no formal aftercare) were assessed in the final week of detoxification and followed up after 3, 6 and 9 months. The primary outcome was abstinence following detoxification. Results: A Cox (adjusted) model indicated participants who opted for outpatient aftercare treatment lapsed/relapsed at a rate of 52% higher than the inpatient aftercare group (hazard ratio = 1.52, 95% confidence interval 0.75-3.08, P = 0.24). Moreover, time to lapse/relapse was considerably shorter for the no formal aftercare group (hazard ratio = 7.68, 95% confidence interval 4.30-13.73, P = 5.75 × 10(-12) ). Abstinence rates for outpatient aftercare and inpatient aftercare are about equal after 9 months. Discussion and conclusion: Patients who opt for aftercare post-detoxification have significantly better outcomes at follow up when compared to no formal aftercare. In addition, patients' intention to attend aftercare affected their outcomes regardless of eventual treatment path.","2017-09-20","published",,"Ivers Jo-Hanna",,"","",,"Drug and Alcohol Review","Early online",,,"Wiley",,,,,,,,"DOI: 10.1111/dar.12597",,,,,"TRUE","","","",,"1465-3362",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://onlinelibrary.wiley.com/doi/10.1111/dar.12597/abstract","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","Early online","Drug and Alcohol Review","BL , HK2 , HK2-4 , HZ26 , JM , JP10 , JP10_2_2 , JT14-10 , VH4-2","B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Detoxification method -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Residential facility","VA Geographic area > Europe > Ireland","Opioids (opiates) -- Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Detoxification method -- Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Residential facility","Europe - Ireland","Ivers Jo-Hanna , Zgaga Lina , Sweeney Brion , Keenan Eamon , Darker Catherine , Smyth Bobby P , Barry Joe","0","no" "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Zgaga","Lina","","",,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Sweeney","Brion","","",,,,,,,,,,,,"HK2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Keenan","Eamon","","",,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Darker","Catherine","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Smyth","Bobby P","","",,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Barry","Joe","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27911",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823","11","archive","5",,,"disk0/00/02/78/23","2017-09-05 08:22:28","2017-09-05 08:22:28","2017-09-05 08:22:28","guideline",,,"show",,,,"","","","","","","","","","",,,,"Nugent","Shannon M","","","","Nugent:Shannon M::","",,,,,"","","The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review.",,"B6","","none",,,,,,,,,"2017-09-05","published",,"Nugent Shannon M",,"","",,"Annals of Internal Medicine","167","5","5","American College of Physicians",,"319-331",,,,,,,,,,,,"","aod_disorder","cannabis",,"1539-3704",,,,,,,"","","","","","","","","","",,"

Background: Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain.

Purpose: To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations.

Data sources: MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017.
Study selection: Intervention trials and observational studies, published in English, involving adults using plant-based cannabis preparations that reported pain, quality of life, or adverse effect outcomes.
Data extraction: Two investigators independently abstracted study characteristics and assessed study quality, and the investigator group graded the overall strength of evidence using standard criteria.

Data synthesis: From 27 chronic pain trials, there is low-strength evidence that cannabis alleviates neuropathic pain but insufficient evidence in other pain populations. According to 11 systematic reviews and 32 primary studies, harms in general population studies include increased risk for motor vehicle accidents, psychotic symptoms, and short-term cognitive impairment. Although adverse pulmonary effects were not seen in younger populations, evidence on most other long-term physical harms, in heavy or long-term cannabis users, or in older populations is insufficient.

Limitation: Few methodologically rigorous trials; the cannabis formulations studied may not reflect commercially available products; and limited applicability to older, chronically ill populations and patients who use cannabis heavily.

Conclusion: limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain. Among general populations, limited evidence suggests that cannabis is associated with an increased risk for adverse mental health effects.

",,,,,,,,,,,"","http://annals.org/aim/article/2648595/effects-cannabis-among-adults-chronic-pain-overview-general-harms-systematic","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","167","Annals of Internal Medicine","B6 , BT6-2 , GA2 , JM , TA14 , VD","B Drugs and alcohol substances > Cannabis / Marijuana -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- G Health and disease > State of health -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Adolescent / youth (teenager / young person)","VA Geographic area > United States","Cannabis / Marijuana -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- State of health -- Patient care management -- Adolescent / youth (teenager / young person)","United States","Nugent Shannon M , Morasco Benjamin J , O'Neil Maya E , Freeman Michele , Low Allison , Kondo Karli , Elven Camille , Zakher Bernadette , Motu'apuaka Makalapua , Paynter Robin , Kansagara Devan","0","yes" "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Morasco","Benjamin J","","",,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Neil","Maya E","","",,,,,,,,,,,,"GA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Freeman","Michele","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Low","Allison","","",,,,,,,,,,,,"TA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kondo","Karli","","",,,,,,,,,,,,"VD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Elven","Camille","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Zakher","Bernadette","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Motu'apuaka","Makalapua","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Paynter","Robin","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27823",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kansagara","Devan","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466","24","archive","5",,,"disk0/00/02/24/66","2014-08-13 10:19:37","2017-10-23 09:35:35","2014-08-13 10:19:37","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix cell B1: practitioners - reducing harm.","pub","JB2-4","","public",,,,,,"From Drug Treatment Matrix, copyright Drug and Alcohol Findings and the Substance Misuse Skills Consortium.",,,"2017-09","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,,,,,,,,,,,,"other","aod_use_harm_reduction","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

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 this cell B1 about?

As described more fully in cell A1, about reducing the harms experienced by the user as a result of their drug use, without necessarily reducing use or seeking to overcome dependence. Common interventions include needle exchanges and substituting a legally prescribed drug of the same type for the original (and usually illegally obtained) substance, also considered as a treatment for addiction in row 3. This cell is however not about the content of the intervention (for which see cell A1), but whether its impact depends on the interpersonal style and other features of the practitioner relating to the client or conducting the intervention – a much less commonly researched topic.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/B1.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JB2-4 , JM , JP10_2_2 , JP10_6 , JS , MP18-2-8-16 , TT2 , TT2-12 , TT2-14 , TT4-4 , TT8-2","J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- J Health care, prevention and rehabilitation > Health care delivery -- MP-MR Policy, planning, economics, work and social services > Policy > Policy on drugs and alcohol > Harm reduction policy -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Counsellor / Therapist -- T Demographic characteristics > Social worker",,"Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Patient care management -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Health care delivery -- Policy - Policy on drugs and alcohol - Harm reduction policy -- Drug or health care worker -- Doctor -- Nurse -- Counsellor / Therapist -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MP18-2-8-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22466",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729","17","archive","5",,,"disk0/00/02/77/29","2017-08-10 07:52:30","2017-08-10 08:16:05","2017-08-10 07:52:30","monograph",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Department of Health","Hepatitis C screening. National clinical guideline no. 15. Summary.","pub","GH16-12-6-6","","public",,,,,,,,"This Summary National Clinical Guideline is relevant to all healthcare professionals, healthcare managers and policy makers working with those at increased risk of hepatitis C virus (HCV) infection. The guideline will also be of value to both statutory and voluntary bodies providing services to those groups at increased risk of HCV infection. It may also be used by those with HCV or in a risk group for HCV and by members of the public. Hepatitis C virus (HCV) is a major cause of liver disease worldwide. Globally, it is estimated that there are 115 million people who have had HCV infection, and 80 million with chronic infection. Transmission of HCV occurs through contact with the blood of an infected person. Risk factors for HCV differ globally. In developed countries like Ireland, injecting drug use (IDU) is the major risk factor. (3.1.4 People who use unprescribed or illicit drugs - page 15)","2017-08","published",,"Department of Health",,"","",,,,,,"Department of Health","Dublin",,"60 p.",,,,,,,,,,,"","","","2009-6267",,,,,,,,"","","","","","","","","","",,"

 

See also, from HPSC

Report on the consultation process and outcomes National clinical guideline - Hepatitis C screening

National guideline on screening for hepatitis C infection - Budget impact analysis

",,,,,,,,,,,"","http://health.gov.ie/national-patient-safety-office/ncec/national-clinical-guidelines/prevention/","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"GH16-12-6-6 , JH10-6 , JM , JS , TL4-10-4 , TT2 , TT2-12 , TT2-14","G Health and disease > Disorder by cause > Communicable disease > Hepatitis C -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Intravenous / injecting drug user -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse",,"Disorder by cause - Communicable disease - Hepatitis C -- Health-related prevention - Health information and education - Communicable disease control -- Patient care management -- Health care delivery -- Intravenous / injecting drug user -- Drug or health care worker -- Doctor -- Nurse",,"Department of Health Department of Health","0","no" "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27729",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752","17","archive","5",,,"disk0/00/02/77/52","2017-08-14 07:58:35","2017-08-14 07:58:35","2017-08-14 07:58:35","article",,,"show",,,,"","","","","","","","","","",,,,"Lyons","Suzi","","","","Lyons:Suzi::","",,,,,"","","New clinical guidelines for opioid substitution treatment.","pub","BL","","public",,,,,,,,,"2017-08",,,"Lyons Suzi",,"","",,"Drugnet Ireland","Issue 62, Summer 2017",,,"Health Research Board",,"27-30",,,,,,,,,,,"FALSE","","","",,,,,,,,,"","","","","","","","","","",,"

New clinical guidelines for opioid substitution treatment (OST) in Ireland have been published.1 They were developed by a working group comprising the Health Service Executive (HSE), the College of Psychiatrists of Ireland, the Irish College of General Practitioners, the Pharmaceutical Society of Ireland and HSE addiction services. The group reviewed all relevant national and international guidelines and consulted stakeholders in the addiction services. Professor Michael Farrell, director of the National Drug and Alcohol Research Centre at the University of New South Wales provided expert opinion throughout the process.

 

This comprehensive document is divided into seven sections, each covering all different aspects of OST treatment: the guiding principles; rehabilitation and psychosocial components of OST; principles and key operational stages of pharmacological interventions of OST; assessment of dependence and management of OST; drug testing; OST and associated health considerations; and specific treatment situations and populations.

 

The guidelines emphasise the importance of clinical governance and standards in OST treatment. Governance looks to put the service user first, working towards delivering a quality service and maintaining patient safety (see Appendix 1, p. 70). The need for properly qualified and accredited staff to deliver the right interventions is also spelt out.

 

There is an acknowledgment of the importance of family/carers in the treatment process. The guidelines recommend that services should proactively engage with family/carers to enable them to be active partners in the treatment, with the service user’s consent. This is particularly important for teenagers. The guidelines also note that this group can have their own issues, distinct from the service user, which may need to be addressed.

 

The document includes in-depth information for prescribing buprenorphine/buprenorphine-naloxone. The guidelines state that due to the safer profile of these formulations, induction and stabilisation can be quicker. They can be commenced by Level 2 general practitioners (GPs) and HSE addiction clinic prescribers. Other recommendations include:

The guide states that evidence shows that contingency management (CM), for example using incentives such as take-home OST, is proven to improve outcomes in this patient group. However, it does have some disadvantages and it is therefore recommended that it be provided as part of a structured care plan in combination with other evidence-based interventions. The guidelines directly address the issue of diversion. They state that take-home OST as an incentive for CM should be balanced against the known positive benefits to the service user and any potential risks, such as unsafe storage in homes or diversion. The criteria for deciding whether or not a client is suitable for take-home OST is based on known risk factors, and an assessment of the individual service user and community safety, but also clinical stability. In the guidelines, clinical stability is defined as:

Contraindications to receiving take-home OST are:

A brief summary of the entire guide contents and all key points are reproduced below.

 

1. Guiding principles

Contents: good governance; therapeutic alliance; and information sharing (p. 11). The key points are:

 

2. Rehabilitation and psychosocial components of OST

Contents: OST as a component of rehabilitation; integrated care plans; psychosocial interventions; key steps involved in the integrated care pathway; (p. 13). The key points are:

 

3. Principles and key operational stages of pharmacological interventions for OST

Contents: aims and objectives of OST; legislative requirements for prescriptions and initiation of OST (including buprenorphine/naloxone); provision of information to the patient; communication between prescriber; dispensing pharmacist and multidisciplinary team; contingency management; diversion of opioid substitution medication; supervised consumption; ongoing assessment of OST; and referral procedure for change of OST location (p. 17). The key points are:

 

4. Assessment of dependence and management of OST

Contents: Phase 1 assessing dependence; Phase 2 induction phase; Phase 3 stabilisation; Phase 4 maintenance; and Phase 5 detoxification (p. 26). The key points are:

 

5. Drug testing

Contents: objectives of drug testing; rationale; procedures for testing; usefulness of drug testing; urine sample adulteration; supervision of urine samples; testing for alcohol and Z-drugs (p. 38). The key points are:

 

6. OST and associated health considerations

Contents: responses to continued drug and alcohol misuse for patients; mental health; viral infections; vaccinations; health implications for continued drug and alcohol use; pain management for drug misusers; ECG monitoring; and drug-related deaths (overdose, reducing drug-related deaths, dealing with overdose emergency) (p. 43). The key points are:

 

7. Specific treatment situations and populations

Contents: hidden harm; criminal justice system (Garda custody, Drug Treatment Court, probation, prison); opiate-dependent patients in hospital; pregnancy and neonatal care; young people; older current and ex-drug users; and palliative care and life-limiting conditions (p. 57).. The key points are:

 

1   Health Service Executive (2016) Clinical guidelines for opioid substitution treatment. Dublin: Health Service Executive. http://www.drugsandalcohol.ie/26573/

",,,,,"Issue 62, Summer 2017",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 62, Summer 2017","Drugnet Ireland","BL , HJ2 , HK2-10-2-2 , HK2-10-2-2-2 , JG26_2_4_2 , JM , JP10 , JT8_8_2 , TT2-12 , TT2-14 , VH4-2","B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > General treatment method concepts -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > Ireland","Opioids (opiates) -- General treatment method concepts -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Treatment and maintenance - treatment factors -- Health care programme or facility - Community-based treatment (primary care) -- Doctor -- Nurse","Europe - Ireland","Lyons Suzi","0","yes" "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HJ2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27752",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754","15","archive","5",,,"disk0/00/02/77/54","2017-08-14 08:00:07","2017-08-14 08:00:07","2017-08-14 08:00:07","article",,,"show",,,,"","","","","","","","","","",,,,"Lyons","Suzi","","","","Lyons:Suzi::","",,,,,"","","Updated community detoxification protocols for methadone and benzodiazepines.","pub","BH2-2","","public",,,,,,,,,"2017-08",,,"Lyons Suzi",,"","",,"Drugnet Ireland","Issue 62, Summer 2017",,,"Health Research Board",,"31",,,,,,,,,,,"FALSE","","","",,,,,,,,,"","","","","","","","","","",,"

The Ana Liffey Drug Project has produced updated community detoxification protocols for both methadone and benzodiazepines.1,2,3 One of the main changes is the removal of the need for the mandatory broker role in the community detoxification structure. Key to the detoxification process is a named key worker or healthcare professional to provide psychosocial support and a GP to provide the necessary initial assessment and medical support throughout the process. There is an emphasis on psychosocial support and the key work process in the updated documents. The issues of dual diagnosis and mental health in community detoxification are discussed. Other updates relate to suggested detoxification schedules for methadone. 

Methadone detoxification schedule 1

Methadone detoxification schedule 2

Timeframe for detoxification from methadone

The rate and pace of dosage reduction for detoxification should be decided on a case-by-case basis, depending on the needs and wishes of the person. For people with dual addiction with a hypnotic (e.g. benzodiazepines or Z-drugs) and methadone, the protocols recommend that they should be detoxified off the hypnotic first, then methadone. There are no updates to the suggested detoxification schedules for benzodiazepines.

 

The aim of the protocols is to improve service delivery and ensure best possible practice for each person seeking a detoxification. This in no way precludes healthcare professionals providing additional supports to meet the needs of person based on their particular circumstances: ‘The Steering Committee fully recognises, and wishes to emphasise, the importance of local knowledge and expertise in ensuring successful delivery of services. There is nothing to prevent services mandating an individual or agency locally to promote and/or coordinate the new guidelines’ (p. 11).

 

1   Ana Liffey Drug Project (2016) National community detoxification: methadone guidelines. Dublin: Ana Liffey Drug Project. http://www.drugsandalcohol.ie/26888/

2   Ana Liffey Drug Project (2016) National community detoxification: benzodiazepine guidelines. Dublin: Ana Liffey Drug Project. http://www.drugsandalcohol.ie/26889/

3   For further information on community detoxification, visit: http://www.drugs.ie/resources/community_detox/information_for_drug_users

",,,,,"Issue 62, Summer 2017",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 62, Summer 2017","Drugnet Ireland","BH2-2 , BL2-1 , HK2-10-2-2 , HK2-10-2-2-2 , HK2-4 , JM , JT8_8_2 , TT2-12 , VH4-2","B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) > Benzodiazepine -- B Drugs and alcohol substances > Opioids (opiates) > Methadone -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- HJ Treatment method > Drugs and alcohol disorder treatment method > Detoxification method -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Doctor","VA Geographic area > Europe > Ireland","Sedatives or tranquillisers (CNS depressants) - Benzodiazepine -- Opioids (opiates) - Methadone -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Drugs and alcohol disorder treatment method - Detoxification method -- Patient care management -- Health care programme or facility - Community-based treatment (primary care) -- Doctor","Europe - Ireland","Lyons Suzi","0","yes" "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL2-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27754",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27758","12","archive","5",,,"disk0/00/02/77/58","2017-08-14 08:02:08","2017-08-14 08:02:08","2017-08-14 08:02:08","article",,,"show",,,,"","","","","","","","","","",,,,"Millar","Sean","","","","Millar:Sean::","",,,,,"","","Healthcare in Irish prisons.","pub","JM","","public",,,,,,,,,"2017-08",,,"Millar Sean",,"","",,"Drugnet Ireland","Issue 62, Summer 2017",,,"Health Research Board",,"36-37",,,,,,,,,,,"FALSE","","","",,,,,,,,,"","","","","","","","","","",,"

A report entitled Healthcare in Irish prisons, prepared by the Inspector of Prisons, the late Mr Justice Michael Reilly, was presented to the Tánaiste and Minister for Justice and Equality on 25 November 2016.1 There were three specific aims of the report:

Obligation to provide healthcare in prisons equivalent to that in non-prison community

The report stressed that the right to health is a fundamental right and that Article 12(1)2 of the International Covenant on Economic, Social and Cultural Rights urges state parties “to recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”. In addition, it is generally accepted as international best practice that the provision of healthcare in prisons should be equivalent to that available in the non-prison community.

 

Entitlement to health services in the Republic of Ireland is primarily based on residency and means. In particular, eligibility to access health services depends on whether a person is a medical card holder or not. It is well established that a majority of prisoners come from lower socioeconomic sectors of communities, and that many present with mental health and other preexisting health problems often resulting from a chaotic lifestyle. Therefore, the report urged that healthcare should be provided to prisoners on the basis that they are entitled to the same treatment and choices as people in the free community who are in receipt of medical cards.

 

Healthcare services in Irish prisons are, in the main, provided by the IPS. An exception is the provision of in-reach mental health psychiatric services by the Central Mental Hospital, which come at no cost to the IPS, as this service is funded by the Health Service Executive (HSE). Doctors are engaged either on a full- or part-time basis. The report noted that the recruitment of full-time doctors is proving difficult. As a result, the IPS are over-reliant on locum doctors, who by their nature are transitory, to provide medical services to prisons. Nurses are employees of the IPS and as such are answerable to the governors of the prisons to which they are attached.

 

The report suggested that Ireland could comply with best international practice by ensuring that the present prison-administered healthcare services form close links with the HSE. However, Judge Reilly also stated that the Department of Justice and Equality have acknowledged that the international trend is now towards a service that is within the responsibility of the Department of Health, and that the Committee of Ministers of the Council of Europe, in its official commentary to the revised and updated European Prison Rules 20063, states:

The most effective way of implementing Rule 40 [organisation of healthcare] is that the national health authority should also be responsible for providing health care in prison, as is the case in a number of European countries.

 

Judge Reilly noted that there may well be resource issues in transferring responsibility for prisoner healthcare from the IPS to the HSE and the Department of Health. However, he also stated that this cannot be used as an excuse for delaying such a transfer of responsibility. The report stressed that it must be borne in mind that the State accepts a heavy responsibility when it detains a person to ensure the well-being of that person, and that it is internationally acknowledged that a lack of financial means cannot reduce this responsibility.

 

Necessity of carrying out health needs assessment of prisoners and staffing needs analysis in each Irish prison

The report stated that irrespective of which body is responsible for healthcare in Irish prisons, be it the IPS or the HSE, a comprehensive assessment of the healthcare needs of prisoners in the 13 prisons in the Republic of Ireland must be undertaken. This must be followed by a staffing needs analysis of healthcare personnel within each prison. Judge Reilly noted that no such assessment has ever been undertaken within Ireland, and that it was impossible to express a view on the adequacy of the healthcare currently provided in Irish prisons, as it seemed to operate on an ad hoc basis.

 

Judge Reilly recommended that a Director of Healthcare, who is a registered healthcare professional, should be appointed immediately. The duty of the director would be to manage the healthcare in prisons and to oversee the transition of healthcare from the IPS to the HSE. The report also stated that the provision of healthcare in Irish prisons should not be confined to that which is provided by doctors and nurses, but should embrace all aspects of care, including addiction, psychiatric and psychology services.

 

Guidance to IPS on what will be expected of them in area of healthcare when future inspections are carried out

The report indicated that at any time upon request, prison governors and/or healthcare staff should be in a position to make the following available to inspecting officials: 

1    Reilly M (2016) Healthcare in Irish prisons. Dublin: Department of Justice and Equality. http://www.drugsandalcohol.ie/26885/

2   United Nations Human Rights Office of the High Commissioner (1966) International Covenant on Economic, Social and Cultural Rights. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx

3   Council of Europe (2006) Commentary to Recommendation REC(2006) 2 of the Committee of      Ministers to member states on the European Prison Rules. In European Prison Rules. Strasbourg: Council of Europe Publishing. https://rm.coe.int/16806f3d4f

",,,,,"Issue 62, Summer 2017",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 62, Summer 2017","Drugnet Ireland","JM , JT8_10_4 , MO4-12-2 , TU8-8-4 , TV6-2 , VH4-2","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care programme or facility > Prison-based health service -- MM-MO Crime and law > Justice system > Correctional system and facility > Prison -- T Demographic characteristics > Prison Inmate (prisoner) -- T Demographic characteristics > Offender","VA Geographic area > Europe > Ireland","Patient care management -- Health care programme or facility - Prison-based health service -- Justice system - Correctional system and facility - Prison -- Prison Inmate (prisoner) -- Offender","Europe - Ireland","Millar Sean","0","yes" "27758",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_10_4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27758",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MO4-12-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27758",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TU8-8-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27758",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TV6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27758",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667","8","archive","5",,,"disk0/00/02/76/67","2017-07-25 14:02:04","2017-07-25 14:02:04","2017-07-25 14:02:04","article",,,"show",,,,"","","","","","","","","","",,,,"Ayu","Astri Parawita","","","","Ayu:Astri Parawita::","",,,,,"","","Core addiction medicine competencies for doctors, an international consultation on training..","pub","JM","","none",,,,,,,,"BACKGROUND: Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education. METHODS: We interviewed 13 members of the International Society of Addiction Medicine (ISAM), from 12 different countries (37% response rate), over Skype, email survey or in-person - at the annual conference. We content-analysed the interview transcripts, using constant comparison methodology. RESULTS: We identified recommendations related to the core set of the addiction medicine competencies at three educational levels: (i) undergraduate (ii) postgraduate and (iii) continued medical education (CME). The participants described broad ideas, such as knowledge / skills / attitudes towards addiction to be obtained at undergraduate level, or knowledge of addiction treatment to be acquired at graduate level, as well as specific recommendations, including the need to tailor curriculum to national settings and different specialties. CONCLUSIONS: While it is unclear whether a global curriculum is needed, a consensus on a core set of principles for progression of knowledge, attitude and skills in addiction medicine to be developed at each educational level amongst medical graduates would likely have substantial value.","2017-07-18","published",,"Ayu Astri Parawita",,"","",,"Substance Abuse","Early online",,,"Taylor & Francis",,"0",,,,,,"http://dx.doi.org/10.1080/08897077.2017.1355868",,,,,"TRUE","","","",,"1747-597X",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.tandfonline.com/doi/full/10.1080/08897077.2017.1355868","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","Early online","Substance Abuse","JM , MQ6-2 , TT2-12 , VA2","J Health care, prevention and rehabilitation > Patient care management -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Doctor","VA Geographic area > International aspects","Patient care management -- Organisational development - Workforce / staff skills and training -- Doctor","International aspects","Ayu Astri Parawita , El-Guebaly Nady , Schellekens Arnt , De Jong Cor , Welle-Strand Gabrielle , Small William , Wood Evan , Cullen Walter , Klimas Jan","0","yes" "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"El-Guebaly","Nady","","",,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Schellekens","Arnt","","",,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"De Jong","Cor","","",,,,,,,,,,,,"VA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Welle-Strand","Gabrielle","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Small","William","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Wood","Evan","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cullen","Walter","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27667",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Klimas","Jan","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27601","8","archive","5",,,"disk0/00/02/76/01","2017-07-17 07:52:08","2017-07-17 07:52:08","2017-07-17 07:52:08","article",,,"show",,,,"","","","","","","","","","",,,,"Peckham","Emily","","","","Peckham:Emily::","",,,,,"","","Smoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis.","pub","BD","","none",,,,,,,,"BACKGROUND: People with severe mental ill health are more likely to smoke than those in the general population. It is therefore important that effective smoking cessation strategies are used to help people with severe mental ill health to stop smoking. This study aims to assess the effectiveness and cost -effectiveness of smoking cessation and reduction strategies in adults with severe mental ill health in both inpatient and outpatient settings. METHODS: This is an update of a previous systematic review. Electronic databases were searched during September 2016 for randomised controlled trials comparing smoking cessation interventions to each other, usual care, or placebo. Data was extracted on biochemically-verified, self-reported smoking cessation (primary outcome), as well as on smoking reduction, body weight, psychiatric symptom, and adverse events (secondary outcomes). RESULTS: We included 26 trials of pharmacological and/or behavioural interventions. Eight trials comparing bupropion to placebo were pooled showing that bupropion improved quit rates significantly in the medium and long term but not the short term (short term RR = 6.42 95% CI 0.82-50.07; medium term RR = 2.93 95% CI 1.61-5.34; long term RR = 3.04 95% CI 1.10-8.42). Five trials comparing varenicline to placebo showed that that the addition of varenicline improved quit rates significantly in the medium term (RR = 4.13 95% CI 1.36-12.53). The results from five trials of specialised smoking cessation programmes were pooled and showed no evidence of benefit in the medium (RR = 1.32 95% CI 0.85-2.06) or long term (RR = 1.33 95% CI 0.85-2.08). There was insufficient data to allowing pooling for all time points for varenicline and trials of specialist smoking cessation programmes. Trials suggest few adverse events although safety data were not always reported. Only one pilot study reported cost effectiveness data. CONCLUSIONS: Bupropion and varenicline, which have been shown to be effective in the general population, also work for people with severe mental ill health and their use in patients with stable psychiatric conditions. Despite good evidence for the effectiveness of smoking cessation interventions for people with severe mental ill health, the percentage of people with severe mental ill health who smoke remains higher than that for the general population.","2017-07-14","published",,"Peckham Emily",,"","",,"BMC psychiatry","17","1","1","BioMed Central",,"252",,,,,,,,,,,"TRUE","","","",,"1471-244X",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","https://www.ncbi.nlm.nih.gov/pubmed/?term=Smoking+cessation+in+severe+mental+ill+health%3A+what+works%3F+an+updated+systematic+review+and+meta-analysis","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","17","BMC psychiatry","BD , HK2-6 , JM , JQ6-8","B Drugs and alcohol substances > Tobacco (cigarette smoking) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care",,"Tobacco (cigarette smoking) -- Drugs and alcohol disorder treatment method - Cessation of drugs and alcohol use -- Patient care management -- Care by type of problem - Mental health care",,"Peckham Emily , Brabyn Sally , Cook Liz , Tew Garry , Gilbody Simon","0","yes" "27601",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Brabyn","Sally","","",,,,,,,,,,,,"HK2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27601",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cook","Liz","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27601",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Tew","Garry","","",,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27601",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gilbody","Simon","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253","35","archive","1684",,,"disk0/00/02/72/53","2017-07-17 08:19:38","2017-10-11 14:27:43","2017-07-17 08:19:38","monograph",,,"show",,,,"","","","","","","","","","",,,,"Bates","Geoff","","","","Bates:Geoff::","",,,,,"","","The effectiveness of interventions related to the use of illicit drugs: prevention, harm reduction, treatment and recovery. A ‘review of reviews’.","pub","AA2-4","","public",,,,,,,,,"2017-07","published",,"Bates Geoff",,"","",,,,,,"Health Research Board","Dublin",,"200 p.",,,,,"HRB Drug and Alcohol Evidence Review 5",,,,,,"","","",,,,,,,,,"","","5336","","available","","","","","",,"

This review examines the evidence on the effectiveness of interventions in the areas of harm reduction, prevention, treatment and long-term recovery related to illicit drug misuse and dependence. The primary research questions for this review were:

Evidence was identified through a ‘review of reviews’ approach. High quality systematic reviews published since 2010 were identified through a comprehensive search of relevant electronic databases, and screened for relevance against pre-defined inclusion and exclusion criteria. The quality of relevant reviews was determined using quality check tool in the Joanna Briggs Institute methods manual for undertaking umbrella reviews (JBI, 2014). Lower quality reviews and reviews published prior to 2010 were included where evidence was missing on key interventions.

In total, 97 review articles were identified to answer the primary research questions and were split across three reviews under the headings of prevention (13 reviews), harm reduction (24 reviews) and treatment and recovery (62 reviews), with two reviews covering both harm reduction and treatment interventions. Outcomes relating to the review research questions were summarised in outcomes tables of evidence. The quality of the evidence was determined using a GRADE approach and rated ‘low’, ‘medium’ or ‘high’ dependent on the quality and extent of primary studies and the consistency of the direction of findings.

","HRB library",,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"AA2-4 , AH18 , HK2 , HT6 , HZ , HZ26 , JB2 , JB2-4 , JB6 , JC4-2 , JC4-4 , JF10-10 , JF8 , JG , JM , JP10 , JT8_8_2 , TA14 , TT2-12 , TT6 , VA2","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Problem drugs and alcohol use -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Other medical treatment method > Alternative medical treatment -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Prevention outcome -- J Health care, prevention and rehabilitation > Basic prevention categories > Universal prevention -- J Health care, prevention and rehabilitation > Basic prevention categories > Targeted prevention -- J Health care, prevention and rehabilitation > Prevention by sponsor or setting > School-based prevention -- J Health care, prevention and rehabilitation > Prevention by sponsor or setting > Community-based prevention -- J Health care, prevention and rehabilitation > Prevention approach -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Adolescent / youth (teenager / young person) -- T Demographic characteristics > Doctor -- T Demographic characteristics > Prevention worker","VA Geographic area > International aspects","Prevalence of drugs and alcohol use - Problem drugs and alcohol use -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Drugs and alcohol disorder treatment method -- Other medical treatment method - Alternative medical treatment -- Psychosocial treatment method -- Treatment outcome -- Drugs and alcohol prevention -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Prevention outcome -- Basic prevention categories - Universal prevention -- Basic prevention categories - Targeted prevention -- Prevention by sponsor or setting - School-based prevention -- Prevention by sponsor or setting - Community-based prevention -- Prevention approach -- Patient care management -- Treatment and maintenance - treatment factors -- Health care programme or facility - Community-based treatment (primary care) -- Adolescent / youth (teenager / young person) -- Doctor -- Prevention worker","International aspects","Bates Geoff , Jones Lisa , Cochrane Madeleine , Pendlebury Marissa , Sumnall Harry","0","yes" "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Jones","Lisa","","",,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"5337",,"available",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cochrane","Madeleine","","",,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Pendlebury","Marissa","","",,,,,,,,,,,,"HT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Sumnall","Harry","","",,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JC4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JC4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JF10-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JF8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27253",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587","14","archive","5",,,"disk0/00/02/75/87","2017-07-14 09:01:06","2017-07-14 09:03:04","2017-07-14 09:01:06","guideline",,,"show",,,,"","","","","","","","","","",,,,"Bonnie","Richard J","","","","Bonnie:Richard J::","",,,,,"","Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse","Pain management and the opioid epidemic: balancing societal and individual benefits and risks of prescription opioid use.","pub","AA2-4","","none",,,,,,,,"Summary s-1 1 introduction 1-1 PART I Pain management and research 2 Pain management and the intersection of pain and opioid use disorder 2-1 • The scope of the problem of pain, 2-1 • Opioid analgesics, 2-4 • Nonopioid pharmacologic treatments, 2-16 • Interventional pain therapies, 2-25 • Nonpharmacologic treatments, 2-27 • Differences in pain experiences and treatment effectiveness among • Subpopulations, 2-33 • The intersection between pain and opioid use disorder, 2-36 • References, 2-36 3 Progress and future directions in research on pain and opioid use disorder 3-1 • Basic pain research, 3-1 • The neurobiology of the reward pathway and the intersection of pain and opioid • Use disorder, 3-10 • Preclinical and translational research, 3-13 • Clinical research, 3-18 • Intersection of pain and opioid use disorder, 3-26 • Support for research, 3-33 • Summary and recommendation, 3-34 • References, 3-34 PART II Addressing the opioid epidemic 4 Trends in opioid use, harms, and treatment 4-1 • Trends in prescription opioid use and misuse, 4-1 • Heroin use and its relation to prescription opioid use, 4-15 • Illicit opioid markets, 4-25 • The current state of surveillance systems, 4-32 • Recent developments in pharmaceutical treatment of opioid use disorder, 4-35 • Trends in treatment of opioid overdose with naloxone, 4-46 • Summary and recommendations, 4-48 • References, 4-49 5 Evidence on strategies for addressing the opioid epidemic 5-1 • Nature of the Evidence, 5-2 • The Need for a Systems Approach, 5-4 • Strategies for Restricting Supply, 5-10 • Strategies for Influencing Prescribing Practices, 5-21 • Strategies for Reducing Demand, 5-39 • Strategies for Reducing Harm, 5-46 • Summary and Recommendations, 5-58 • References, 5-60 6 Opioid approval and monitoring by the U.S. Food and drug administration 6-1 • Overview of the FDA’s regulatory process for prescription drugs and its application to opioids, 6-2 • Public health dimensions of FDA drug regulation, 6-17 • Key elements of an integrated decision-making framework for opioid • Regulation,6-22 • Implementation of an integrated framework for opioid regulation, 6-25 • Summary and recommendations, 6-40 • References, 6-44 • Annex table 6-1: extended-release(er)/long-acting (la) opioid post-marketing • Study requirements, 6-49 Appendixes A Data sources and methods a-1 B Biographical sketches of committee members and consultants b-1 C Existing data sources on opioid use, misuse, overdose, and other harms c-1 [Note: Download from NAP site if free, but may require guest registration with your email.]","2017-07","published",,"Bonnie Richard J",,"","",,,,,,"National Academies Press","Washington",,"380 p.",,,,,,,,,,,"report","aod_disorder","opioid",,"ISBN 978-0-309-45954-9",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://www.nap.edu/24781","https://www.nap.edu/catalog/24781/pain-management-and-the-opioid-epidemic-balancing-societal-and-individual","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AA2-4 , BL , BT6-2 , GA2 , JA6-6 , JM , MK12-2 , VD","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Problem drugs and alcohol use -- B Drugs and alcohol substances > Opioids (opiates) -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- G Health and disease > State of health -- J Health care, prevention and rehabilitation > Risk and protective factors > risk factors -- J Health care, prevention and rehabilitation > Patient care management -- MA-ML Social science, culture and community > Social costs and benefits > Social costs and benefits of drugs and alcohol","VA Geographic area > United States","Prevalence of drugs and alcohol use - Problem drugs and alcohol use -- Opioids (opiates) -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- State of health -- Risk and protective factors - risk factors -- Patient care management -- Social costs and benefits - Social costs and benefits of drugs and alcohol","United States","Bonnie Richard J , Ford Morgan A , Phillips Jonathan K , Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse","0","yes" "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ford","Morgan A","","",,,,,,,,,,,,"BL",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Phillips","Jonathan K","","",,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MK12-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27587",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27709","13","archive","5",,,"disk0/00/02/77/09","2017-08-04 07:39:46","2017-08-04 07:39:46","2017-08-04 07:39:46","guideline",,,"show",,,,"","","","","","","","","","",,,,"Nielsen","Suzanne","","","",,"",,,,,"","","Frequently asked questions on opioid agonist treatment for pharmaceutical opioid dependence: An evidence summary.","pub","BL","","public",,,,,,,,"This evidence summary from Australia comes from a program of work that aimed to build the evidence base for the treatment of pharmaceutical opioid dependence, or dependence on opioid pain medications such as oxycodone, morphine and codeine. Many of the original trials examining methadone and buprenorphine (+/- naloxone) were conducted in people dependent on heroin. In recent years new studies and revised analysis from older studies have aimed to provide information on the use of methadone and buprenorphine (+ naloxone) for those dependent on pharmaceutical opioids such as codeine, morphine and oxycodone. This document is a summary of key findings in a ‘frequently asked questions’ format.","2017-07",,,"NDARC",,"","",,,,,,"National Drug and Alcohol Research Centre","Sydney",,"16 p.",,,,,,,,,,,"guideline","aod_disorder_drug_therapy","opioid",,,,,,"NDARC",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"https://ndarc.med.unsw.edu.au/resource/frequently-asked-questions-opioid-agonist-treatment-pharmaceutical-opioid-dependence","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BL , HK2 , HK2-10 , HK2-10-2-2 , JM , VK2","B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- J Health care, prevention and rehabilitation > Patient care management","VA Geographic area > Australia and Oceania > Australia","Opioids (opiates) -- Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Patient care management","Australia and Oceania - Australia","Nielsen Suzanne","0","yes" "27709",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27709",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27709",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27709",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27709",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595","27","archive","5",,,"disk0/00/02/75/95","2017-07-14 12:06:36","2017-08-31 08:18:17","2017-07-14 12:06:36","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group","Drug misuse and dependence. UK guidelines on clinical management.","pub","GA2","","public",,,,,,,,"Contents Chapter 1: Introduction 9 Chapter 2: Essential elements of treatment provision 15 2.1 Key points 15 2.2 Assessment, planning care and treatment 15 2.3 Delivery of treatment 27 2.4 Drug testing 28 2.5 General health assessment at presentation and in treatment 31 2.6 Effective communication with primary and secondary care services 35 2.7 Organisational factors for effective drug treatment 35 2.8 Intimate partner violence and domestic abuse 43 2.9 Planning and contracting or commissioning services 44 Chapter 3: Psychosocial components of treatment 47 3.1 Key points 47 3.2 Introduction 47 3.3 Core elements underpinning effective delivery 51 3.4 Making psychosocial interventions effective 52 3.5 Interventions focused on social network and family, friends and carers 56 3.6 Medication and psychosocial interventions 57 3.7 Delivering psychosocial interventions 58 3.8 Resources and further reading 81 3.9 References 81 Chapter 4: Pharmacological interventions 83 4.1 Key points 83 4.2 Prescribing 84 4.3 Choosing an appropriate opioid substitute 88 4.4 Induction onto methadone and buprenorphine substitution treatment 90 4.5 Supervised consumption 101 4.6 Assessing and responding to progress and failure to benefit 104 4.7 Opioid maintenance prescribing 110 4.8 Opioid detoxification 115 4.9 Naltrexone for relapse prevention 118 4.10 Pharmacological management of dependence on other drugs 119 4.11 Resources and further reading 124 4.12 References 125 Chapter 5: Criminal justice system 127 5.1 Key points 127 5.2 Introduction 128 5.3 Criminal justice systems in the community 130 5.4 Prisons and other secure environments 133 5.5 References 160 Chapter 6: Health considerations 163 6.1 Key points 163 6.2 Blood-borne viruses and other infections 163 6.3 Preventing drug-related deaths 174 6.4 Naloxone 178 6.5 Alcohol in drug treatment 183 6.6 Smoking and respiratory function 187 6.7 Oral health 190 6.8 References 194 Chapter 7: Specific treatment situations and populations 197 7.1 General key points 197 7.2 Pain management 197 7.3 Dependence on prescribed and over-the-counter opioids 205 7.4 Misuse of or dependence on gabapentinoids 208 7.5 Hospitalisation 209 7.6 Pregnancy and neonatal care 220 7.7 New psychoactive substances and club drugs 225 7.8 Image and performance enhancing drugs 229 7.9 Coexisting problems with mental health and substance use 231 7.10 Young people 240 7.11 Older people 247 7.12 References 252 Annexes 255 A1: Working group members and other contributors 257 A2: Governance 263 A3: Marketing authorisations 271 A4: Writing prescriptions 277 A5: Interactions 293 A6: Travelling abroad with controlled drugs 303 A7: Drugs and driving 305 A8: Glossary 311","2017-07","published",,"Public Health England",,"","",,,,,,"Department of Health","London",,"317 p.",,,,,,,,,,,"guideline","aod_disorder","alcohol",,,,,,"Public Health England",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://findings.org.uk/PHP/dl.php?file=Clinical_Guidelines_Working_Group_1.txt&s=eb","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GA2 , HK2 , HK2-10-2-2 , HK2-10-2-2-2 , HZ , HZ26 , JB2-4 , JH10-6 , JH2-2 , JM , JP10 , JS , JT8_8_2 , JU10 , TL4 , TT2 , TT2-12 , TT2-14 , VH4-4","G Health and disease > State of health -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Health promotion -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- T Demographic characteristics > Drug user -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > United Kingdom","State of health -- Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Psychosocial treatment method -- Treatment outcome -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Health-related prevention - Health information and education - Communicable disease control -- Health-related prevention - Health information and education - Health promotion -- Patient care management -- Treatment and maintenance - treatment factors -- Health care delivery -- Health care programme or facility - Community-based treatment (primary care) -- Health care administration - Health care quality control -- Drug user -- Drug or health care worker -- Doctor -- Nurse","Europe - United Kingdom","Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group","0","yes" "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy","alcohol_drugs_in_general",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method","cannabis",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"alternative_medical_treatment","cns_depressants",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention","cns_stimulants",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction","cocaine",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method","inhale_solvent",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation","opioid",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening","psychoactive",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"prescription",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27595",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912","17","archive","5",,,"disk0/00/02/49/12","2015-12-10 08:01:41","2017-07-13 08:50:04","2015-12-10 08:01:41","article",,,"show",,,,"","","","","","","","","","",,,,"Van Hout","Marie Claire","","","","Van Hout:Marie Claire::","",,,,,"","","‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland.","pub","BL2-4","","none",,,,,,,,"Objectives: Global concern around over the counter availability of codeine containing products and risk of misuse, dependence and related harms are evident. A phenomenological study of lived experiences of codeine misuse and dependence was undertaken in Ireland, following the Pharmaceutical Society of Ireland’s 2010 guidelines for restricted supply of non-prescription codeine containing products. Methods: In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents (n=21), both actively using, in treatment and in recovery. The narratives were analysed using the Empirical Phenomenological Psychological five-step method (Karlsson, 1995). A total of 10 themes with 82 categories were identified. Two concepts at a higher level of abstraction above the theme-level emerged during the final stage of analysis. The concepts identified were ‘emotional pain and user self-legitimization of use’ and ‘entrapment into habit-forming and invisible dependent use’. These concepts were reported in different ways by a majority of participants. Results: Findings are presented under the following themes: (1) profile and product preferences; (2) awareness of habit forming use and harm; (3) negotiating pharmacy sales; (4) alternative sourcing routes; (5) the codeine feeling; (6) the daily routine; (7) acute and chronic side effects; (8) social isolation; (9) withdrawal and dependence and (10) help-seeking and treatment experiences. Conclusions: There is a public health and regulatory imperative to develop proactive responses tackling public availability of codeine containing medicines, risk minimisation in consumer self-treatment for pain, enhanced patient awareness of potential for habit forming use and its consequences and continued health professional pharmacovigilence.","2017-07","published",,"Van Hout Marie Claire",,"","",,"Qualitative Health Research","27","3","3","Sage",,"341-350",,,,,,,,,,,,"","","",,"1049-7323",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://journals.sagepub.com/doi/10.1177/1049732315613764","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","27","Qualitative Health Research","BL2-4 , BT6-1 , BT6-2 , FR16 , JA6-6 , JM , TT2-12 , TT2-18 , VH4-2","B Drugs and alcohol substances > Opioids (opiates) > Codeine -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Over the counter drug (medicine / medication) -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol -- J Health care, prevention and rehabilitation > Risk and protective factors > risk factors -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Doctor -- T Demographic characteristics > Pharmacist","VA Geographic area > Europe > Ireland","Opioids (opiates) - Codeine -- Drugs and alcohol substance by legal status - Over the counter drug (medicine / medication) -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Attitude and behaviour - Attitude toward drugs and alcohol -- Risk and protective factors - risk factors -- Patient care management -- Doctor -- Pharmacist","Europe - Ireland","Van Hout Marie Claire , Horan A , Santlal K , Rich E , Bergin M","0","yes" "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Horan","A","","",,,,,,,,,,,,"BT6-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Santlal","K","","",,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Rich","E","","",,,,,,,,,,,,"FR16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bergin","M","","",,,,,,,,,,,,"JA6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24912",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27658","10","archive","5",,,"disk0/00/02/76/58","2017-07-25 09:53:50","2017-07-25 09:53:50","2017-07-25 09:53:50","guideline",,,"show",,,,"","","","","","","","","","",,,,"Ward","Matt","","","","Ward:Matt::","",,,,,"","","Elevated alcohol consumption following alcohol cue exposure is partially mediated by reduced inhibitory control and increased craving.","pub","AD12-6","","none",,,,,,,,"Rationale: Exposure to alcohol-related cues leads to increased alcohol consumption, and this may be partially attributable to momentarily impaired impulse control. Objectives: We investigated if exposure to alcohol cues would impair inhibitory control and if the extent of this impairment would partially mediate the effect of alcohol cues on subsequent voluntary alcohol consumption. Methods: We recruited 81 heavy drinkers (50 female) who completed baseline measures of inhibitory control (stop-signal task) and subjective craving before random allocation to an alcohol cue exposure or control group. The alcohol cue exposure group then completed a second stop-signal task (with embedded alcohol cues) with concurrent exposure to olfactory alcohol cues, in an alcohol context. The control group completed a second stop-signal task (with embedded water cues), accompanied by exposure to water cues, in a neutral context. Then, subjective craving and ad libitum alcohol consumption were measured in all participants. Results: Inhibitory control worsened (compared to baseline) to a greater extent in the alcohol cue exposure group compared to the control group. Craving and ad libitum alcohol consumption were elevated in the alcohol cue exposure group compared to the control group, although the group difference in alcohol consumption fell short of statistical significance. In support of our hypotheses, multiple mediation analyses demonstrated that elevated ad libitum alcohol consumption following alcohol cue exposure was partially mediated by both impaired inhibitory control and increased craving. Conclusions: These findings suggest that state fluctuations in inhibitory control are a potential mechanism through which alcohol cues increase drinking behaviour.","2017-07",,,"Ward Matt",,"","",,"Psychopharmacology","Early online",,,"Springer",,,,,,,,,,,,,,"","aod_disorder","alcohol",,"1432-2072",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","https://link.springer.com/article/10.1007/s00213-017-4694-6","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","Early online","Psychopharmacology","AD12-6 , BB , JA6-6 , JM , JP10","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Drugs and alcohol use behaviour > Alcohol consumption -- B Drugs and alcohol substances > Alcohol -- J Health care, prevention and rehabilitation > Risk and protective factors > risk factors -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors",,"Prevalence of drugs and alcohol use - Drugs and alcohol use behaviour - Alcohol consumption -- Alcohol -- Risk and protective factors - risk factors -- Patient care management -- Treatment and maintenance - treatment factors",,"Ward Matt , Jones Andrew","0","yes" "27658",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Jones","Andrew","","",,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27658",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27658",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27658",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666","14","archive","5",,,"disk0/00/02/76/66","2017-07-25 14:03:29","2017-07-25 14:03:29","2017-07-25 14:03:29","article",,,"show",,,,"","","","","","","","","","",,,,"Crowley","Des","","","","Crowley:Des::","",,,,,"","","Exploring patient characteristics and barriers to hepatitis C treatment in patients on opioid substitution treatment attending a community based fibro-scanning clinic.","pub","BL","","none",,,,,,,,"BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is a major public health issue. There is substandard uptake in HCV assessment and treatment among people who inject drugs (PWID). Community fibroscanning is used to assess disease severity and target treatment. METHODS: A survey was administered to a cohort of chronically HCV infected patients attending a community fibroscanning clinic. Questions targeted diagnosis of HCV, suitability, willingness and barriers to engagement in treatment. Descriptive and regression analysis, with thematic analysis of open-ended data was conducted. RESULTS: There was high acceptance of community fibroscanning among this cohort with over 90% (68) attending. High levels of unemployment (90%) and homelessness (40%) were identified. Most patients were on methadone treatment and had been HCV infected for greater than 10 years with length of time since HCV diagnosis being significantly longer in patients with fibroscan scores > 8.5 kPa (P = 0.016). With each unit increase in methadone dose, the odds of the >8.5 fibroscan group increased by 5.2%. Patient identified barriers to engagement were alcohol and drug use, fear of HCV treatment and liver biopsy, imprisonment, distance to hospital and early morning appointments. CONCLUSION: The study highlights the usefulness of community fibroscanning. Identifying barriers to treatment in this cohort affords an opportunity to increase the treatment uptake. The availability of afternoon clinics and enhanced prison linkage are warranted.","2017-06","published",,"Crowley Des",,"","",,"Journal of Translational Internal Medicine","5","2","2","De Gruyter",,"112-119",,,,,,,,,,,"TRUE","","","",,"2450-131X",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506411/","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","5","Journal of Translational Internal Medicine","BL , GH16-12-6-6 , HK2-10-2-2 , HK2-10-2-2-2 , JH10-6 , JM , JP10 , JT8_8_2 , VH4-2","B Drugs and alcohol substances > Opioids (opiates) -- G Health and disease > Disorder by cause > Communicable disease > Hepatitis C -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Opioids (opiates) -- Disorder by cause - Communicable disease - Hepatitis C -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Health-related prevention - Health information and education - Communicable disease control -- Patient care management -- Treatment and maintenance - treatment factors -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","Crowley Des , Cullen Walter , Laird Eamon , Lambert John S , Mc Hugh Tina , Murphy Carol , Van Hout Marie Claire","0","no" "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cullen","Walter","","",,,,,,,,,,,,"GH16-12-6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Laird","Eamon","","",,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Lambert","John S","","",,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mc Hugh","Tina","","",,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Murphy","Carol","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Van Hout","Marie Claire","","",,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27666",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732","23","archive","5",,,"disk0/00/02/37/32","2015-04-08 08:54:21","2017-07-12 09:01:00","2015-04-08 08:54:21","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol matrix cell C5: Management/supervision - safeguarding the community.","pub","BB","","public",,,,,,,,,"2017-06","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,,,,,,,,,,,,"","aod_disorder","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

 

What is this cell about? Therapy and therapists matter of course, but so do 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 get adopted and adequately implemented, and whether staff are able to develop and maintain appropriate attitudes and knowledge, depend on management and supervision.

This cell is about the role played by these management functions in treatment organised and/or funded by criminal justice and other authorities, whose primary aim is to safeguard those in contact with the patient or the wider community. Typically in these contexts, treatment is offered or imposed not because it has been sought by the patient, but because it is thought that treating their drinking problems could cut crime, safeguard the drinker’s family, and prevent harm to others through drink-driving or other alcohol-affected behaviour. Studies which document the community and family impacts of treatment in general may also be found in this cell.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/C5.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , JP10_2_2 , JP10_6 , JT , JT8_8_2 , MM8-2 , MQ6 , MQ6-2 , TT2 , TT4-4 , TT8-2","B Drugs and alcohol substances > Alcohol -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- J Health care, prevention and rehabilitation > Health care programme or facility -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- MM-MO Crime and law > Crime prevention -- MP-MR Policy, planning, economics, work and social services > Organisational development -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Counsellor / Therapist -- T Demographic characteristics > Social worker",,"Alcohol -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Health care programme or facility -- Health care programme or facility - Community-based treatment (primary care) -- Crime prevention -- Organisational development -- Organisational development - Workforce / staff skills and training -- Drug or health care worker -- Counsellor / Therapist -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"crime_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MM8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23732",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27483","12","archive","5",,,"disk0/00/02/74/83","2017-06-29 08:58:08","2017-06-29 08:58:08","2017-06-29 08:58:08","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","National Institute for Health and Care Excellence","Liver disease. Quality standard.","pub","AM","","none",,,,,,,,,"2017-06","published",,"NICE",,"","",,,,,,"National Institute for Health and Care Excellence","London",,,,,,,,,,,,,"guideline","aod_disorder","alcohol",,,,,,"NICE",,,"","","","","","","","","","",,"

This quality standard covers identifying, assessing and managing chronic liver disease in children, young people and adults, and cirrhosis in young people and adults. It describes high-quality care in priority areas for improvement.

 

Statement 1 People with non‑alcoholic fatty liver disease are given advice on physical activity, diet and alcohol.

Statement 2 People with non‑alcoholic fatty liver disease are offered regular testing for advanced liver fibrosis.

Statement 3 Young people and adults with risk factors for cirrhosis are offered non‑invasive testing for cirrhosis.

Statement 4 Adults with cirrhosis are offered 6‑monthly surveillance for hepatocellular carcinoma.

Statement 5 Young people and adults with cirrhosis and upper gastrointestinal bleeding are given prophylactic intravenous antibiotics at presentation.

",,,,,,,,,,,"","https://www.nice.org.uk/guidance/QS152","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AM , GA2-2 , JM , JS , TT2 , TT2-12 , VH4-4","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor","VA Geographic area > Europe > United Kingdom","Drugs and alcohol effects and consequences -- State of health - Physical health -- Patient care management -- Health care delivery -- Drug or health care worker -- Doctor","Europe - United Kingdom","National Institute for Health and Care Excellence National Institute for Health and Care Excellence","0","yes" "27483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27705","12","archive","5",,,"disk0/00/02/77/05","2017-08-03 08:40:49","2017-08-03 08:40:50","2017-08-03 08:40:49","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","National Institute for Health and Care Excellence","Multimorbidity: quality standard.","pub","GA2-2","","public",,,,,,,,"This quality standard covers clinical assessment, prioritising and managing healthcare for adults aged 18 years and over with 2 or more long-term health conditions (multimorbidity). At least 1 of these conditions must be a physical health condition. It describes high-quality care in priority areas for improvement. (It does not cover care for people who have multiple mental health problems and no physical health conditions because their care is largely delivered by psychiatric services.) Improving outcomes: This quality standard is expected to contribute to improvements in the following outcomes: • health-related quality of life for adults with multimorbidity • adults with multimorbidity feeling involved in decisions about their care • effects of health problems and treatment on day-to-day activities of adults with multimorbidity.","2017-06","published",,"NICE",,"","",,,,,,"NICE","London",,"21 p.",,,,,"QS153",,,,,,"","aod_disorder","alcohol_drugs_in_general",,,,,,"NICE",,,"","","","","","","","","","",,,,,,,,,,,,,"","https://www.nice.org.uk/guidance/qs153","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GA2-2 , JM , JS , VH4-4","G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery","VA Geographic area > Europe > United Kingdom","State of health - Physical health -- Patient care management -- Health care delivery","Europe - United Kingdom","National Institute for Health and Care Excellence National Institute for Health and Care Excellence","0","yes" "27705",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27705",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27705",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27317","12","archive","5",,,"disk0/00/02/73/17","2017-05-19 15:22:44","2017-05-19 15:22:44","2017-05-19 15:22:44","guideline",,,"show",,,,"","","","","","","","","","",,,,"Webster","Russell","","","","Webster:Russell::","",,,,,"","","What do prisoners think of drug treatment?","pub","JP10_2_2","","none",,,,,,,,"A very mixed picture By way of a change today, I am actually summarising a piece of research undertaken by myself. Over the last two months I’ve been researching the experiences of opiate using offenders seeking substitute prescribing (methadone or buprenorphine – usually known as Subutex or “Subbies”) in prison and on release. Interestingly, service users had very mixed experiences with some finding access to a script easier than in the community while others received no help despite being on a prescription in the community prior to being sent to prison. I used two main methods to gain service user views. First, an online survey was completed by 102 opiate users who had been in an English or Welsh prison in the last two years. Opiate using prisoners were identified and recruited by 10 peer researchers trained, supervised and supported by the Revolving Doors Agency. Analysis of the survey data informed the second stage of the research study; a focus group with nine individuals with recent experience of Opioid Substitute Treatment (OST) in prison...........","2017-05-18","published",,"Webster Russell",,"","",,,,,,"Russell Webster",,,,,,,,,,,,,,"","aod_use_harm_reduction","alcohol_drugs_in_general",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://www.russellwebster.com/what-do-prisoners-think-of-drug-treatment-2/","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JP10_2_2 , JT8_10_4 , MO4-12 , MO4-12-2 , TU8-8-4","J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Health care programme or facility > Prison-based health service -- MM-MO Crime and law > Justice system > Correctional system and facility -- MM-MO Crime and law > Justice system > Correctional system and facility > Prison -- T Demographic characteristics > Prison Inmate (prisoner)",,"Treatment and maintenance - patient attitude toward treatment -- Health care programme or facility - Prison-based health service -- Justice system - Correctional system and facility -- Justice system - Correctional system and facility - Prison -- Prison Inmate (prisoner)",,"Webster Russell","0","yes" "27317",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_10_4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"crime_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27317",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MO4-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27317",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MO4-12-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27317",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TU8-8-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731","22","archive","5",,,"disk0/00/02/37/31","2015-04-08 08:49:08","2017-07-12 09:03:36","2015-04-08 08:49:08","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol matrix cell B5: Practitioners - safeguarding the community.","pub","BB","","public",,,,,,,,,"2017-05","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,"4 p.",,,,,,,,,,,"","aod_disorder","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

 

What is this cell about?  In cell A4’s bite we learnt that among the ‘common factors’ affecting treatment’s success is the patient’s relationships with treatment staff. This cell explores research on this relationship and on worker attributes which affect their clients’ progress in criminal justice and other settings where treatment is offered or imposed not because it has been sought by the client, but because it is thought that treating their substance use could reduce offending or otherwise benefit the community. Though across psychotherapy now seen as of at least as much importance as the intervention they are delivering, the interpersonal style and other features of staff are much less commonly researched. From the small number of documents in this cell, you will see this is particularly apparent in criminal justice and allied settings. In the expectation that the influences exerted by practitioners in these settings may not differ too much from those elsewhere, for more studies we can refer you back to the other cells dealing with practitioner influences: cell B1 for brief interventions, cell B2 for treatment in general, cell B3 for medical treatments, and cell B4 for psychosocial therapies

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B5.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , FR16-6-4-2 , JP10_2_2 , JP10_6 , TT2 , TT2-12 , TT2-14 , TT4-4 , TT8-2","B Drugs and alcohol substances > Alcohol -- F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Counsellor / Therapist -- T Demographic characteristics > Social worker",,"Alcohol -- Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Drug or health care worker -- Doctor -- Nurse -- Counsellor / Therapist -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"FR16-6-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"crime_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23731",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27226","17","archive","5",,,"disk0/00/02/72/26","2017-04-27 14:52:06","2017-04-27 14:52:06","2017-04-27 14:52:06","monograph",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","National Office for Traffic Medicine","Sláinte agus Tiomáint. Medical fitness to drive guidelines (Group 1 and Group 2 Drivers).","pub","AN8-4","","public",,,,,,,,"Sláinte agus Tiomáint provides guidance on medical fitness to drive and is aimed primarily at medical professionals and those working at the interface between road safety and health e.g. On-road Driving Assessors, the National Driver Licence Service. It supports clinicians in providing guidance to patients who may have medical fitness to drive issues. The guidelines highlight the need for all of us to appreciate that the state of our health impacts, to a greater or lesser degree, on our ability to drive safely. Driver fitness is governed by EU law and regulations made in Ireland under the Road Traffic Acts. Sláinte agus Tiomáint is an interpretation of these laws; however, the Directive/regulations form the overriding legal basis for driver medical fitness in Ireland. One of the objectives of Sláinte agus Tiomáint is to promote mobility and to do this in a way that is consistent with safety on our roads. Once a driver is aware of any health aspects that impact on driving and follows the advice of their doctor, they can continue to drive in most cases. P.15 3.9 Medications and driving P.84 Chapter 6: Drug misuse and dependence","2017-04",,,"National Office for Traffic Medicine",,"","",,,,,,"Road Safety Authority","Dublin",,"128 p.",,,,,,,,,,,"","","",,,,,"6th edition",,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.rsa.ie/en/Utility/News/2017/New-driver-information-leaflets-published-for-drivers-with-health-problems-/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"AN8-4 , AN8-4-4 , JM , MN32 , TT2-12 , VH4-2","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol related societal (social) problems > Drug use and driving -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol related societal (social) problems > Drinking and driving -- J Health care, prevention and rehabilitation > Patient care management -- MM-MO Crime and law > Transportation safety laws (driving) -- T Demographic characteristics > Doctor","VA Geographic area > Europe > Ireland","Drugs and alcohol related societal (social) problems - Drug use and driving -- Drugs and alcohol related societal (social) problems - Drinking and driving -- Patient care management -- Transportation safety laws (driving) -- Doctor","Europe - Ireland","National Office for Traffic Medicine National Office for Traffic Medicine","0","no" "27226",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AN8-4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27226",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27226",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MN32",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27226",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27226",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25451","15","archive","5",,,"disk0/00/02/54/51","2016-04-29 11:15:46","2017-05-29 08:32:44","2016-04-29 11:15:46","guideline",,,"show",,,,"","","","","","","","","","",,,,"Saulle","Rosella","","","",,"",,,,,"","","Supervised dosing with a long acting opioid medication in the management of opioid dependence.","pub","BL","","none",,,,,,,,"Take-home medication strategies are attractive to treatment services due to lower costs, and place less restrictions on clients, but it is unknown whether they may be associated with increased risk of diversion and unsanctioned use of medication. There is uncertainty about the effects of supervised dosing compared with unsupervised medication due to the low and very low quality of the evidence for the primary outcomes of interest for this review. Data on defined secondary outcomes were similarly limited. More research comparing supervised and take-home medication strategies is needed to support decisions on the relative effectiveness of these strategies. The trials should be designed and conducted with high quality and over a longer follow-up period to support comparison of strategies at different stages of treatment. In particular, there is a need for studies assessing in more detail the risk of diversion and safety outcomes of using supervised OST to manage opioid dependence.","2017-04","published",,"The Cochrane Library",,"","",,"Cochrane Database of Systematic Reviews",,"4","4","John Wiley & Sons, Ltd","London",,,,,,,"DOI: 10.1002/14651858.CD011983.pub2",,,,,,"review","aod_disorder_drug_therapy","opioid",,"ISSN: 1469-493X",,,,"The Cochrane Library",,,"","","","","","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011983.pub2/full","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","unspecified","Cochrane Database of Systematic Reviews","BL , HK2-10-2-2 , HZ26 , JM , JP10","B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors",,"Opioids (opiates) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors",,"Saulle Rosella , Vecchi Simona , Gowing Linda","0","yes" "25451",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Vecchi","Simona","","",,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25451",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gowing","Linda","","",,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25451",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25451",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525","26","archive","5",,,"disk0/00/02/25/25","2014-08-21 08:44:15","2017-04-05 07:59:52","2014-08-21 08:44:15","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell B4: Practitioners - psychosocial therapies.","pub","BB","","public",,,,,,,,,"2017-03",,,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,"7 p.",,,,,,,,,,,"","education_and_training","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

What is cell B4 about?

Every treatment involves direct or indirect human interaction, but this cell is about ‘psychosocial’ therapies in which interaction is intended to be the main active ingredient. These range in form from brief advice and counselling to extended outpatient therapies and all-embracing residential communities where clients stay for months. In their content and techniques therapies also differ, varying for example from the deep probing of psychoanalysis to the more skills-based cognitive-behavioural approaches. But as long as it is a well structured, bona fide treatment which ‘makes sense’ to patient and therapist, the ‘common factors’ shared by supposedly distinct therapies (on which see cell A4) seem more critical to their success.

For patients and researchers, how the therapist relates to the client is the main embodiment of the common factors shared by therapies and the most salient way they affect engagement and outcomes. We have seen this generally across treatment and in respect of medical treatments. Unsurprisingly, the evidence is strongest for psychosocial therapies, when the structured enactment of the therapist-client relationship is the treatment, forcing attention to it even in studies designed to minimise such influences. In this cell we focus on client-worker relationships, and on whether some therapists are more successful because they more strongly forge the right kind of relationships – ‘therapeutic’ relationships. Before moving into that territory, a reminder that therapists and counsellors typically work in organisations which limit or enhance their ability to maximise client progress, an issue explored earlier in this matrix in the context of the influence of practitioners in medically-based treatments. The same issue will emerge in this cell from a study (described in the supplementary text towards the end of this ‘bite’) which identified significant relationships between abstinence and the characteristics of the treatment organisation, but not (once organisational factors links had been taken into account) between abstinence and the client-worker relationship.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B4.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , HZ , HZ26 , JM , JP10 , JP10_2_2 , JP10_6 , MQ6-2 , TT2 , TT2-14 , TT4-4","B Drugs and alcohol substances > Alcohol -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Nurse -- T Demographic characteristics > Counsellor / Therapist",,"Alcohol -- Psychosocial treatment method -- Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Organisational development - Workforce / staff skills and training -- Drug or health care worker -- Nurse -- Counsellor / Therapist",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22525",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052","15","archive","5",,,"disk0/00/02/70/52","2017-03-20 13:03:57","2017-03-20 13:05:48","2017-03-20 13:03:57","guideline",,,"show",,,,"","","","","","","","","","",,,,"Laporte","Catherine","","","","Laporte:Catherine::","",,,,,"","","Cannabis and young users- a brief intervention to reduce their consumption (CANABIC): a cluster randomized controlled trial in primary care.","pub","AA2","","none",,,,,,,,"PURPOSE: Brief intervention to reduce cannabis is a promising technique that could be adapted for use in primary care, but it has not been well studied in this setting. We tested the efficacy of a brief intervention conducted by general practitioners among cannabis users aged 15 to 25 years. METHODS: We performed a cluster randomized controlled trial with 77 general practitioners in France. The intervention consisted of an interview designed according to the FRAMES (feedback, responsibility, advice, menu, empathy, self-efficacy) model, while the control condition consisted of routine care. RESULTS: The general practitioners screened and followed up 261 young cannabis users. After 1 year, there was no significant difference between the intervention and control groups in the median number of joints smoked per month among all users (17.5 vs 17.5; P = .13), but there was a difference in favor of the intervention among nondaily users (3 vs 10; P = .01). After 6 months, the intervention was associated with a more favorable change from baseline in the number of joints smoked (-33.3% vs 0%, P = .01) and, among users younger than age of 18, smoking of fewer joints per month (12.5 vs 20, P = .04). CONCLUSIONS: Our findings suggest that a brief intervention conducted by general practitioners with French young cannabis users does not affect use overall. They do, however, strongly support use of brief intervention for younger users and for moderate users.","2017-03","published",,"Laporte Catherine",,"","",,"Annals of Family Medicine","15","2","2",,,"131-139",,,,,,,,,,,,"review","aod_disorder","cannabis",,"1544-1717",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://www.annfammed.org/content/15/2/131.full","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","15","Annals of Family Medicine","AA2 , B6 , HZ2-2-2 , JM , JT8_8_2 , TA14 , TT2-12 , TT2-14 , VH4-6","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use -- B Drugs and alcohol substances > Cannabis / Marijuana -- HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Adolescent / youth (teenager / young person) -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > France","Prevalence of drugs and alcohol use -- Cannabis / Marijuana -- Psychosocial treatment method - Individual therapy - Brief intervention -- Patient care management -- Health care programme or facility - Community-based treatment (primary care) -- Adolescent / youth (teenager / young person) -- Doctor -- Nurse","Europe - France","Laporte Catherine , Vaillant-Roussel Hélène , Pereira Bruno , Blanc Olivier , Eschalier Bénédicte , Kinouani Shérazade , Brousse Georges , Llorca Pierre-Michel , Vorilhon Philippe","0","yes" "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Vaillant-Roussel","Hélène","","",,,,,,,,,,,,"B6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Pereira","Bruno","","",,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Blanc","Olivier","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Eschalier","Bénédicte","","",,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kinouani","Shérazade","","",,,,,,,,,,,,"TA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Brousse","Georges","","",,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Llorca","Pierre-Michel","","",,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "27052",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Vorilhon","Philippe","","",,,,,,,,,,,,"VH4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869","14","archive","5",,,"disk0/00/02/68/69","2017-02-20 08:28:08","2017-02-20 08:28:08","2017-02-20 08:28:08","guideline",,,"show",,,,"","","","","","","","","","",,,,"Parkman","Tom","","","",,"",,,,,"","","Qualitative exploration of why people repeatedly attend emergency departments for alcohol-related reasons.","pub","BB","","none",,,,,,,,"Background: Understanding why people repeatedly attend Emergency Departments (EDs) for alcohol-related reasons is an important prerequisite to identifying ways of reducing any unnecessary demands on hospital resources. We use Andersen’s Behavioural Model of Health Services Use to explore factors that contributed to repeat ED attendances. Methods: Qualitative interviews were conducted with 30 people who repeatedly attended EDs for alcohol-related reasons (≥10 attendances in the past 12 months). We recruited participants from 6 EDs in London, United Kingdom. Data on socio-demographic characteristics, substance use, contact with specialist addiction and other health services, most recent ED attendance, and previous ED attendances were analysed. Results: Participants reported long-standing health problems, almost all were unemployed, and many had limited education and unstable housing. Most held positive health beliefs about EDs, despite some negative experiences. They reported limited community resources: poor social support, inaccessible primary care services, dislike or lack of information about specialist addiction services, and difficulties travelling to services. In contrast, EDs offered immediate, sympathetic care and free transport by ambulance. Participants’ perceived need for care was high, with physical injury and pain being the main reasons for ED attendance. Conclusions: Push’ and ‘pull’ factors contributed to repeated ED use. ‘Push’ factors included individual-level problems and wider community service failings. ‘Pull’ factors included positive experiences of, and beliefs about, ED care. Community services need to better engage and support people with complex drinking problems, whilst ED staff can be more effective in referring patients to community-based services.","2017-02",,,"Biomed Central",,"","",,"BMC Health Services Research","17","140","140","BioMed Central",,,,,,,,"DOI: 10.1186/s12913-017-2091-9",,,,,,"","aod_disorder","alcohol",,"1472-6963",,,,"Biomed Central",,,"","","","","","","","","","",,,,,,,,,,,,,"","https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2091-9","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","17","BMC Health Services Research","BB , GC16-4 , GC16-6 , JP10_2_2 , JQ8-2 , JT14-4 , JT8_8_2 , TT2-12 , TT2-14","B Drugs and alcohol substances > Alcohol -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol intoxication -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse",,"Alcohol -- Drugs and alcohol disorder - Alcohol use - Alcohol intoxication -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Treatment and maintenance - patient attitude toward treatment -- Care by type of problem - emergency care -- Health care programme or facility - Hospital -- Health care programme or facility - Community-based treatment (primary care) -- Doctor -- Nurse",,"Parkman Tom , Neale Joanne , Day Ed , Drummond Colin","0","yes" "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Neale","Joanne","","",,,,,,,,,,,,"GC16-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Day","Ed","","",,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Drummond","Colin","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26869",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707","15","archive","5",,,"disk0/00/02/67/07","2017-02-02 14:25:25","2017-02-02 14:25:25","2017-02-02 14:25:25","article",,,"show",,,,"","","","","","","","","","",,,,"Galvin","Brian","","","","Galvin:Brian::","",,,,,"","","HRB drug and alcohol evidence review on case management.","pub","HJ2","","public",,,,,,,,,"2017-01",,,"Galvin Brian",,"","",,"Drugnet Ireland","Issue 60, Winter 2017",,,"Health Research Board",,"15-17",,,,,,,,,,,"FALSE","","","",,,,,,,,,"","","","","","","","","","",,"

The objective of the HRB’s recently published scoping review1 was to examine the peer-reviewed non-experimental literature on case management and substance use published between 2003 and 2013, and to answer specific research questions based on the literature. These comprised questions on the nature of case management, the outcomes studied, and gaps in the literature.

 

In a case management approach to service provision, clients are typically offered and receive, or are linked to, a range of services tailored to meet their specific, individual needs. The objective of linking clients to relevant medical and social services is a key characteristic of this approach. Case managers also frequently work as advocates for their clients. This advocacy work may involve liaising with housing associations to address accommodation needs or job centres to improve employability. The rationale behind the linkage and advocacy work is that clients frequently present with multiple needs or complications which impact on their recovery or rehabilitation. Developing and maintaining links with existing services can help to address these multiple needs and aid the recovery process. Case management is also used to increase client retention in services and improve treatment outcomes.

 

Case management: models and roles

Vanderplasschen et al. identified six basic models following their review of the case management literature up to 20032. These are outlined briefly below.

 

In recent years, the role of case management has been promoted in a number of important policy reports in Ireland, which include plans to improve service coordination for people in recovery from substance misuse. In 2007 the Report of the Working Group on Drugs Rehabilitation3 made a number of key recommendations and set out the structural arrangements required to implement them. One of these was the development of broad national protocols to facilitate interagency working; these cover issues such as confidentiality, common assessment tools, referral procedures, and conflict resolution between agencies. In 2010, the Health Service Executive (HSE) published the National Drugs Rehabilitation Framework (NDRF), setting out how services to current and former drug users were to be provided in the form of supported integrated care pathways (ICPs) with the cooperation of different service providers. The report recognised that service users may present with diverse needs, such as treatment, education, vocational training, employment support and accommodation, and that no single agency can cater for all possible needs. An individual care plan for each service user needs to be delivered by a multidisciplinary team. Where a service user has complex and multifaceted needs, a more intensive case management approach may be used. The framework stated that the provision of rehabilitation pathways is a shared responsibility of the education, training and employment sectors alongside the health, welfare and housing sector, non-governmental organisations, communities, families, and the individual themselves.

 

The ICP comprises four steps, linked to the four-tier model of service provision: initial contact, involving screening and referral; initial assessment and identification of appropriate service; comprehensive assessment, following which a case manager is identified to support the individual on their rehabilitation pathway; and implementation of the care plan.

 

The HRB’s scoping review was commissioned to examine the non-experimental research literature on case management and people in recovery from substance misuse. The objectives of the review were to explore the nature of case management as reported in the literature, document the outcomes associated with case management, and identify the gaps in the research literature. It is hoped that the report can be used by policy-makers and practitioners in Ireland to update their understanding and use of case management as an approach to improving service coordination and recovery.

 

In order to focus this review, three research questions were agreed at the outset:

  1. What additional knowledge regarding the nature of case management can we gain from a review of recent non-experimental research on the topic?
  2. What outcomes have been evaluated in the non-experimental research literature?
  3. What are the gaps in the literature?

What additional knowledge regarding the nature of case management can be gained from a review of recent non-experimental research on the topic?

Case management interventions tend to target clients experiencing extreme disadvantage relative to other substance misuse treatment clients, with a disproportionate amount applying to females. The groups of people being targeted by case management present with a multitude of personal and social problems, including substance misuse, homelessness, economic deprivation and mental health problems.

 

From the literature reviewed, it would appear that there are multiple objectives of case management, including reducing substance misuse and visits to hospital emergency departments, reducing hospital admissions, and improving social and psychological functioning. In addition, there are a number of objectives reported in the literature related to improving service coordination, such as providing linkages with medical and social services and retaining people in treatment. The identification of such a broad range of objectives points to the multiple needs of the client base and the expectations on case management as an intervention.

 

The review identified a number of features of case management delivery that were associated with improved outcomes reported in the evaluations. These included that duration and intensity of the intervention could be an important variable to consider both in future planning and evaluation of case management. Team-based case management and extensive engagement by case managers with the client group are also associated with positive outcomes.

 

What outcomes have been evaluated in the non-experimental research literature?

Of the 20 evaluations included in this review, 13 examined outcomes under the broad heading of psychosocial functioning, which, after substance use, is the second most frequent type of indicator in these studies. Two of these evaluations – one on a combination of ACT and ICM, and the other on using a community-based case management model – had a particular focus on quality-of -life issues, and both studies showed improvements in these outcome domains. Only three of the 20 evaluation studies in the review did not find sufficient evidence to support the claim that case management contributed to improved outcomes in at least one area. The improved outcomes reported in these studies may well be associated with the use of case management, or they may be due to unknown factors or influences which cannot be ruled out given the design of the evaluations reported. Only one-quarter of the evaluation studies used a comparison group; the rest of the evaluation studies used retrospective single groups and before-and-after designs.

 

What are the gaps in the literature?

Vanderplasschen et al. argue that there is a need to consider outcomes beyond drug use and other ‘socially acceptable outcomes’ and to take into account quality-of-life outcomes and clients’ subjective perceptions when evaluating the effectiveness of case management. They also noted that there is little information on the crucial features of case management and what specific aspects of this intervention contribute to specific outcomes. This is exacerbated by the lack of fidelity in implementation and the distance between the model chosen and its practical application.

 

The review identified similar gaps in the literature as those reported by Vanderplasschen et al. As pointed out above, in the 20 evaluations included in this review, two broad categories of outcomes were evaluated. The predominant use of these hard outcomes to evaluate case management suggests an overemphasis on using case management as a deficit-reduction intervention. Indeed, there is almost a complete absence in the literature of the strengths-based case management model being used and evaluated. This type of model prioritises the empowerment of the client group by emphasising their strengths and would be more amenable to evaluating the softer outcomes that may be associated with improvements in quality of life.

 

This review also identified a major gap in the literature around any attempt to identify what specific aspects of case management contribute to improved outcomes. In essence, both primary and secondary studies sought to determine whether case management works for people in recovery from substance misuse; in the main these studies and reviews have produced some evidence to suggest that case management is an effective intervention to use with this target group. While such study designs are important in determining the efficacy and effectiveness of an intervention, the authors suggest that the evidence base would also benefit from an evaluation approach that seeks to understand not only does it work, but for whom and under what conditions and contexts. They suggest that the realist approach to evaluation and synthesis may be an appropriate approach to consider for researchers and reviewers to use in future investigations of case management.

 

The authors suggested earlier that certain features of case management identified in this review ‒ notably the duration, intensity, the team-based nature of some of the work and the nature of the engagement between case managers and clients ‒ could be important variables that require further elaboration and evaluation. Although their observations are based on a small number of studies, the authors reiterate the point here and suggest that these features and perhaps many more could be investigated using the realist approach. The realist approach is a theory-driven approach to evaluation and synthesis; it seeks to uncover the processes or mechanisms that lead to particular outcomes, and the context within which this occurs.

 

A recent review in 2014 by Jackson et al.4 provides a useful example on how the realist approach may elucidate important learning about case management in future investigations4. This is a realist review and the methods used enabled the authors to draw certain conclusions about why an intervention may work sometimes and under what conditions. Its exploration of the literature in the area suggests that engagement with an intervention appears to be key to its success.

 

It could well be hypothesised that engagement is also a key mechanism that is associated with improved outcomes in clients of case management, for example, when the intervention is intensive, of longer duration, accompanied by a good working alliance between the case manager and client and with dedicated care plans. These components could well contribute to the client engaging with the intervention and ‘investing’ in their recovery and accruing some benefits. Further evaluation and synthesis of case management with people in recovery from substance misuse are needed to investigate the role of these potential features of case management in delivering improved outcomes for clients.

 

  1. Nic Gabhainn S, D’Eath M, Keane M and Sixsmith JA (2016) Scoping review of case management in the treatment of drug and alcohol misuse, 2003–2013. HRB Drug and Alcohol Evidence Review 3. Dublin: Health Research Board.
  2. Vanderplasschen W, Wolf J, Rapp RC and Broekaert E (2007) Effectiveness of different models of case management for substance-abusing populations. Journal of Psychoactive Drugs, 39(1): 81–95.
  3. Working Group on Drugs Rehabilitation (2007) National Drugs Strategy 2001‒2008: rehabilitation. Report of the Working Group on Drugs Rehabilitation, May 2007. Dublin: Department of Community, Rural and Gaeltacht Affairs.
  4. Jackson LA, Buxton JA, Dingwell J, Dykeman M, Gahagan J, Gallant K, Karabanow J, Kirkland S, LeVangie D, Sketris I, Gossop M, Davison C (2014) Improving psychosocial health and employment outcomes for individuals receiving methadone treatment: a realist synthesis of what makes interventions work. BMC Psychology, 2(1): 26.
",,,,,"Issue 60, Winter 2017",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 60, Winter 2017","Drugnet Ireland","HJ2 , HZ26 , JM , JP10 , JS , MQ6-2 , TL4 , TT2","HJ Treatment method > General treatment method concepts -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care delivery -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug user -- T Demographic characteristics > Drug or health care worker",,"General treatment method concepts -- Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors -- Health care delivery -- Organisational development - Workforce / staff skills and training -- Drug user -- Drug or health care worker",,"Galvin Brian","0","yes" "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26707",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624","16","archive","5",,,"disk0/00/02/66/24","2017-01-04 11:54:40","2017-01-04 11:54:40","2017-01-04 11:54:40","guideline",,,"show",,,,"","","","","","","","","","",,,,"Koivula","Riitta","","","","Koivula:Riitta::","",,,,,"","","How does older people’s drinking appear in the daily work of home care professionals?","pub","AD12-6","","none",,,,,,,,"AIMS - In this article the authors ask how the alcohol use of elderly home care clients affects the daily work of home care professionals and how the professionals act to support the drinking client. METHODS - Semi-structured interviews with 10 home care professionals were conducted from December 2014 to February 2015 in the Helsinki metropolitan area of Finland. Everyday situations during home visits related to the clients’ alcohol use were analysed according to modalities of agency of the home care professionals. RESULTS - The results focus on three themes raised in the interviews: supporting life management of the client, the lack of qualifications in tackling clients’ drinking and the need for multi-professional collaboration. Intoxicated clients complicated the home care nurses’ work and obstructed the implementation of recommendations set out to guide the professionals’ operations. Care work with alcohol-using clients was particularly demanding, and the professionals were concerned about not having enough training in how to encounter elderly clients’ drinking. Multi-professional collaboration with substance abuse services and emergency department personnel was called for to remedy this problem. CONCLUSIONS - More extensive and detailed research is needed for a better picture of how clients’ drinking influences home care nurses’ working conditions and what kind of skills nurses need in different alcohol-related situations. Such research would have the potential to benefit clients and improve the well-being of the employees.","2016-12",,,"Koivula Riitta",,"","",,"Nordic Studies on Alcohol and Drugs","33","5-6","5-6","De Gruyter",,,"537-50",,,,,,,,,,,"","aod_disorder","alcohol",,"1455-0725",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","https://www.degruyter.com/view/j/nsad.2016.33.issue-5-6/nsad-2016-0044/nsad-2016-0044.xml?format=INT","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","33","Nordic Studies on Alcohol and Drugs","AD12-6 , AM , BB , GC16-4 , JM , LC2-4 , TA16-6 , TT2 , TT2-14 , VH2-2","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Drugs and alcohol use behaviour > Alcohol consumption -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Alcohol -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol intoxication -- J Health care, prevention and rehabilitation > Patient care management -- L Social psychology and related concepts > Interpersonal interaction and group dynamics > Social support -- T Demographic characteristics > Elderly / Older person -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Nurse","VA Geographic area > Europe > Finland","Prevalence of drugs and alcohol use - Drugs and alcohol use behaviour - Alcohol consumption -- Drugs and alcohol effects and consequences -- Alcohol -- Drugs and alcohol disorder - Alcohol use - Alcohol intoxication -- Patient care management -- Interpersonal interaction and group dynamics - Social support -- Elderly / Older person -- Drug or health care worker -- Nurse","Europe - Finland","Koivula Riitta , Tigerstedt Christoffer , Vilkko Anni , Kuussaari Kristiina , Pajala Satu","0","yes" "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Tigerstedt","Christoffer","","",,,,,,,,,,,,"AM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Vilkko","Anni","","",,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kuussaari","Kristiina","","",,,,,,,,,,,,"GC16-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Pajala","Satu","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LC2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TA16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26624",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519","19","archive","5",,,"disk0/00/02/25/19","2014-08-21 08:10:16","2017-04-05 08:19:45","2014-08-21 08:10:16","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell A3: Interventions - medical treatment.","pub","BB","","public",,,,,,,,,"2016-11",,,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,"5 p.",,,,,,,,,,,"","aod_disorder","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

What is cell A3 about?

About the treatment of alcohol dependence in a medical context and/or involving medical care, typically by GPs or by alcohol treatment or psychiatric units in hospitals. Clinical staff are responsible for medications, so the centrality of these to an intervention distinguishes it most clearly as medical. Drugs (primarily benzodiazepines) help patients withdraw from alcohol more comfortably and safely, or (primarily in the UK acamprosate, but also naltrexone and disulfiram) are intended to sustain longer term abstinence or moderate drinking.

But drugs are never all there is to medical care. They help to forge a relatively intoxication-free space during which patients can lose the habit of regular drinking and be supported to find other ways to cope and construct lives incompatible with a return to heavy drinking. Drug-based treatments also include potentially therapeutic interactions with clinical and other staff, and ways to encourage patients to take medications. Sometimes this means enlisting family and others, deepening their involvement in the patient’s recovery. Without these factors there is a risk that any benefits of medication will be lost once the treatment ends.

Though usage has been increasing, in Britain treatment for alcohol dependence usually consists entirely of advice and support. Drugs are almost universally used to ease withdrawal in inpatient units, but in 2013/14 in England, of the 101,782 drinkers treated in non-residential community settings, just 16% were prescribed a medication. As we’ll see later in this bite, relegation of medications to a minority option accurately reflects their generally minor effects relative to the other influences which together constitute the ‘placebo effect’ seen in trials. For this ‘disease’, medications usually add little (but on average, do add a little) to the patient’s impetus to get better, the processes in their life which help them realise and sustain this ambition, and the impact of deciding to enter and get actively engaged in treatment, one manifestation of which is regularly taking medication.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/A3.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , HJ2 , HK2 , HK2-10 , HK2-10-2-2 , JM , JP10 , JS , JT14-4 , TT2-12","B Drugs and alcohol substances > Alcohol -- HJ Treatment method > General treatment method concepts -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital -- T Demographic characteristics > Doctor",,"Alcohol -- General treatment method concepts -- Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Patient care management -- Treatment and maintenance - treatment factors -- Health care delivery -- Health care programme or facility - Hospital -- Doctor",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HJ2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22519",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520","23","archive","5",,,"disk0/00/02/25/20","2014-08-21 08:15:44","2017-04-05 08:50:29","2014-08-21 08:15:44","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell B3: Practitioners - medical treatment.","pub","BB","","public",,,,,,,,,"2016-11",,,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,"3 p.",,,,,,,,,,,"","aod_disorder","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

What is cell B3 about?

About the treatment of alcohol dependence in a medical context and/or involving medical care, typically by GPs or at alcohol treatment or psychiatric units in hospitals. Clinical staff are responsible for medications, so the centrality of these to an intervention distinguishes it most clearly as medical. But drugs are never all there is to medical care, and are prescribed in a relapse-prevention role to only a minority of patients in Britain. Even when they are prescribed, the clinician-patient relationship influences whether the drugs are taken and is also a therapeutic – or possibly anti-therapeutic – influence in its own right. Apparent also in the studies set in hospital treatment units listed in cell B2, how clinicians relate to patients affects whether they enter and engage in treatment. Through these mechanisms and perhaps also directly, relationships ultimately affect the degree to which treatment helps overcome drinking problems.

Pinning down the impact of these influences is however much harder than pinning down the impacts of medications or other specific interventions. To set the scene for randomised trials, researchers can ensure some patients get treatment x, and others treatment y or no treatment at all. The relationship-forming qualities of treatment staff are less easily controlled. Rather than deliberately allocating patients to workers known to differ along these dimensions, studies often have to rely on an association between outcomes and relationship quality or staff attributes observed in everyday practice, or as a by-product of a trial organised for another purpose. Usually the most that can be said is that the findings are consistent with these qualities affecting outcomes, not that they actually did affect outcomes. Usually such research designs cannot eliminate the possibilities that clinicians are reacting to the patient’s progress rather than causing it, that patients differed from the start, or that the clinician’s behaviour and the patient’s progress are both related to other factors.

However, difficulty in demonstrating to scientific standards that something is true, does not mean it is untrue. Observations and patient feedback testifying to the role of the clinician-patient relationship are persuasive, if not clinching, evidence.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B3.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , JP10 , JP10_2_2 , JP10_6 , JS , TT2 , TT2-12 , TT2-14","B Drugs and alcohol substances > Alcohol -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse",,"Alcohol -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Health care delivery -- Drug or health care worker -- Doctor -- Nurse",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22520",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26313","14","archive","5",,,"disk0/00/02/63/13","2016-10-27 13:22:01","2016-10-27 13:22:01","2016-10-27 13:22:01","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","World Health Organization","Global report on access to hepatitis C treatment - Focus on overcoming barriers.","pub","GH16-12-6-6","","public",,,,,,,,"This is the first-ever global report on treatment access to hepatitis C medicines. The report provides the information that countries and health authorities need to identify the appropriate HCV treatment, and procure it at affordable prices. The report uses the experience of several pioneering countries to demonstrate how barriers to treatment access can be overcome. It also provides information on the production of new hepatitis C drugs and generic versions worldwide, including where the drugs are registered, where the drugs are patented and where not, and what opportunities countries have under the license agreements that were signed by some companies as well as current pricing of all recommended direct-acting antivirals (DAAs), including by generic companies all over the world. P.12 - People who inject drugs (PWID) are the group with the highest HCV prevalence, an estimated 67%. Injections among PWID with unsterilized syringes or shared injecting equipment are the major transmission mode in high-income countries and are increasingly being reported in LMICs (low- and middle-income countries). The major route of transmission in LMICs is through the reuse of syringes and needles, and through substandard infection control practices in health-care settings.","2016-10",,,"WHO",,"","",,,,,,"World Health Organization","Geneva",,"68 p.",,,,,,,,,,,"report","aod_use_harm_reduction","opioid",,,,,,"WHO",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GH16-12-6-6 , JM , MP18-2-8-16 , TL4-10-4 , VA2","G Health and disease > Disorder by cause > Communicable disease > Hepatitis C -- J Health care, prevention and rehabilitation > Patient care management -- MP-MR Policy, planning, economics, work and social services > Policy > Policy on drugs and alcohol > Harm reduction policy -- T Demographic characteristics > Intravenous / injecting drug user","VA Geographic area > International aspects","Disorder by cause - Communicable disease - Hepatitis C -- Patient care management -- Policy - Policy on drugs and alcohol - Harm reduction policy -- Intravenous / injecting drug user","International aspects","World Health Organization World Health Organization","0","yes" "26313",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26313",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MP18-2-8-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26313",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26313",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057","20","archive","5",,,"disk0/00/02/60/57","2016-09-07 08:09:04","2016-09-07 08:15:05","2016-09-07 08:09:04","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell B2: Practitioners; generic and cross-cutting issues.","pub","AD12-6","","public",,,,,,,,,"2016-09","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,"4 p.",,,,,,,,,,,"review","aod_disorder","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level.

 

What is cell B1 about?

Whether medical or psychosocial, chosen positively or under pressure, among the ‘common factors’ affecting treatment’s success is the nature of the patient’s relationships with referral and treatment staff. (Common factors are dealt with more generally in cell A2.) Relationships affect whether people want to enter and stay in treatment, and through these and also directly, the degree to which treatment helps them overcome their drinking problems. Relationships emerge partly from the patient, but of most interest is the therapist’s contribution, because this is what can be changed by recruitment, training and experience. The interpersonal style and other features of treatment staff are much less commonly researched than the nature of the intervention, and many studies try to eliminate these influences in order to focus on the specific content of the intervention. This risks eliminating what matters, in order to focus on what generally (1 2) does not.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B2.htm&format=open&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AD12-6 , BB , FR16-6-4-2 , HZ26 , JP10 , JP10_2_2 , JP10_6 , TT2 , TT2-12 , TT2-14 , TT6 , TT8-2","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Drugs and alcohol use behaviour > Alcohol consumption -- B Drugs and alcohol substances > Alcohol -- F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Prevention worker -- T Demographic characteristics > Social worker",,"Prevalence of drugs and alcohol use - Drugs and alcohol use behaviour - Alcohol consumption -- Alcohol -- Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- Treatment outcome -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Drug or health care worker -- Doctor -- Nurse -- Prevention worker -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"FR16-6-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26057",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26614","14","archive","5",,,"disk0/00/02/66/14","2017-01-03 09:18:32","2017-01-03 09:18:32","2017-01-03 09:18:32","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell D2: Organisational functioning; Generic and cross-cutting issues.","pub","BB","","public",,,,,,,,,"2016-09","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,"4 p.",,,,,,,,,,,"review","aod_disorder","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level.  

 

What is this cell about? As well as concrete things like staff, management committees, resources, and an institutional structure, organisations have links with other organisations, histories, values, priorities, and an ethos, determining whether they offer an environment in which staff and patients/clients can maximise their potential. For these and other reasons, agencies differ in how keenly and effectively they seek and incorporate knowledge and implement evidence-based practices. The best might, for example, have effective procedures for monitoring performance and identifying where improvements are needed, facilitate staff learning from research and from each other, and forge learning or service provision links with other organisations. Openness to change and encouraging sources of change such as research and staff and patient feedback emerge as key attributes, along with the will and organisation to implement change. Research cited in this cell is about the impact of these attributes and their identification and development. At this distance from the preoccupation with intervention effectiveness, research is scarce, and generic sources (incorporated for example in Australian guidance) beyond the scope of the matrices become more important.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/D2.htm&s=eb","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , JM , JS , JU10 , MQ6 , MQ6-2 , TT2","B Drugs and alcohol substances > Alcohol -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- MP-MR Policy, planning, economics, work and social services > Organisational development -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker",,"Alcohol -- Patient care management -- Health care delivery -- Health care administration - Health care quality control -- Organisational development -- Organisational development - Workforce / staff skills and training -- Drug or health care worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "26614",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26614",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26614",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26614",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26614",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26614",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185","47","archive","5",,,"disk0/00/01/51/85","2011-05-30 10:35:37","2017-02-22 10:22:18","2011-05-30 10:35:37","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","","Alcohol-use disorders overview.","pub","HZ26","","none",,,,,,,,"NICE Pathways is an online tool for health and social care professionals that brings together all related NICE guidance and associated products in a set of interactive topic-based diagrams. Visually representing everything NICE has said on a particular topic, the pathways enable you to see at a glance all of NICE's recommendations on a specific clinical or health topic. In this pathway,click on the information,implementation and guidance links for details.","2016-09","published",,"NICE",,"","",,,,,,"National Institute for Health and Clinical Excellence","London",,,,,,,"NICE Pathways",,,,,,"other","aod_disorder","alcohol",,,,,,"NICE",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://pathways.nice.org.uk/pathways/alcohol-use-disorders#content=view-info%3Aintroduction-source","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HZ26 , HK2 , JM , HZ2-2-2 , BB , JS , JU10 , GA2 , VH4-4 , GC16 , JT8_8_2 , NM6-2 , JG26_2_4_2 , TT2-12 , GC16-6 , HZ , JP10","HJ Treatment method > Treatment outcome -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- B Drugs and alcohol substances > Alcohol -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- G Health and disease > State of health -- G Health and disease > Drugs and alcohol disorder > Alcohol use -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- T Demographic characteristics > Doctor -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- HJ Treatment method > Psychosocial treatment method -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors","VA Geographic area > Europe > United Kingdom","Treatment outcome -- Drugs and alcohol disorder treatment method -- Patient care management -- Psychosocial treatment method - Individual therapy - Brief intervention -- Alcohol -- Health care delivery -- Health care administration - Health care quality control -- State of health -- Drugs and alcohol disorder - Alcohol use -- Health care programme or facility - Community-based treatment (primary care) -- Recommendations or guidelines - Practice / clinical guidelines -- Identification and screening - Identification and screening for drugs and alcohol use -- Doctor -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Psychosocial treatment method -- Treatment and maintenance - treatment factors","Europe - United Kingdom",,"0","no" "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15185",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734","13","archive","1684",,,"disk0/00/02/57/34","2016-06-27 10:40:50","2016-08-02 07:24:48","2016-06-27 10:40:50","article",,,"show",,,,"","","","","","","","","","",,,,"Cousins","Gráinne","","","","Cousins:Gráinne::","",,,,,"","","Estimating risk of alcohol dependence using empirically validated ordinal risk zones versus recommended binary risk zones of the RAPS4: a validation study using stratum-specific likelihood ratio analysis.","pub","GC16-6","","none",,,,,,,,"BACKGROUND: Effective treatment options for alcohol dependence exist; yet, only 10% of people with alcohol dependence receive treatment. The objective of the current study was to examine the performance of previously recommended Rapid Alcohol Problem Screen 4 (RAPS4) risk zones, based on single binary cut-points (RAPS4 ≥ 1; RAPS4 ≥ 2), and empirically identified RAPS4 risk zones to identify people with alcohol dependence so that further diagnostic assessment or interventions can be offered. METHOD: Stratum-specific likelihood ratio (SSLR) and receiver operating characteristic analyses were used to compare the screening performance of empirically identified ""risk zones"" on the RAPS4 to previously recommended binary cut-points in a general population sample of current drinkers in Ireland (N = 4,267). SSLRs were also used along with the pretest prevalence of alcohol dependence to estimate posttest probabilities of alcohol dependence for the recommended and empirically identified risk zones. RESULTS: The weighted prevalence estimate of alcohol dependence among current drinkers was 6.9% (9.3% men; 4.5% women). The SSLR analysis identified multiple risk zones in the RAPS4, with each of the individual scores (0, 1, 2, 3, 4) retained as 5 separate ordinal risk zones for both men and women. A comparison of the area under the receiver operating characteristic curve showed that the ordinal RAPS4 risk zones performed better than recommended binary thresholds for both men and women. Based on the pretest probability of 9.3% and the identified SSLRs for the ordinal risk zones, the posttest probability of alcohol dependence for men ranged from 1.6% for those in the lower risk zone (RAPS4 = 0) to 86.7% for those in the highest risk zone (RAPS4 = 4). The posttest probability of alcohol dependence for women ranged from 0.4% for those in the lower risk zone to 80% for those in the higher risk zone. CONCLUSIONS: The detection of alcohol dependence may be improved using the empirically identified ordinal RAPS4 risk zones for both men and women. The application of the identified SSLRs, particularly if integrated into a clinical decision support system, may be helpful for clinicians in providing feedback to patients regarding their risk of alcohol dependence.","2016-08","published",,"Cousins Gráinne",,"","",,"Alcoholism Clinical and Experimental Research","40","8","8","Wiley-Blackwell",,"1700-1706",,,,,,,,,,,"TRUE","","","",,"1530-0277",,,,,,,"","","","","available","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_in_all_cases",,"1","40","Alcoholism Clinical and Experimental Research","GC16-6 , JA6-6 , JG26_2_4_2 , JM , JP10 , TE2 , TT2-12 , VH4-2","G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- J Health care, prevention and rehabilitation > Risk and protective factors > risk factors -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- T Demographic characteristics > Gender differences -- T Demographic characteristics > Doctor","VA Geographic area > Europe > Ireland","Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Risk and protective factors - risk factors -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Treatment and maintenance - treatment factors -- Gender differences -- Doctor","Europe - Ireland","Cousins Gráinne , Mongan Deirdre , Barry Joe , Smyth Bobby , Rackard Marion , Long Jean","0","no" "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mongan","Deirdre","","",,,,,,,,,,,,"JA6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Barry","Joe","","",,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Smyth","Bobby","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Rackard","Marion","","",,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Long","Jean","","",,,,,,,,,,,,"TE2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25734",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25822","12","archive","5",,,"disk0/00/02/58/22","2016-07-20 07:53:08","2016-07-20 07:53:08","2016-07-20 07:53:08","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Medicines and Healthcare products Regulatory Agency","Citalopram: suspected drug interaction with cocaine; prescribers should consider enquiring about illicit drug use.","pub","BT6-2","","none",,,,,,,,"The UK Medicines and Healthcare products Regulatory Agency received a Coroner’s report that raised concerns about a suspected drug interaction between citalopram and cocaine after the death of a man due to subarachnoid haemorrhage. The case was discussed by the UK Commission on Human Medicine’s Pharmacovigilance Expert Advisory Group. There are plausible mechanisms for an interaction between cocaine and citalopram that could lead to subarachnoid haemorrhage, including hypertension related to cocaine and an additive increased bleeding risk in combination with citalopram. Enquiring about potential illicit drug use: Guidance from the General Medical Council states that, together with the patient, healthcare professionals should make an assessment of the patient’s condition before deciding to prescribe a medicine. The professional must have, or take, an adequate history, which considers recent use of other medicines—including non-prescription medicines, herbal medicines, illegal drugs, and medicines purchased online. In particular, when prescribing selective serotonin reuptake inhibitors (SSRIs), prescribers are reminded to enquire about cocaine use when considering drug–drug interactions and the need to avoid concurrent use of multiple serotonergic drugs. In light of this Coroner’s case, we remind prescribers to note the potential increased risk of bleeding when citalopram is prescribed to patients who are taking cocaine. More generally, the possibility of illicit drug use and interactions should be considered when prescribing any medicines that have the potential to interact adversely. Possible interactions with illicit drugs should also be considered in patients who present with suspected adverse reactions to a medicine.","2016-07-18","published",,"gov.uk",,"","",,"Drug Safety Update","9","12","12",,,,,,,,,,,,,,,"guideline","aod_use_harm_reduction","alcohol_drugs_in_general",,,,,,"gov.uk",,,"","","","","","","","","","",,,,,,,,,,,,,"","https://www.gov.uk/drug-safety-update/citalopram-suspected-drug-interaction-with-cocaine-prescribers-should-consider-enquiring-about-illicit-drug-use","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","9","Drug Safety Update","BT6-2 , GA2-4 , JM , JQ6-8 , TT2-12 , VH4-4","E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- G Health and disease > State of health > Mental health -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- T Demographic characteristics > Doctor","VA Geographic area > Europe > United Kingdom","Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- State of health - Mental health -- Patient care management -- Care by type of problem - Mental health care -- Doctor","Europe - United Kingdom","Medicines and Healthcare products Regulatory Agency Medicines and Healthcare products Regulatory Agency","0","yes" "25822",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"cocaine",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25822",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25822",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25822",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25822",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806","12","archive","5",,,"disk0/00/02/58/06","2016-07-18 12:48:01","2016-07-18 12:48:01","2016-07-18 12:48:01","guideline",,,"show",,,,"","","","","","","","","","",,,,"Kendrick","Tony","","","","Kendrick:Tony::","",,,,,"","","Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults.","pub","GA2-4","","none",,,,,,,,"What questions does this review aim to answer? • Does the use of PROMs to monitor progress in people with CMHDs improve health outcomes, including symptoms, quality of life, and social functioning? • Does the use of PROMs in people with CMHDs change the way their problems are managed, including drug therapy and referrals for specialist help? Which studies were included in the review? Trial databases were searched to find all high-quality studies of the use of PROMs to monitor the treatment of CMHDs published up to May 2015. Included studies had to be randomised controlled trials in adult participants, where the majority diagnosed had a CMHD. Seventeen studies involving 8787 participants were included in the review, nine from mental health, six from psychological therapy, and two from primary care settings. The quality of the studies was rated ‘low’ to 'moderate'. What does the evidence from the review tell us? Routine outcome monitoring of CMHDs using PROMs was not shown conclusively to be helpful in analyses combining study results, either in terms of improving patient symptom outcomes (across 12 studies), or in changing the duration of treatment for their conditions (across seven studies). It was not possible to analyse changes in drug treatment or referrals for further treatment as only two studies reported these. Similarly, health-related quality of life, social functioning, adverse events, and costs were reported in very few studies. What should happen next? More research of better quality is required, especially in primary care where most CMHDs are treated. Studies should include people treated with drugs as well as psychological therapies, and should follow them for longer than six months. As well as symptoms and length of treatment, studies should measure possible harms, quality of life, social functioning, and the costs of monitoring.","2016-07","published",,"The Cochrane Library",,"","",,"Cochrane Database of Systematic Reviews","7",,,"John Wiley & Sons, Ltd","London",,,,,,,"DOI: 10.1002/14651858.CD011119.pub2",,,,,,"review","screening","",,"ISSN: 1469-493X",,,,"The Cochrane Library",,,"","","","","","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011119.pub2/full","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","7","Cochrane Database of Systematic Reviews","GA2-4 , HZ26 , JM , JQ6-8","G Health and disease > State of health > Mental health -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care",,"State of health - Mental health -- Treatment outcome -- Patient care management -- Care by type of problem - Mental health care",,"Kendrick Tony , El-Gohary Magdy , Stuart Beth , Gilbody Simon , Churchill Rachel , Aiken Laura , Bhattacharya Abhishek , Gimson Amy , Brutt Anna L , de Jong Kim , Moore Michael","0","yes" "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"El-Gohary","Magdy","","",,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Stuart","Beth","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gilbody","Simon","","",,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Churchill","Rachel","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Aiken","Laura","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bhattacharya","Abhishek","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gimson","Amy","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Brutt","Anna L","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"de Jong","Kim","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25806",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Moore","Michael","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483","26","archive","5",,,"disk0/00/02/24/83","2014-08-14 12:31:50","2016-09-07 08:11:17","2014-08-14 12:31:50","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell B1: Practitioners - screening and brief intervention.","pub","BB","","public",,,,,,,,,"2016-06",,,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,,,,,,,,,,,,"","psychosocial_treatment_method","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level.

What is cell B1 about?

As described more fully in the cell A1 bite, screening and brief interventions are usually seen as public health measures, aiming to reduce alcohol-related harm across a population of drinkers rather than focusing on dependent individuals seeking treatment. Screening programmes aim to identify people at risk of or experiencing substance use problems who are not seeking help. Many are not at the stage where treatment is appropriate or desired, so the typical response is brief advice – the 'brief intervention'. This cell is however not about the content of the intervention (for which see cell A1), but whether its impact depends on the interpersonal style and other features of the person doing the advising – a much less commonly researched topic.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Alcohol/B1.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , GC16-6 , HC , HH , HZ2-2-2 , JG26_2_4_2 , JM , JQ8-2 , JT8_8_2 , TT2 , TT2-12 , TT2-14 , TT8-2","B Drugs and alcohol substances > Alcohol -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- HA Screening, identification, and diagnostic method > Medical screening and diagnostic method -- HA Screening, identification, and diagnostic method > Psychosocial screening and diagnostic method -- HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Social worker",,"Alcohol -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Medical screening and diagnostic method -- Psychosocial screening and diagnostic method -- Psychosocial treatment method - Individual therapy - Brief intervention -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - emergency care -- Health care programme or facility - Community-based treatment (primary care) -- Drug or health care worker -- Doctor -- Nurse -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HC",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HH",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22483",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066","28","archive","1684",,,"disk0/00/02/00/66","2013-06-24 10:15:27","2016-07-28 07:29:21","2013-06-24 10:15:26","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix: Evidence for effective treatment.","pub","BB","","none",,,,,,,,"The Alcohol Matrix is concerned with the treatment of alcohol-related problems among adults (a similar table deals with drug-related problems). It maps the terrain within which relevant evidence may be found and for each location tries to find the most important UK-relevant research and guidance. In widening contextual circles, across the top of the matrix the 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 whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. At the intersections, inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level.","2016-06","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Consortium","London",,,,,,,,,,,,,"guideline","aod_disorder_drug_therapy","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://findings.org.uk/docs/amatrix.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , HK2 , HZ , HZ26 , JG26_2_4_2 , JM , JP10 , MQ6 , MQ6-2 , VH4-4","B Drugs and alcohol substances > Alcohol -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- MP-MR Policy, planning, economics, work and social services > Organisational development -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training","VA Geographic area > Europe > United Kingdom","Alcohol -- Drugs and alcohol disorder treatment method -- Psychosocial treatment method -- Treatment outcome -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Treatment and maintenance - treatment factors -- Organisational development -- Organisational development - Workforce / staff skills and training","Europe - United Kingdom","Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20066",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25702","11","archive","5",,,"disk0/00/02/57/02","2016-06-22 15:22:56","2016-06-22 15:22:56","2016-06-22 15:22:56","monograph",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","HSE Mental Health Division","Partnership for change. Report of the Mental Health Reference Group.","pub","GA2-4","","public",,,,,,,,"The HSE Mental Health Division established a mental Health Reference Group in August 2014, consisting of 13 service users, family members and carers. The group submitted recommendations to the HSE national mental health management team that were accepted in full. The recommendations outline the key structures that will be used to engage service users, their families and carers and service providers at local and national level. In line with the recommendations, Liam Hennessy was appointed as the new Head of Service User Engagement in February and will be leading on the development of the engagement structures. A user of the mental health services himself, Liam has a background in teaching and has worked as a senior civil servant, a management consultant and, most recently, as the Service User, Assistant Inspector of Mental Health Services at the Mental Health Commission. Liam was Chair of St Patrick’s University Hospital Consumer and Carers’ Council and joint Chair of REFOCUS (Recovery Experience Forum of Carers and Users of Services), a committee of the College of Psychiatrists of Ireland. The next stages in the development of the service will include the recruitment of nine Area Leads for Engagement who will work in their designated areas, with service users and their supporters, to establish local and area forums. These forums will work in partnership with the local services to ensure that service user, family members and carer experiences and views will be taken into account in the planning and delivery of services.","2016-06","published",,"HSE Mental Health Division",,"","",,,,,,"Health Service Executive","Dublin",,"35 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"GA2-4 , JM , JQ6-8 , VH4-2","G Health and disease > State of health > Mental health -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care","VA Geographic area > Europe > Ireland","State of health - Mental health -- Patient care management -- Care by type of problem - Mental health care","Europe - Ireland","HSE Mental Health Division HSE Mental Health Division","0","no" "25702",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25702",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25702",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25715","13","archive","5",,,"disk0/00/02/57/15","2016-06-24 07:31:28","2016-08-18 08:38:58","2016-06-24 07:31:28","article",,,"show",,,,"","","","","","","","","","",,,,"Rowntree","R","","","","Rowntree:R::","",,,,,"","","How do we compare with best practice? A completed audit of benzodiazepine and z-hypnotic prescribing.","pub","BH","","none",,,,,,,,"Objectives. To compare benzodiazepine and z-hypnotic prescribing practices in an inpatient psychiatric unit to best practice standards. Methods. Medication charts of all inpatients in the psychiatric unit, over a 1-week period, were reviewed. Details of current benzodiazepine and z-hypnotic prescriptions were collected. Information collected included the substance prescribed, duration and administration instructions. Feedback was communicated to medical practitioners through a presentation and email. A re-audit was completed 4 months later. Results. There were increases in total benzodiazepine and z-hypnotic prescribing despite intervention. A reduction of 2mg occurred in the mean regular dose of benzodiazepine prescribed. Lorazepam was the most prescribed benzodiazepine throughout. In both data sets, at least 50% of regular z-hypnotics and benzodiazepines were initiated before admission. There was an increase of 14% in regular benzodiazepines initiated in hospital exceeding 4 weeks in duration. In neither data collection did regular z-hypnotics initiated in hospital exceed this cut off. A greater number of individuals were in the process of being withdrawn from regular benzodiazepine or z-hypnotic prescriptions in the re-audit. There were minimal improvements in ‘as required’ prescribing as regards documentation of an indication, time limit and maximum dose. Conclusion. The increase in overall prescribing, despite intervention, maybe because these medications continued to be indicated in the acute presentations needing inpatient treatment. The small improvements in ‘as required’ prescribing patterns suggest that the intervention was limited in effecting change in this area.","2016-06","published",,"Rowntree R",,"","",,"Irish Journal of Psychological Medicine","Early online",,,"Medmedia Group",,,,,,,,"DOI: http://dx.doi.org/10.1017/ipm.2016.24",,,,,"TRUE","","","",,"0790-9667",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://journals.cambridge.org/action/displayJournal?jid=IPM","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","Early online","Irish Journal of Psychological Medicine","BH , BH2-2 , BT6-2 , JM , JQ6-8 , JT14-4 , TT2-12","B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) -- B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) > Benzodiazepine -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital -- T Demographic characteristics > Doctor",,"Sedatives or tranquillisers (CNS depressants) -- Sedatives or tranquillisers (CNS depressants) - Benzodiazepine -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Patient care management -- Care by type of problem - Mental health care -- Health care programme or facility - Hospital -- Doctor",,"Rowntree R , Sweeney J , Crumlish N , Flynn G","0","yes" "25715",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Sweeney","J","","",,,,,,,,,,,,"BH2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25715",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Crumlish","N","","",,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25715",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Flynn","G","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25715",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25715",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25715",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471","26","archive","5",,,"disk0/00/02/54/71","2016-05-05 07:44:45","2016-05-05 07:50:17","2016-05-05 07:44:45","guideline",,,"show",,,,"","","","","","","","","","",,,,"Neale","Joanne","","","",,"",,,,,"","","Frequent attenders to accident and emergency departments: a qualitative study of individuals who repeatedly present with alcohol-related health conditions.","pub","AM","","public",,,,,,,,"Key findings • People who frequently attend Accident and Emergency (A&E) departments for alcohol-related reasons tend to experience alcohol dependence associated with multiple and complex needs, but also report diverse patterns of drinking and other substance use, and varied health and social problems. • Although A&E staff are generally sympathetic to the needs of people with complex drinking and related problems, they do not have the resources or training to provide the kind of personalised support that people who frequently attend A&E for alcohol-related reasons often need. • Assertive outreach – a treatment model that offers intensive, individualised, caseworker support for patients in the community – seems to offer good potential for helping people who frequently attend A&E for alcohol-related reasons.","2016-05","published",,"Alcohol Research UK",,"","",,,,,,"Alcohol research UK","London",,"5 p.",,,,,"Alcohol Insight Number 0134",,,,,,"report","aod_disorder","alcohol",,,,,,"Alcohol Research UK",,,"","","","","","","","","","",,"

Supplemental material:

Download a copy of the Survey Report.
Download the Patient Leaflet used in this study.

Open: The 3rd national emergency department survey of alcohol identification and intervention activity

",,,,,,,,,,,"",,"http://alcoholresearchuk.org/alcohol-insights/frequent-attenders-to-accident-and-emergency-departments-a-qualitative-study-of-individuals-who-repeatedly-present-with-alcohol-related-health-conditions/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AM , BB , FR16-6-4-2 , GA2 , GC16-6 , JM , JQ8-2 , TT2 , TT2-12 , TT2-14 , TT8-2 , VH4-4","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Alcohol -- F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- G Health and disease > State of health -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Social worker","VA Geographic area > Europe > United Kingdom","Drugs and alcohol effects and consequences -- Alcohol -- Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- State of health -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Patient care management -- Care by type of problem - emergency care -- Drug or health care worker -- Doctor -- Nurse -- Social worker","Europe - United Kingdom","Neale Joanne , Parkman Tom , Day Ed , Drummond Colin","0","yes" "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Parkman","Tom","","",,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Day","Ed","","",,,,,,,,,,,,"FR16-6-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Drummond","Colin","","",,,,,,,,,,,,"GA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25471",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482","22","archive","5",,,"disk0/00/02/24/82","2014-08-14 12:26:08","2016-07-28 07:20:55","2014-08-14 12:26:08","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell A1: Interventions - screening and brief intervention.","pub","BB","","public",,,,,,,,,"2016-05","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"","psychosocial_treatment_method","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level.

What is cell A1 about?

Screening and brief interventions are usually seen as public health measures, aiming to reduce alcohol-related harm across a population of drinkers rather than focusing on dependent individuals seeking treatment. Screening programmes aim to identify people at risk of or experiencing substance use problems who are not seeking help and would otherwise not be identified. Many are not at the stage where treatment is appropriate or desired, so the typical response is brief advice – the 'brief intervention'.

For a population-level impact a high proportion of risky-drinkers must be reached. In Britain, GPs' surgeries are the principal venue, but programmes are also mounted in other generic medical settings (eg, emergency departments) and have been tried in non-medical settings such as probation offices.

Typically a few standard questions are asked of all adult patients/clients or those in certain categories (eg, new patients, having health checks, suffering possibly alcohol-related conditions) to identify risky drinking. Those whose responses indicate hazardous/harmful drinking are then advised for what may be just a few minutes or one or two longer sessions. Patients whose scores indicate very serious problems may instead be more fully assessed and offered treatment.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Alcohol/A1.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , HC , HH , HZ2-2-2 , JG26_2_4_2 , JM , JQ8-2 , JT8_8_2 , TT2","B Drugs and alcohol substances > Alcohol -- HA Screening, identification, and diagnostic method > Medical screening and diagnostic method -- HA Screening, identification, and diagnostic method > Psychosocial screening and diagnostic method -- HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Drug or health care worker",,"Alcohol -- Medical screening and diagnostic method -- Psychosocial screening and diagnostic method -- Psychosocial treatment method - Individual therapy - Brief intervention -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - emergency care -- Health care programme or facility - Community-based treatment (primary care) -- Drug or health care worker",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HC",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HH",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22482",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552","16","archive","5",,,"disk0/00/02/55/52","2016-05-26 08:50:10","2017-02-27 11:36:43","2016-05-26 08:50:10","article",,,"show",,,,"","","","","","","","","","",,,,"Simpson","Alan","","","","Simpson:Alan::","",,,,,"","","Recovery-focused care planning and coordination in England and Wales: a cross-national mixed methods comparative case study.","pub","AH18","","none",,,,,,,,"BACKGROUND: In the UK, concerns about safety and fragmented community mental health care led to the development of the care programme approach in England and care and treatment planning in Wales. These systems require service users to have a care coordinator, written care plan and regular reviews of their care. Processes are required to be collaborative, recovery-focused and personalised but have rarely been researched. We aimed to obtain the views and experiences of stakeholders involved in community mental health care and identify factors that facilitate or act as barriers to personalised, collaborative, recovery-focused care. METHODS: We conducted a cross-national comparative study employing a concurrent transformative mixed-methods approach with embedded case studies across six service provider sites in England and Wales. The study included a survey of views on recovery, empowerment and therapeutic relationships in service users (n = 448) and recovery in care coordinators (n = 201); embedded case studies involving interviews with service providers, service users and carers (n = 117) and a review of care plans (n = 33). Quantitative and qualitative data were analysed within and across sites using inferential statistics, correlations and framework method. RESULTS: Significant differences were found across sites for scores on therapeutic relationships. Variation within sites and participant groups was reported in experiences of care planning and understandings of recovery and personalisation. Care plans were described as administratively burdensome and were rarely consulted. Carers reported varying levels of involvement. Risk assessments were central to clinical concerns but were rarely discussed with service users. Service users valued therapeutic relationships with care coordinators and others, and saw these as central to recovery. CONCLUSIONS: Administrative elements of care coordination reduce opportunities for recovery-focused and personalised work. There were few common understandings of recovery which may limit shared goals. Conversations on risk appeared to be neglected and assessments kept from service users. A reluctance to engage in dialogue about risk management may work against opportunities for positive risk-taking as part of recovery-focused work. Research to investigate innovative approaches to maximise staff contact time with service users and carers, shared decision-making in risk assessments, and training designed to enable personalised, recovery-focused care coordination is indicated.","2016-03","published",,"Simpson Alan",,"","",,"BMC Psychiatry","16","1","1","BioMed Central",,"147",,,,,,,,,,,"TRUE","","","",,"1471-244X",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868048/","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","16","BMC Psychiatry","AH18 , HZ26 , JA8-2 , JP10 , JP10_2_2 , JP10_6 , JS , MQ6 , TT2 , VH4-4-12 , VH4-4-2","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Risk and needs assessment > Risk assessment -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- J Health care, prevention and rehabilitation > Health care delivery -- MP-MR Policy, planning, economics, work and social services > Organisational development -- T Demographic characteristics > Drug or health care worker","VA Geographic area > Europe > United Kingdom > Wales -- VA Geographic area > Europe > United Kingdom > England","Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Treatment outcome -- Risk and needs assessment - Risk assessment -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Health care delivery -- Organisational development -- Drug or health care worker","Europe - United Kingdom - Wales -- Europe - United Kingdom - England","Simpson Alan , Hannigan Ben , Coffey Michael , Barlow Sally , Cohen Rachel , Jones Aled , Všetečková Jitka , Faulkner Alison , Thornton Alexandra , Cartwright Martin","0","yes" "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hannigan","Ben","","",,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Coffey","Michael","","",,,,,,,,,,,,"JA8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Barlow","Sally","","",,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cohen","Rachel","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Jones","Aled","","",,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Všetečková","Jitka","","",,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Faulkner","Alison","","",,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Thornton","Alexandra","","",,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cartwright","Martin","","",,,,,,,,,,,,"VH4-4-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25552",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26338","10","archive","5",,,"disk0/00/02/63/38","2016-11-01 11:01:16","2017-02-16 12:36:16","2016-11-01 11:01:16","article",,,"show",,,,"","","","","","","","","","",,,,"Van Hout","Marie Claire","","","","Van Hout:Marie Claire::","",,,,,"","","Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies.","pub","AM","","none",,,,,,,,"Misuse of opioid analgesics is an emergent global public health concern. Codeine has an identified abuse liability, given its effect and development of tolerance within a short timeframe on regular or excessive use. Estimation and management of misuse of over the counter (OTC) codeine containing products are hampered by widespread and easy availability and the heterogeneous and hidden nature of misuse. Continued debate around availability centre on increasing evidence of misuse, dependence and adverse health effects associated with presence of non-opioid agents (paracetamol, ibuprofen) in combination products, and lack of evidence of a significant clinical analgesic benefit of combining low dose codeine in OTC products. Limited up scheduling that still enables purchase of codeine products without a prescription, and varied measures of pharmacist intervention at point of sale have not succeeded in curtailing therapeutic and non-therapeutic forms of misuse. This commentary broadly discusses the concepts of medication misuse, codeine's potential for misuse and dependence, characteristics of codeine misuse in general, harms from OTC codeine products in particular, 'unique issues' with OTC codeine products, the problems with scheduling solutions and pharmacy based interventions targeting users, along with the supports needed for these interventions. The recent introduction of new OTC combinations of non-opioid agents which provide greater analgesic efficacy than OTC codeine combination analgesics with no risk of opioid dependence provides a satisfactory alternative to these widely misused products.","2016-01","published",,"Van Hout Marie Claire",,"","",,"International Journal of Drug Policy","27",,,"Elsevier",,"17-22",,,,,,"DOI: 10.1016/j.drugpo.2015.09.007",,,,,"TRUE","","","",,"0955-3959",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.sciencedirect.com/science/article/pii/S0955395915003023","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","27","International Journal of Drug Policy","AM , BL2-4 , BT6-1 , JM , TT2-18","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Opioids (opiates) > Codeine -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Over the counter drug (medicine / medication) -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Pharmacist",,"Drugs and alcohol effects and consequences -- Opioids (opiates) - Codeine -- Drugs and alcohol substance by legal status - Over the counter drug (medicine / medication) -- Patient care management -- Pharmacist",,"Van Hout Marie Claire , Norman Ian","0","yes" "26338",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Norman","Ian","","",,,,,,,,,,,,"BL2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26338",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BT6-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26338",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26338",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25864","13","archive","5",,,"disk0/00/02/58/64","2016-07-26 09:33:53","2016-07-26 09:34:25","2016-07-26 09:33:53","guideline",,,"show",,,,"","","","","","","","","","",,,,"Bhui","Kamaldeep S","","","","Bhui:Kamaldeep S::","",,,,,"","","Smuggling compassion into care: is the NHS destined for system D?","pub","FR16-6-4-2","","none",,,,,,,,"Editorial: Compassion requires emotional connection, role exchange, empathy, experimentation and exploration of people’s world views and experiences, their perspectives on what troubles them beyond the illness label, and a shift of the professional gaze to the person’s location in a social world of relationships and a life-course legacy of risks which include genetics and life events, and current contextual impacts. A remarkable positive consequence is that the practitioner feels that they can perform their professional role with their full range of skills, and without a conveyor-belt culture of processing and outcome measurement, before and after unthinking intervention. The sense that the system we work in is not socially inclusive, and transmits inequity, as only the most able remain engaged and effective consumers, erodes the ethos of professionals. The skill of exploring the personal biographies and narratives of patients requires flexible and reflexive awareness by professionals of their own histories, and therefore connection with the true self rather than alienation from one’s ethos and values. The notion of smuggling ideas, of commodities, of geopolitical and imperial conquests, of romantic piracy all come together to reveal that smuggling is a pretty ordinary part of the informal economy of organisations and societies (Harvey, 2016). All organisations have creative spaces in which people negotiate and resolve shortages of resources, conflicting interests and avoid scrutiny in order to realise what is not attended to or seen as important in formal economies and structures, alternatively known as System D. Should compassion be relegated to the System D in NHS practice, or health care in any country? Surely not.","2016",,,"Bhui Kamaldeep S",,"","",,"Australian & New Zealand Journal of Psychiatry","50","7","7","Sage",,,"611-12",,,,,"DOI: 10.1177/0004867416654577",,,,,,"","aod_disorder_treatment_method","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://anp.sagepub.com/content/50/7/611.long","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","50","Australian New Zealand Journal of Psychiatry","FR16-6-4-2 , JM , JP10_6 , JQ6-8 , JS , MQ6-2 , VH4-4","F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- J Health care, prevention and rehabilitation > Health care delivery -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training","VA Geographic area > Europe > United Kingdom","Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- Patient care management -- Treatment and maintenance - provider attitude toward treatment -- Care by type of problem - Mental health care -- Health care delivery -- Organisational development - Workforce / staff skills and training","Europe - United Kingdom","Bhui Kamaldeep S","0","yes" "25864",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25864",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25864",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25864",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25864",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25864",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25875","13","archive","5",,,"disk0/00/02/58/75","2016-07-27 09:13:54","2017-02-08 11:37:07","2016-07-27 09:13:54","article",,,"show",,,,"","","","","","","","","","",,,,"Carroll","R","","","","Carroll:R::","",,,,,"","","Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentation.","pub","FS62","","none",,,,,,,,"PURPOSE: Self-harm patient management varies markedly between hospitals, with fourfold differences in the proportion of patients who are admitted to a medical or psychiatric inpatient bed. The current study aimed to investigate whether differences in admission practices are associated with patient outcomes (repeat self-harm) while accounting for differences in patient case mix. METHODS: Data came from the National Self-Harm Registry Ireland. A prospective cohort of 43,595 self-harm patients presenting to hospital between 2007 and 2012 were included. As well as conventional regression analysis, instrumental variable (IV) methods utilising between hospital differences in rates of hospital admission were used in an attempt to gain unbiased estimates of the association of admission with risk of repeat self-harm. RESULTS: The proportion of self-harm patients admitted to a medical bed varied from 10 to 74 % between hospitals. Conventional regression and IV analysis suggested medical admission was not associated with risk of repeat self-harm. Psychiatric inpatient admission was associated with an increased risk of repeat self-harm in both conventional and IV analyses. This increased risk persisted in analyses stratified by gender and when restricted to self-poisoning patients only. CONCLUSIONS: No strong evidence was found to suggest medical admission reduces the risk of repeat self-harm. Models of health service provision that encourage prompt mental health assessment in the emergency department and avoid unnecessary medical admission of self-harm patients appear warranted. Psychiatric inpatient admission may be associated with a heightened risk of repeat self-harm in some patients, but these findings could be biased by residual confounding and require replication.","2016","published",,"Carroll R",,"","",,"Social Psychiatry and Psychiatric Epidemiology","51","11","11","Springer",,"1485-1493",,,,,,"10.1007/s00127-016-1247-y",,,,,"TRUE","","","",,"1433-9285",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://nsrf.ie/wp-content/uploads/journals/2016/Carroll%20et%20al%202016.pdf","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","51","Social Psychiatry and Psychiatric Epidemiology","FS62 , FS62_4 , JH10-4 , JM , JT14-4 , VH4-2","F Concepts in psychology > Specific attitude and behaviour > self-destructive behaviour -- F Concepts in psychology > Specific attitude and behaviour > self-destructive behaviour > suicidal behaviour / suicide -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Suicide prevention -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital","VA Geographic area > Europe > Ireland","Specific attitude and behaviour - self-destructive behaviour -- Specific attitude and behaviour - self-destructive behaviour - suicidal behaviour / suicide -- Health-related prevention - Health information and education - Suicide prevention -- Patient care management -- Health care programme or facility - Hospital","Europe - Ireland","Carroll R , Corcoran Paul , Griffin E , Perry I , Arensman Ella , Gunnell D , Metcalfe C","0","yes" "25875",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Corcoran","Paul","","",,,,,,,,,,,,"FS62_4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25875",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Griffin","E","","",,,,,,,,,,,,"JH10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25875",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Perry","I","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25875",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Arensman","Ella","","",,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25875",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gunnell","D","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25875",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Metcalfe","C","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507","14","archive","5",,,"disk0/00/02/55/07","2016-05-11 15:15:54","2016-07-19 12:45:21","2016-05-11 15:15:54","article",,,"show",,,,"","","","","","","","","","",,,,"Darker","Catherine D","","","","Darker:Catherine D::","",,,,,"","","Screening and brief interventions for illicit drug use and alcohol use in methadone maintained opiate-dependent patients: results of a pilot cluster randomized controlled trial feasibility study.","pub","GC14","","none",,,,,,,,"BACKGROUND AND OBJECTIVES: The present study evaluated the effectiveness of a single clinician delivered brief intervention (BI) to reduce problem alcohol use and illicit substance use in an opiate-dependent methadone maintained cohort of patients attending for treatment. METHODS: Four addiction treatment centers were randomly assigned to either treatment as usual (TAU; control group) or BI (intervention group). Clinicians screened patients using the alcohol, smoking, and substance involvement screening test (ASSIST) screening tool at baseline and again at three-month follow up. Fidelity checks were performed to ensure that training was delivered effectively and uniformly across all study sites. Feasibility of administering a BI within daily practice was assessed through intervention fidelity checks, patient satisfaction questionnaires and process evaluation. RESULTS: A total of 465 patients were screened (66% of the overall eligible population) with a total of 433 (93%) ASSIST positive cases. Randomization was effective, with no differences in the control versus the intervention arms at baseline for key demographic or clinical indicators including substance us. There was a statistically significant difference between global risk score for the intervention (x = 39.36, sd = 25.91) group and the control group (x = 45.27, SD = 27.52) at 3-month follow-up (t(341) = -2.07, p < .05). CONCLUSIONS: This trial provides the first evidence that a single clinician delivered BI can result in a reduction in substance use within a methadone maintained opiate-dependent cohort, and this effect is sustained at three month follow up.","2016","published",,"Darker Catherine D",,"","",,"Substance Use & Misuse","51","9","9","Informa healthcare",,"1104-1115",,,,,,,,,,,"TRUE","","","",,"1532-2491",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.tandfonline.com/doi/abs/10.3109/10826084.2016.1160118","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","51","Substance Use Misuse","GC14 , HC , HK2-10-2-2-2 , HZ2-2-2 , HZ26 , JG26_2_4_2 , JM , VH4-2","G Health and disease > Drugs and alcohol disorder > Multiple drugs and alcohol use (Polydrug) -- HA Screening, identification, and diagnostic method > Medical screening and diagnostic method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management","VA Geographic area > Europe > Ireland","Drugs and alcohol disorder - Multiple drugs and alcohol use (Polydrug) -- Medical screening and diagnostic method -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Psychosocial treatment method - Individual therapy - Brief intervention -- Treatment outcome -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management","Europe - Ireland","Darker Catherine D , Sweeney Brion , Keenan Eamon , Whiston Lucy , Anderson Rolande , Barry Joseph","0","no" "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Sweeney","Brion","","",,,,,,,,,,,,"HC",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Keenan","Eamon","","",,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Whiston","Lucy","","",,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Anderson","Rolande","","",,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Barry","Joseph","","",,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25507",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681","21","archive","1684",,,"disk0/00/02/66/81","2017-02-02 15:20:53","2017-03-01 15:26:01","2017-02-02 15:20:53","monograph",,,"show",,,,"","","","","","","","","","",,,,"Nic Gabhainn","Saoirse","","","","Nic Gabhainn:Saoirse::","",,,,,"","","Scoping review of case management in the treatment of drug and alcohol misuse, 2003–2013.","pub","HK2","","public",,,,,,,,"This is the final report of a scoping review commissioned by the HRB National Drugs Library. The objective of the review was to examine the peer-reviewed non-experimental literature on case management and substance use published between 2003 and 2013, and to answer specific research questions based on the literature. These comprised questions on the nature of case management, the outcomes that have been studied, and gaps in the literature.","2016","published",,"Nic Gabhainn Saoirse",,"","",,,,,,"Health Research Board","Dublin",,"64 p.",,,,,"HRB drug and alcohol evidence review 3",,,,,,"","","","ISSN: 2009-7948 Online",,,,,,,,"","","5311","","available","","","","","",,,"HRB library",,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"HK2 , JM , JS , ML8-2 , MQ8 , MQ8-2 , TT2 , TT6 , TT8-2 , VA2","HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- MA-ML Social science, culture and community > Community action > Community involvement > AOD task forces -- MP-MR Policy, planning, economics, work and social services > Programme planning, implementation, and evaluation -- MP-MR Policy, planning, economics, work and social services > Programme planning, implementation, and evaluation > Programme planning (strategy) -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Prevention worker -- T Demographic characteristics > Social worker","VA Geographic area > International aspects","Drugs and alcohol disorder treatment method -- Patient care management -- Health care delivery -- Community action - Community involvement - AOD task forces -- Programme planning, implementation, and evaluation -- Programme planning, implementation, and evaluation - Programme planning (strategy) -- Drug or health care worker -- Prevention worker -- Social worker","International aspects","Nic Gabhainn Saoirse , D'Eath M , Keane Martin , Sixsmith Jane","0","no" "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"D'Eath","M","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Keane","Martin","","",,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Sixsmith","Jane","","",,,,,,,,,,,,"ML8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26681",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26334","12","archive","5",,,"disk0/00/02/63/34","2016-11-01 09:12:49","2016-11-01 09:12:49","2016-11-01 09:12:49","guideline",,,"show",,,,"","","","","","","","","","",,,,"Friedrichs","Anke","","","","Friedrichs:Anke::","",,,,,"","","Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature.","pub","HZ26","","none",,,,,,,,"BACKGROUND: Shared Decision Making (SDM) as means to the involvement of patients in medical decision making is increasingly demanded by treatment guidelines and legislation. Also, matching of patients' preferences to treatments has been shown to be effective regarding symptom reduction. Despite promising results for patients with substance use disorders (SUD) no systematic evaluation of the literature has been provided. The aim is therefore to give a systematic overview of the literature of patient preferences and SDM in the treatment of patients with SUD. METHODS: An electronic literature search of the databases Medline, Embase, Psyndex and Clinical Trials Register was performed. Variations of the search terms substance use disorders, patient preferences and SDM were used. For data synthesis the populations, interventions and outcomes were summarized and described according to the PRISMA statement. Methodological quality of the included articles was assessed with the Mixed Methods Appraisal Tool. RESULTS: N = 25 trials were included in this review. These were conducted between 1986 and 2014 with altogether n = 8.729 patients. Two studies found that patients with SUD preferred to be actively involved in treatment decisions. Treatment preferences were assessed in n = 18 studies, where the majority of patients preferred outpatient compared with inpatient treatment. Matching patients to preferences resulted in a reduction on substance use (n = 3 studies), but the majority of studies found no significant effect. Interventions for SDM differed across patient populations and optional therapeutic techniques. DISCUSSION: Patients with substance use disorders should be involved in medical treatment decisions, as patients with other health conditions. A suitable approach is Shared Decision Making, emphasizing the patients' preferences. However, due to the heterogeneity of the included studies, results should be interpreted with caution. Further research is needed regarding SDM interventions in patient populations with substance use disorders.","2016","published",,"PLOS One",,"","",,"PloS one","11","1","1","National Library for Public Health",,"e0145817",,,,,,"http://dx.doi.org/10.1371/journal.pone.0145817",,,,,,"","aod_disorder","alcohol_drugs_in_general",,"1932-6203",,,,"PLOS One",,,"","","","","","","","","","",,"

 

[See also article in Drug and Alcohol Findings, 27 September 2016, http://findings.org.uk/PHP/dl.php?file=Friedrichs_A_1.txt&s=]

",,,,,,,,,,,"","http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145817","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","11","PloS one","HZ26 , JM , JP10 , JP10_2_2 , JP10_6","HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment",,"Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment",,"Friedrichs Anke , Spies Maren , Härter Martin , Buchholz Angela","0","yes" "26334",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Spies","Maren","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26334",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Härter","Martin","","",,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26334",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Buchholz","Angela","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26334",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24881","13","archive","5",,,"disk0/00/02/48/81","2015-12-02 09:56:03","2015-12-02 09:56:03","2015-12-02 09:56:03","guideline",,,"show",,,,"","","","","","","","","","",,,,"Harris","Jane","","","","Harris:Jane::","",,,,,"","","Late diagnosis of HIV in the United Kingdom: An evidence review.","pub","GH16-12-20-2","","public",,,,,,,,"•Late diagnosis of HIV remains an important public health issue in the UK, with 40% of newly diagnosed individuals in 2014 diagnosed late •Reducing the number of people presenting to care at a late stage of HIV infection is a key public health priority in the United Kingdom. It is one of only three sexual health indicators included on the Public Health Outcomes Framework for England and a key ambition of the Framework for Sexual Health Improvement in England •Late diagnosis of HIV is defined as having a CD4 count of less than 350 cells per mm3 within 3 months of diagnosis and is associated with significantly heightened levels of HIV related morbidity and mortality, increased risk of onward HIV transmission (Halve it, 2011) and higher healthcare costs •Evidence suggests that certain groups are disproportionally affected by late diagnosis, namely older adults, heterosexuals and non-national populations, in particular black Africans •Evidence suggest that the majority of individuals have lowered perceptions of their risk of acquiring HIV and for those who have recent high risk behaviour, fear of disease is an important barrier to testing. Amongst black African populations, there are additional barriers to testing including a heightened fear of disclosure due to stigma •Amongst healthcare professionals, missed diagnostic opportunities are well documented and are linked to clinician’s own perceptions of risk and a lack of knowledge of HIV and testing procedures •Interventions to expand testing beyond routine settings have been shown as both acceptable and feasible to patients and staff and, cost effective. Pilots to expand testing in hospital and primary care settings have found varying levels of testing activity among clinicians suggesting that support and training for healthcare staff is necessary and effective in increasing testing •Community outreach testing has been found particularly effective among MSM and black African populations. Research suggests that effective interventions must be: grounded in community mobilisation and outreach settings; normalise both testing and treatment for HIV and, address HIV related stigma. Emerging evidence also suggests that new home sampling and home testing methods will be particularly effective in accessing harder to reach groups particularly among MSM","2015-12-02","published",,"Harris Jane",,"","",,,,,,"Liverpool John Moores University",,,"20 p.",,,,,,,,,,,"review","aod_use_harm_reduction","opioid",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GH16-12-20-2 , JB2-4 , JH10-6-2 , JM , TL4-10-4 , VH4-4","G Health and disease > Disorder by cause > Communicable disease > HIV infection -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control > HIV prevention -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Intravenous / injecting drug user","VA Geographic area > Europe > United Kingdom","Disorder by cause - Communicable disease - HIV infection -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Health-related prevention - Health information and education - Communicable disease control - HIV prevention -- Patient care management -- Intravenous / injecting drug user","Europe - United Kingdom","Harris Jane , Khatri Rose","0","yes" "24881",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Khatri","Rose","","",,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24881",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24881",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24881",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24881",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24915","10","archive","5",,,"disk0/00/02/49/15","2015-12-10 12:19:18","2015-12-10 12:19:18","2015-12-10 12:19:18","article",,,"show",,,,"","","","","","","","","","",,,,"Calami","Alvise","","","","Calami:Alvise::","",,,,,"","","The challenge of opioid-induced hyperalgeisa.","pub","AM","","none",,,,,,,,"Long-term exposure to opiates or synthetic opioids has been shown to sensitise subjects to painful stimuli. This is of significances in the areas of chronic pain management (as patients receiving opioid analgesia can actually become more sensitive to pain) and in managing acute and chronic pain in people on the methadone replacement programme for addiction to opiates,","2015-12","published",,"Calami Alvise",,"","",,"Forum","32","11","11","Irish College of General Practitioners",,"39-42",,,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","32","Forum","AM , BL , GA2-2 , JM , TT2-12 , VH4-2","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Opioids (opiates) -- G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Doctor","VA Geographic area > Europe > Ireland","Drugs and alcohol effects and consequences -- Opioids (opiates) -- State of health - Physical health -- Patient care management -- Doctor","Europe - Ireland","Calami Alvise , Dowdall Deirdre","0","yes" "24915",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Dowdall","Deirdre","","",,,,,,,,,,,,"BL",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24915",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24915",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24915",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24915",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067","17","archive","5",,,"disk0/00/02/60/67","2016-09-09 09:10:12","2016-09-09 09:10:12","2016-09-09 09:10:12","guideline",,,"show",,,,"","","","","","","","","","",,,,"Williams","Janet F","","","","Williams:Janet F::","",,,,,"","","Fetal Alcohol Spectrum Disorders. Clinical report: Guidance for the clinician in rendering pediatric care.","pub","BB","","none",,,,,,,,"Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. In 1973, fetal alcohol syndrome was first described as a specific cluster of birth defects resulting from alcohol exposure in utero. Subsequently, research unequivocally revealed that prenatal alcohol exposure causes a broad range of adverse developmental effects. Fetal alcohol spectrum disorder (FASD) is the general term that encompasses the range of adverse effects associated with prenatal alcohol exposure. The diagnostic criteria for fetal alcohol syndrome are specific, and comprehensive efforts are ongoing to establish definitive criteria for diagnosing the other FASDs. A large and growing body of research has led to evidence-based FASD education of professionals and the public, broader prevention initiatives, and recommended treatment approaches based on the following premises: ▪ Alcohol-related birth defects and developmental disabilities are completely preventable when pregnant women abstain from alcohol use. ▪ Neurocognitive and behavioral problems resulting from prenatal alcohol exposure are lifelong. ▪ Early recognition, diagnosis, and therapy for any condition along the FASD continuum can result in improved outcomes. ▪ During pregnancy: ◦no amount of alcohol intake should be considered safe; ◦there is no safe trimester to drink alcohol; ◦all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and ◦binge drinking poses dose-related risk to the developing fetus.","2015-11","published",,"Williams Janet F",,"","",,"Pediatrics","136","5","5","American Academy of Pediatrics",,,"14 p.",,,,,"DOI: 10.1542/peds.2015-3113",,,,,,"report","aod_disorder","alcohol",,"1098-4275",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://pediatrics.aappublications.org/content/early/2015/10/13/peds.2015-3113","http://pediatrics.aappublications.org/content/pediatrics/early/2015/10/13/peds.2015-3113.full.pdf","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","136","Pediatrics","BB , ED4-12 , GA2 , GJ2-16-2-4-6 , JM , JS , T10-4-2 , TT2-12 , TW2-10-4 , VD","B Drugs and alcohol substances > Alcohol -- E Concepts in biomedical areas > Pregnancy -- G Health and disease > State of health -- G Health and disease > Disorder by cause > Developmental disorder > Foetal (fetal) alcohol syndrome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Pregnant woman -- T Demographic characteristics > Doctor -- T Demographic characteristics > Child of drugs and alcohol user","VA Geographic area > United States","Alcohol -- Pregnancy -- State of health -- Disorder by cause - Developmental disorder - Foetal (fetal) alcohol syndrome -- Patient care management -- Health care delivery -- Pregnant woman -- Doctor -- Child of drugs and alcohol user","United States","Williams Janet F , Smith Vincent C","0","yes" "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Smith","Vincent C","","",,,,,,,,,,,,"ED4-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GJ2-16-2-4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"T10-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TW2-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26067",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24620","13","archive","5",,,"disk0/00/02/46/20","2015-10-14 07:20:55","2015-10-14 07:20:55","2015-10-14 07:20:55","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","BMA Board of Science","Prescribed drugs associated with dependence and withdrawal – building a consensus for action. Analysis report.","pub","BH","","public",,,,,,,,"Prescribing is a major clinical activity and a key therapeutic tool for influencing the health of patients. When certain psychoactive drugs are inappropriately prescribed there is potential for patients to become dependent or suffer withdrawal symptoms, leading to a range of health and social harms. The prescription of a number of these drugs continues to rise mainly because of longer term use, and this issue is becoming increasingly ingrained with complex medical, political and ethical challenges. Too little is known about prescribing patterns, the levels of dependence and withdrawal, and the level of harm that is being caused. There is also too little research about the long-term effects of these drugs. This analysis report has been developed following the board of science’s call for evidence undertaken in March 2014. It aims to provide a platform for action to improve the prevention, identification and management of dependence and withdrawal associated with prescribed drugs, and has a particular focus on the prescribed use of benzodiazepines, z-drugs, opioids and antidepressants.","2015-10","published",,"BMA",,"","",,,,,,"British Medical Association","London",,"44 p.",,,,,,,,,,,"report","aod_disorder","prescription",,,,,,"BMA",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BH , BH2-2 , BT6-2 , JM , TT2-12 , VH4-4","B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) -- B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) > Benzodiazepine -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Doctor","VA Geographic area > Europe > United Kingdom","Sedatives or tranquillisers (CNS depressants) -- Sedatives or tranquillisers (CNS depressants) - Benzodiazepine -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Patient care management -- Doctor","Europe - United Kingdom","BMA Board of Science BMA Board of Science","0","yes" "24620",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BH2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24620",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24620",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24620",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24620",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580","18","archive","5",,,"disk0/00/02/45/80","2015-10-06 11:13:40","2015-10-06 11:13:40","2015-10-06 11:13:40","guideline",,,"show",,,,"","","","","","","","","","",,,,"Dolan","Kate","","","",,"",,,,,"","","Medication-assisted treatment of opioid dependence information toolkit.","pub","BL","","public",,,,,,,,"This information kit developed by researchers at the National Drug and Alcohol Research Centre at UNSW provides a step by step guide to the evidence for medically assisted treatment for heroin dependence as well as answering commonly asked questions. Heroin or opioid dependence can be treated with medication and psychosocial support, also known as medication-assisted treatment of opioid dependence (MATOD). The most common medicines used for MATOD in Australia are methadone, buprenorphine and naltrexone. There is a strong body of research that underpins the use of these and other medicines, but NDARC’s Professor Kate Dolan says often people are uncertain about the role of MATOD in treating heroin or opioid use and dependence. “Heroin dependence can lead to serious health, social and economic consequences for users, their families and society,” said Professor Dolan. “The more information and easy to understand research evidence we can provide for affected people and for the wider community, the better outcomes for those seeking help.” This Information Kit includes two booklets. The first booklet answers some of the most frequently asked questions about MATOD and addresses common misunderstandings, while the second booklet provides a review of evidence of MATOD.","2015-10","published",,"NDARC",,"","",,,,,,"Australian National Council on Drugs","Sydney",,,,,,,,,,,,,"review","aod_disorder","opioid",,,,,,"NDARC",,,"","","","","","","","","","",,,,,,,,,,,,,"","https://ndarc.med.unsw.edu.au/news/new-ndarc-resource-provides-heroin-dependence-treatment-information","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BL , BL2-1 , BL2-3 , HK2-10 , HK2-10-2-2 , JM , RA14 , VA2","B Drugs and alcohol substances > Opioids (opiates) -- B Drugs and alcohol substances > Opioids (opiates) > Methadone -- B Drugs and alcohol substances > Opioids (opiates) > Buprenorphine -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- J Health care, prevention and rehabilitation > Patient care management -- R Research > Research outcome","VA Geographic area > International aspects","Opioids (opiates) -- Opioids (opiates) - Methadone -- Opioids (opiates) - Buprenorphine -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Patient care management -- Research outcome","International aspects","Dolan Kate , Mehrjerdi Zahra Alam","0","yes" "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mehrjerdi","Zahra Alam","","",,,,,,,,,,,,"BL2-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL2-3",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"RA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24580",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24381","19","archive","5",,,"disk0/00/02/43/81","2015-08-05 15:25:37","2015-08-05 15:25:37","2015-08-05 15:25:37","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","The Royal Australian College of General Practitioners","Prescribing drugs of dependence in general practice, Part A – Clinical governance framework.","pub","BT6-2","","public",,,,,,,,"This guide on clinical governance is a starting place for general practice to be a solution to problematic prescription drug use. The guide is a living document and will be regularly updated.","2015-08","published",,"RACGP",,"","",,,,,,"The Royal Australian College of General Practitioners","Melbourne",,"88 p.",,,,,,,,,,,"report","aod_disorder","alcohol_drugs_in_general",,"978-0-86906-429-0",,,,"RACGP",,,"","","","","","","","","","",,"

Summary of Recommendations

1. Introduction

Disclaimer

Acknowledgements

Acronyms

1.1 Aims

1.2 How to use this guide

1.3 Why do we need this guide?

1.4 Developing an environment for quality improvement in prescribing of drugs of dependence

 

2 Laws and regulations

2.1 Legislative requirements

2.2 Regulatory, professional bodies and monitoring bodies

 

3. General practice systems of care

3.1 The medical home model of care

3.2 Practice accreditation

3.3 Clinical leaders

3.4 Staff education and competency

3.5 Balancing patients’ needs with practice capacity (risk stratification)

3.6 Coordination of care

3.7 Practice policies

3.8 Using information – Government resources

3.9 Quality improvement activities

 

4. Accountable prescribing

4.1 Being an accountable prescriber of drugs of dependence

4.2 Assessment of patient risk

4.3 Providing patients with other (often better) management options

 

5. Patient Focus

5.1 Shared decision making

 

A. Key terms and definitions

A.1 Drugs of addiction and drugs of dependence

A.2 Tolerance, dependence, substance use disorder and withdrawal

A.3 Misuse, non-medical use and abuse

A.4 Drug-seeking behaviour

A.5 Prescriber behaviour

B. Drug scheduling

B.1 Drug schedule

B.2 S8 terminology variations across Australia

C. State and territory legislation and contacts

C.1 Non drug-dependent persons – Legislative requirements when prescribing S8 drugs

C.2 State/territory contacts

D. Example practice policies

D.1 Practice policy – Opioid prescribing policy for patients

D.2 Practice policy – Restriction of prescribing rights for drugs of dependence

D.3 Practice policy – Handover standards

D.4 Practice policy – Continuation of opioid management plans for new patients originating from external healthcare providers

D.5 Practice policy – Drugs of dependence therapy agreement

D.6 Practice policy – Requests for repeat scripts for drugs of dependence

D.7 Practice policy – Risk assessment for patients with complex needs

D.8 Practice policy – Approach to drug seeking patients

D.9 Practice policy – Opioid dosing thresholds

D.10 Practice policy – One-year review of opioid prescribing

D.11 Practice policy – Opioid reduction policy

D.12 Practice policy – Benzodiazepine fact sheet for patients

D.13 Practice policy – Opioid fact sheet for patients

D.14 Practice policy – Simple checklist for a general practice to examine its quality management of drugs of dependence

 

Practice letters

Drug misuse behaviours

Assessment of current drug and alcohol use

Urine drug testing

Resources

I.1 Staff safety

I.2 Risk assessment

I.3 24-hour drug and alcohol services

Process of guide development

",,,,,,,,,,,"",,"http://www.racgp.org.au/your-practice/guidelines/drugs-of-dependence-a","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BT6-2 , JM , JS , JT8_8_2 , JU10 , TT2-12 , VK2","E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- T Demographic characteristics > Doctor","VA Geographic area > Australia and Oceania > Australia","Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Patient care management -- Health care delivery -- Health care programme or facility - Community-based treatment (primary care) -- Health care administration - Health care quality control -- Doctor","Australia and Oceania - Australia","The Royal Australian College of General Practitioners The Royal Australian College of General Practitioners","0","yes" "24381",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy","prescription",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://www.drugsandalcohol.ie/24380/","pubn",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24381",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24381",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24381",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24381",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24381",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311","15","archive","5",,,"disk0/00/02/43/11","2015-07-20 07:59:28","2015-07-20 07:59:28","2015-07-20 07:59:28","monograph",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Ireland. Department of Health","Public health plan for the pharmaceutical treatment of Hepatitis C.","pub","GA2-2","","public",,"government_publication",,,,,,,"2015-07","published",,"Ireland. Department of Health",,"","",,,,,,"Department of Health","Dublin",,"43 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,"

In Ireland and in other countries hepatitis C infection is recognised as a significant public health problem with its associated burden of managing and treating the disease on individuals, their families, health services, communities and society.

 

Hepatitis C became a notifiable disease in Ireland in 2004 and between then and 2013, 12,333 cases were notified with a peak in 2007 (n=1539). In recent years there has been a significant decrease in notifications with 847 cases notified in 2013. Studies to estimate the prevalence of chronic hepatitis C in the population have been carried out over the last few years. A study in 2009 estimated the national prevalence of chronic hepatitis C as 0.5-1.2% (20,000-50,000) while more recent information indicates prevalence is likely to be 0.5-0.7% (20,000-30,000). However although there has been a recent decrease in notifications there is still a significant burden associated with advanced stage hepatitis C infection including liver disease, liver failure, liver cancer requiring for some transplant and death.

 

In Ireland the main route of transmission is through sharing of needles and drug paraphernalia by people who inject drugs. In notified cases when data was available 75% of the cases of hepatitis C were in people who inject drugs. In the past transmission occurred primarily through infected blood products.

 

Viral eradication prevents disease progression. Until 2011 the standard treatment for people with hepatitis C infection was dual therapy interferon and ribavirin. This treatment led to a variable response but was associated with significant side effects, particularly from interferon. Recently new pharmacological treatment regimens have been developed which have demonstrated high rates of viral clearance in clinical trials. These new drug regimens are at various stages of development and regulatory approval. Some have been licensed and others are expected to be in the near future. Those licensed in the EU include sofosbuvir, daclatasvir and simeprevir. These drugs are commonly used in combination with other drugs for example Sofosbuvir +/- daclatasvir +/- ribavirin. Currently in Ireland a number of these new drug regimens are going through the assessment process for reimbursement in the HSE.

 

Internationally there is an increasing focus on these new drug treatments. They are recognised as clinically effective treatments with significantly improved treatment outcomes and fewer side effects, however the cost of these drugs is resulting in a significant burden on health care systems worldwide. A number of diverse strategies have been implemented by different countries to address these issues of affordability; with many adopting the approach of prioritisation based on clinical need of infected patients. Following these important developments in the area of new and emerging treatment regimens for hepatitis C, the Chief Medical Officer, in the Department of Health established a group to advise the Minister for Health through the office of the Chief Medical Officer.

 

The role of this advisory group was to advise on the feasibility of a multiannual public health treatment plan for patients with hepatitis C infection based on clinical prioritisation criteria for identification of patients for each treatment phase. The Advisory group included patient advocates, clinicians, the National Centre for Pharmaco-economics (NCPE), HIQA, the HSE and officials from the Department of Health and is chaired by the CMO’s office (Appendix 1).

 

After reviewing the evidence on clinical and cost effectiveness and the budget impact of the new drug regimens, the Group advised on the development of a treatment strategy. This treatment strategy’s implementation will over the next few years aim to increase the number of people with hepatitis C infection being treated effectively with complete clearance of the virus and reduce the numbers of people in the community with hepatitis C. The implementation of the treatment strategy is an important component in ultimately working towards eradication of hepatitis C in the Irish population.

",,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"GA2-2 , GH16-12-6-6 , JB2-4 , JH10-6 , JM , JS , TL4-10-4 , VH4-2","G Health and disease > State of health > Physical health -- G Health and disease > Disorder by cause > Communicable disease > Hepatitis C -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Intravenous / injecting drug user","VA Geographic area > Europe > Ireland","State of health - Physical health -- Disorder by cause - Communicable disease - Hepatitis C -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Health-related prevention - Health information and education - Communicable disease control -- Patient care management -- Health care delivery -- Intravenous / injecting drug user","Europe - Ireland","Ireland. Department of Health Ireland. Department of Health","0","no" "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-12-6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24311",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291","15","archive","5",,,"disk0/00/02/42/91","2015-07-15 07:41:29","2015-07-15 07:41:29","2015-07-15 07:41:29","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Public Health England","Improving access to, and completion of, hepatitis C treatment.","pub","GH16-12-6-6","","public",,,,,,,,"New treatments for hepatitis C virus (HCV) infection have shorter, easier, oral regimens with fewer side effects and better outcomes. These represent a real opportunity to reduce the incidence of HCV-related cirrhosis and liver cancer among people already infected with HCV and to remove the virus from the ‘infection pool’, resulting in reduced transmission among people who inject drugs and the general population. Treating hepatitis C infection is an effective and cost-effective way to substantially reduce prevalence, especially in areas where it is high. Compliance with the new treatments is easier and can be further improved by well-planned support for patients. Needle and syringe programmes (NSP) and opioid substitution treatment (OST) have been effective in capping English hepatitis C virus (HCV) rates at an average of around 50% among people who inject drugs.* There are wide geographical variations, with prevalence much higher in some cities and metropolitan areas. Sustained long-term increases in the coverage of NSP and OST could further reduce the virus’s prevalence. The rate of treatment for hepatitis C in people who inject drugs is extremely low (just 3% of people estimated to be infected with chronic infections access treatment each year) but it can be improved by attention to assessment and engagement pathways, peer and other support, improved staff awareness and attitudes, and better access. Evidence also shows that addressing people’s healthcare needs, such as hepatitis, can help them progress in their drug recovery. This briefing provides an overview of the key issues that local providers and commissioners of drug and hepatitis treatment should consider.","2015-07","published",,"Public Health England",,"","",,,,,,"Public Health England","London",,"6 p.",,,,,"Turning evidence into practice series",,,,,,"guideline","aod_use_harm_reduction","opioid",,,,,,"Public Health England",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GH16-12-6-6 , JH10-6 , JM , JP10 , JS , MP18-2-8-16 , TL4-10-4 , VH4-4-2","G Health and disease > Disorder by cause > Communicable disease > Hepatitis C -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Health care delivery -- MP-MR Policy, planning, economics, work and social services > Policy > Policy on drugs and alcohol > Harm reduction policy -- T Demographic characteristics > Intravenous / injecting drug user","VA Geographic area > Europe > United Kingdom > England","Disorder by cause - Communicable disease - Hepatitis C -- Health-related prevention - Health information and education - Communicable disease control -- Patient care management -- Treatment and maintenance - treatment factors -- Health care delivery -- Policy - Policy on drugs and alcohol - Harm reduction policy -- Intravenous / injecting drug user","Europe - United Kingdom - England","Public Health England Public Health England","0","yes" "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MP18-2-8-16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24291",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24341","12","archive","5",,,"disk0/00/02/43/41","2015-07-28 08:06:40","2015-07-28 08:06:40","2015-07-28 08:06:40","guideline",,,"show",,,,"","","","","","","","","","",,,,"Strang","John","","","",,"",,,,,"","","Naloxone – preliminary advice from the working group updating Drug misuse and dependence: UK guidelines on clinical management.","pub","BL2-2","","public",,,,,,,,"The working group updating the 2007 UK national clinical guidelines on drug treatment has published some preliminary advice on naloxone before addressing its supply and use more fully in the published update in 2016. The advice covers naloxone dosing in overdose situations, take-home naloxone products that can be supplied and training that should be provided. An open letter from Professor John Strang, chair of the clinical guidelines update working group. Naloxone and its use: Across Europe, illicit opioid users are 10 times more likely to die than their peers of the same age group and gender, and 6,100 deaths were attributed directly to opioid overdose in 2012. Naloxone is a potentially life-saving medicine when used in settings associated with opiate misuse and overdose. There is evidence that take-home naloxone given to service users, and training family members or peers in how to administer naloxone, can be effective in reversing heroin overdoses. Its legal status means that anyone can administer naloxone for the purpose of saving a life, and it has been supplied by some drug treatment services since 2005. However naloxone is only licensed for use in injectable form and remains a prescription-only medicine. This means that at present it can only be distributed to patients with a prescription or via an alternative mechanism (patient group direction (PGD) or patient specific direction (PSD)). Naloxone is an opioid/opiate antagonist and is already licensed for use in: 1. complete or partial reversal of central nervous system depression and especially respiratory depression, caused by natural or synthetic opioids; and 2. treatment of suspected acute opioid overdose or intoxication. An NHS England Patient Safety Alert in November 2014 highlighted risks associated with the use of naloxone in patients where it is not indicated, or in larger than recommended doses......","2015-07",,,"Public Health England",,"","",,,,,,"Public Health England","London",,"3 p.",,,,,,,,,,,"guideline","aod_use_harm_reduction","opioid",,,,,,"Public Health England",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.nta.nhs.uk/Naloxone%20preliminary%20advice%20from%20the%20working%20group%20updating%20Drug%20Misuse%20and%20Dependence%20UK%20Guidelines%20on%20Clinical%20Management.aspx","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BL2-2 , GC4-6 , JM , JQ8-2 , VH4-4","B Drugs and alcohol substances > Opioids (opiates) > Naloxone -- G Health and disease > Drugs and alcohol disorder > Drug use > Drug intoxication > Drugs and alcohol poisoning (overdose) -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care","VA Geographic area > Europe > United Kingdom","Opioids (opiates) - Naloxone -- Drugs and alcohol disorder - Drug use - Drug intoxication - Drugs and alcohol poisoning (overdose) -- Patient care management -- Care by type of problem - emergency care","Europe - United Kingdom","Strang John","0","no" "24341",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24341",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24341",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24341",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16602","16","archive","5",,,"disk0/00/01/66/02","2011-12-19 15:56:52","2015-07-07 15:24:19","2011-12-19 15:56:52","guideline",,,"show",,,,"","","","","","","","","","","0",,,"Barth","Jürgen","","","",,"",,,,,"","","Psychosocial interventions for smoking cessation in patients with coronary heart disease.","pub","GA2-2","","none",,,,,,,,"Smoking is a risk factor for heart attacks and stopping smoking is recommended for patients after a heart attack. Psychosocial smoking cessation interventions like counseling can help such patients to stop smoking, if they are provided for over one month. Psychosocial interventions can help such patients to quit within 6 months but studies about the long term effects did not support the beneficial short-term findings. Most trials used a mixture of different intervention strategies, therefore no single strategy showed superior efficacy.","2015-07","published",,"The Cochrane Library",,"","",,"Cochrane Database of Systematic Reviews",,"7","7","John Wiley & Sons, Ltd","London",,,,,,,"DOI: 10.1002/14651858.CD006886.pub2",,,,,,"review","aod_use_harm_reduction","tobacco",,"ISSN: 1469-493X",,,,"The Cochrane Library",,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD006886.pub2","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","unspecified","Cochrane Database of Systematic Reviews","GA2-2 , JM , HZ , BD , HK2-6","G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- HJ Treatment method > Psychosocial treatment method -- B Drugs and alcohol substances > Tobacco (cigarette smoking) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use",,"State of health - Physical health -- Patient care management -- Psychosocial treatment method -- Tobacco (cigarette smoking) -- Drugs and alcohol disorder treatment method - Cessation of drugs and alcohol use",,"Barth Jürgen , Jacob Tiffany , Daha Ioana , Critchley Julia A.","0","yes" "16602",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Jacob","Tiffany","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16602",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Daha","Ioana","","",,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16602",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Critchley","Julia A.","","",,,,,,,,,,,,"BD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16602",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24178","14","archive","5",,,"disk0/00/02/41/78","2015-06-26 08:21:55","2015-06-26 08:21:55","2015-06-26 08:21:55","guideline",,,"show",,,,"","","","","","","","","","",,,,"Abercrombie","Rob","","","","Abercrombie:Rob::","",,,,,"","","Systems change: a guide to what it is and how to do it.","pub","JM","","public",,,,,,,,"We have produced this guide to plug a gap in the systems change literature—providing accessible material and recommendations for action. It introduces the basic concepts, maps out the different perspectives in the systems change landscape and suggests good practice for systemic social action. It has been written as a resource for those working or supporting the social sector—namely charities and funders, but also those in the public sector or in social enterprises. In summary, this guide: • clarifies what is meant by systems and systems change • describes the main perspectives on systems change • outlines good practice for systems change • identifies what is and is not agreed upon by experts in the field • provides recommendations for charities, funders and the public sector on how to act systemically.","2015-06","published",,"Abercrombie Rob",,"","",,,,,,"New Philanthropy Capital","London",,"45 p.",,,,,,,,,,,"guideline","education_and_training","alcohol_drugs_in_general",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.thinknpc.org/publications/systems-change/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JM , JS , ML2 , MP14-10 , MQ6 , TT2 , VH4-4","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- MA-ML Social science, culture and community > Community action > Community development -- MP-MR Policy, planning, economics, work and social services > Political process > Advocacy -- MP-MR Policy, planning, economics, work and social services > Organisational development -- T Demographic characteristics > Drug or health care worker","VA Geographic area > Europe > United Kingdom","Patient care management -- Health care delivery -- Community action - Community development -- Political process - Advocacy -- Organisational development -- Drug or health care worker","Europe - United Kingdom","Abercrombie Rob , Harries Ellen , Wharton Rachel","0","yes" "24178",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Harries","Ellen","","",,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24178",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Wharton","Rachel","","",,,,,,,,,,,,"ML2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24178",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MP14-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24178",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24178",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24178",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380","17","archive","5",,,"disk0/00/02/43/80","2015-08-05 15:07:58","2015-08-05 15:07:58","2015-08-05 15:07:58","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","The Royal Australian College of General Practitioners","Prescribing drugs of dependence in general practice, Part B - benzodiazepines.","pub","BH","","public",,,,,,,,"Drugs of dependence have important therapeutic uses, but there is a need to ensure the supply of these medicines is clinically appropriate. A key measure is accountable prescribing that can be supported by a range of strategies at the practice level. Please refer to RACGP’s Prescribing drugs of dependence in general practice, Part A – Clinical governance framework for information about these strategies. Since 2002, approximately 7 million prescriptions for benzodiazepines have been dispensed in Australia each year, for conditions such as anxiety and insomnia. There is concern a portion of these prescriptions is causing or contributing to patient harm. This is a practical guide general practitioners (GPs) can use to minimise harm and maximise benefits to patients. Evidence-based recommendations are collated here and there is further information in the body of the guide.","2015-06",,,"RACGP",,"","",,,,,,"The Royal Australian College of General Practitioners","Victoria",,"101 p.",,,,,,,,,,,"report","aod_disorder","cns_depressants",,"978-0-86906-430-6",,,,"RACGP",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BH , BH2-2 , BT6-2 , HK2-10 , JM , JT8_8_2 , TT2-12 , VK2","B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) -- B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) > Benzodiazepine -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Doctor","VA Geographic area > Australia and Oceania > Australia","Sedatives or tranquillisers (CNS depressants) -- Sedatives or tranquillisers (CNS depressants) - Benzodiazepine -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Patient care management -- Health care programme or facility - Community-based treatment (primary care) -- Doctor","Australia and Oceania - Australia","The Royal Australian College of General Practitioners The Royal Australian College of General Practitioners","0","yes" "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BH2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24380",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281","16","archive","5",,,"disk0/00/02/42/81","2015-07-13 08:04:21","2015-07-13 08:04:21","2015-07-13 08:04:21","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","The Royal College of Emergency Medicine","Alcohol: a toolkit for improving care.","pub","BB","","public",,,,,,,,"The aims of the toolkit are: 1. Promotion of best practice in the area of alcohol management - methods of screening and complete management of the patient with alcohol related illness and injury in EDs. 2. Advancement of safe and effective care in this area - advising on approaches on how to care for this subset of patients and sharing best practice with the use of medications. 3. Education and training of Emergency Medicine doctors - by provision of guidelines and advocating training.","2015-06",,,"The Royal College of Emergency Medicine",,"","",,,,,,"The Royal College of Emergency Medicine","London",,"47 p.",,,,,,,,,,,"guideline","aod_disorder_treatment_method","alcohol",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , GC16-4 , JG26_2_4_2 , JM , JQ8-2 , JT14-4 , TT2-12 , TT2-14 , VH4-4","B Drugs and alcohol substances > Alcohol -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol intoxication -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > United Kingdom","Alcohol -- Drugs and alcohol disorder - Alcohol use - Alcohol intoxication -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - emergency care -- Health care programme or facility - Hospital -- Doctor -- Nurse","Europe - United Kingdom","The Royal College of Emergency Medicine The Royal College of Emergency Medicine","0","yes" "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24281",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292","25","archive","5",,,"disk0/00/02/42/92","2015-07-15 08:08:09","2015-07-15 08:08:09","2015-07-15 08:08:09","guideline",,,"show",,,,"","","","","","","","","","",,,,"Abdulrahim","D","","","",,"",,,,,"","Novel Psychoactive Treatment UK Network","Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances.","pub","AM","","public",,,,,,,,"For the purposes of this document, ‘club drugs’ is a short-hand term used for convenience to refer to a group of psychoactive substances typically used in dance venues, house parties, music festivals and sometimes in a sexual context. The term therefore describes a diverse group of substances with different actions. They include substances with primarily stimulant effects, those with primarily hallucinogenic effects, as well as some central nervous system depressants and synthetic cannabinoids. Club drugs include substances well established in the UK such as MDMA (ecstasy), as well as the rapidly expanding range of novel psychoactive substances (NPS) such as synthetic cannabinoids, synthetic cathinones and a range of other amphetamine-type stimulants. Some club drugs are sold on the illicit market, whilst others are sold as so-called ‘legal highs’. This document provides guidance on the clinical management of harms resulting from acute intoxication and from the harmful and dependent use of club drugs and NPS. It categorises club drugs broadly according to their clinical effects: depressant; stimulant; hallucinogenic. In addition, the synthetic cannabinoids are treated as a separate category, largely for reasons relating to their clinical management but also because they do not fit neatly into that threefold categorisation. The guidance is based on available evidence and clinical consensus. It is a response to the current gap in knowledge and experience in the management of these drugs across the UK and beyond. Guidance is aimed in particular at clinicians in a range of settings, specifically: • specialist drug treatment services • hospital emergency departments (EDs) • general practice/ primary care • sexual health clinics This document provides guidance, not guidelines. Together with the recommendations of its reviews, technical appraisals and standards, national guidelines produced by the National Institute for Health and Care Excellence (NICE) determine the wider principles within which treatment and care should be provided within drug services, EDs, primary care, sexual health and mental health services in the UK. However, these guidelines do not relate specifically to NPS. NEPTUNE guidance must be used within the wider principles of national guidelines. Non-UK readers of this document should contact their local, regional or national poisons information service for up–to-date advice and guidance on the management of acute club drug intoxication and withdrawal.","2015-03",,,"Public Health England",,"","",,,,,,"NEPTUNE","London",,"335 p.",,,,,,,,,,,"guideline","aod_use_harm_reduction","psychoactive",,,,,,"Public Health England",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AM , BE4 , BH , BJ , BJ2-8-2 , BJ6-1 , BK , BN , GA2-2 , JM , JQ8-2 , JS , JT8_8_2 , LN , LN4 , TT2-12 , TT2-14 , VH4-4","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Cannabis product (synthetic cannabinoids) -- B Drugs and alcohol substances > Sedatives or tranquillisers (CNS depressants) -- B Drugs and alcohol substances > CNS stimulants -- B Drugs and alcohol substances > CNS stimulants > MDMA > Ecstasy -- B Drugs and alcohol substances > CNS stimulants > Synthetic cathinones > Mephedrone -- B Drugs and alcohol substances > Cocaine -- B Drugs and alcohol substances > New psychoactive substances -- G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- L Social psychology and related concepts > Social context -- L Social psychology and related concepts > Social context > Context encouraging drugs and alcohol use -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > United Kingdom","Drugs and alcohol effects and consequences -- Cannabis product (synthetic cannabinoids) -- Sedatives or tranquillisers (CNS depressants) -- CNS stimulants -- CNS stimulants - MDMA - Ecstasy -- CNS stimulants - Synthetic cathinones - Mephedrone -- Cocaine -- New psychoactive substances -- State of health - Physical health -- Patient care management -- Care by type of problem - emergency care -- Health care delivery -- Health care programme or facility - Community-based treatment (primary care) -- Social context -- Social context - Context encouraging drugs and alcohol use -- Doctor -- Nurse","Europe - United Kingdom","Abdulrahim D , Bowden-Jones O , Novel Psychoactive Treatment UK Network Novel Psychoactive Treatment UK Network","0","yes" "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bowden-Jones","O","","",,,,,,,,,,,,"BE4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BH",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BJ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BJ2-8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BJ6-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BK",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BN",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LN",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LN4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24292",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25683","16","archive","5",,,"disk0/00/02/56/83","2016-06-16 13:43:44","2016-06-16 13:47:56","2016-06-16 13:43:44","monograph",,,"show",,,,"","","","","","","","","","",,,,"Higgins","A","","","","Higgins:A::","",,,,,"","","Best practice principles for risk assessment and safety planning for nurses working in mental health services.","pub","JA8-2","","public",,,,,,,,"The clinical role and responsibilities of the nurse has developed significantly to meet the changing nature and context of mental health care. Risk assessment and safety planning constitutes a significant component of the role of every nurse working in a recovery focused way in contemporary services and is particularly significant for those working in specialist and advanced practice roles in areas such as Liaison, Self Harm, Suicide Crisis Assessment and Community Mental Health. These principles are a resource for all nurses and provide a benchmark for the delivery of care. This document and these principles relate to the specific area of risk assessment and safety planning of an individual’s care. It is internationally accepted that risk and safety planning is an integral part of a standardised, comprehensive mental health bio psychosocial assessment of care which every individual will have when accessing mental health services. However, the profession requires a more in-depth knowledge and expertise in the area of risk assessment and safety planning. How risk is defined, classified and responded to needs to be evidence-based and consistent across all clinical settings and locations where care is being delivered nationally.","2015",,,"Higgins A",,"","",,,,,,"Health Service Executive","Dublin",,"24 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"JA8-2 , JM , JQ6-8 , JU10 , TT2-14 , VH4-2","J Health care, prevention and rehabilitation > Risk and needs assessment > Risk assessment -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- T Demographic characteristics > Nurse","VA Geographic area > Europe > Ireland","Risk and needs assessment - Risk assessment -- Patient care management -- Care by type of problem - Mental health care -- Health care administration - Health care quality control -- Nurse","Europe - Ireland","Higgins A , Morrissey J , Doyle L , Bailey J , Gill A","0","yes" "25683",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Morrissey","J","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25683",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Doyle","L","","",,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25683",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bailey","J","","",,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25683",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gill","A","","",,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "25683",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144","14","archive","5",,,"disk0/00/02/41/44","2015-06-19 10:33:35","2015-06-19 10:33:35","2015-06-19 10:33:35","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","National Institute for Health and Care Excellence","Psychosis with coexisting substance misuse overview (Dual diagnosis).","pub","GA2-4","","none",,,,,,,,,"2015","published",,"NICE",,"","",,,,,,"National Institute for Health and Care Excellence","London",,,,,,,"NICE Pathways",,,,,,"","aod_use_harm_reduction","alcohol_drugs_in_general",,,,,,"NICE",,,"","","","","","","","","","",,"

This pathway covers assessment and management of psychosis with coexisting substance misuse in adults and young people.

 

The term psychosis is used to describe a group of severe mental health disorders characterised by the presence of delusions and hallucinations that disrupt a person's perception, thoughts, emotions and behaviour. The main forms of psychosis are schizophrenia, bipolar disorder or other affective psychosis.

 

Substance misuse is a broad term encompassing, in this pathway, the harmful use of any psychotropic substance, including alcohol and either legal or illicit drugs. Such use is usually, but not always, regarded as a problem if there is evidence of dependence. However, substance misuse can be harmful without dependence, especially among people with coexisting psychosis.

 

Approximately 40% of people with psychosis misuse substances at some point in their lifetime, at least double the rate seen in the general population. Substance misuse among individuals with psychiatric disorders is associated with significantly poorer outcomes than for individuals with a single disorder

",,,,,,,,,,,"","http://pathways.nice.org.uk/pathways/psychosis-with-coexisting-substance-misuse","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GA2-4 , GC12 , GD2 , JG26_2_4_2 , JM , JQ6-8 , JT8_8_2 , TA14 , VH4-4","G Health and disease > State of health > Mental health -- G Health and disease > Drugs and alcohol related disorder > Dual diagnosis (comorbidity) -- G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- T Demographic characteristics > Adolescent / youth (teenager / young person)","VA Geographic area > Europe > United Kingdom","State of health - Mental health -- Drugs and alcohol related disorder - Dual diagnosis (comorbidity) -- Drugs and alcohol related disorder - Drugs and alcohol related mental disorder -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - Mental health care -- Health care programme or facility - Community-based treatment (primary care) -- Adolescent / youth (teenager / young person)","Europe - United Kingdom","National Institute for Health and Care Excellence National Institute for Health and Care Excellence","0","yes" "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GD2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24144",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24967","17","archive","5",,,"disk0/00/02/49/67","2015-12-23 11:26:49","2017-02-10 13:26:33","2015-12-23 11:26:49","monograph",,,"show",,,,"","","","","","","","","","",,,,"O'Brien","Tom","","","","O'Brien:Tom::","",,,,,"","","Evaluating the implementation of the RCI in Irish mental health services.","pub","AH18","","public",,"other",,,,,,"The Recovery Context Inventory has been designed as a profiling and outcome tool to support personal mental health recovery and recovery-oriented service development and represents an innovation in e-mental health. The measure allows people to comprehensively assess the presence of contextual factors in their lives which they consider important to their wellbeing and recovery, under the main headings of Personal Supports and Service Supports. In this way, the structure of the RCI adopts a whole life approach in facilitating a personal evaluation of a broad range of factors in a person’s life, including mental health services, that impact upon the personal recovery process","2015","published",,"O'Brien Tom",,"","",,,,,,"Health Service Executive","Dublin",,"130 p.",,,,,,,,,,,"","","",,,,,,,,,"","","5288","","available","","","","","",,,"JQ6.2, MQ8, VH4.2",,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"AH18 , GA2-4 , JM , JQ6-8 , VH4-2","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- G Health and disease > State of health > Mental health -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care","VA Geographic area > Europe > Ireland","Natural history of drugs and alcohol use - Drugs and alcohol recovery -- State of health - Mental health -- Patient care management -- Care by type of problem - Mental health care","Europe - Ireland","O'Brien Tom , Webb Margaret , Stynes Greg , Cosgrave Gavin , Ardis Jennifer","0","no" "24967",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Webb","Margaret","","",,,,,,,,,,,,"GA2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"5289",,"available",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24967",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Stynes","Greg","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"5290",,"available",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24967",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cosgrave","Gavin","","",,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24967",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ardis","Jennifer","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023","11","archive","1684",,,"disk0/00/02/40/23","2015-06-02 14:25:40","2015-12-22 15:22:42","2015-06-02 14:25:40","article",,,"show",,,,"","","","","","","","","","",,,,"Ohakim","Adanna","","","","Ohakim:Adanna::","",,,,,"","","Smoking, attitudes to smoking and provision of smoking cessation advice in two teaching hospitals in Ireland: do smoke-free policies matter?","pub","BD","","none",,,,,,,,,"2015","published",,"Ohakim Adanna",,"","",,"Health Psychology and Behavioral Medicine","3","1","1",,,"142-153",,,,,,,,,,,"TRUE","","","",,,,,,,,,"","","","","electronic_only","","","","","",,"

Brief cessation advice from health-care professionals in the hospital setting significantly increases the likelihood of patients quitting smoking, yet patients are not routinely provided with this advice. Smoke-free hospital policies aim to protect individuals from the adverse effects of smoking; however, it is unclear if such policies encourage systematic delivery of cessation advice by health-care professionals. The study's aim was to determine the prevalence of smoking and cessation advice received by in-patients in two teaching hospitals in Ireland which have implemented smoke-free hospital policies, and to examine patient attitudes towards smoking cessation. Change in smoking prevalence and delivery of smoking cessation advice prior to and post-policy implementation was also examined in one hospital. This study surveyed 466 in-patients across 2 hospital sites, over a 3-week and 5-week period, respectively. Data were also compared to a survey completed prior to the implementation of the smoke-free policy in one of the hospital sites. Smoking prevalence was 17% in Beaumont Hospital and 28% in Connolly Hospital. Overall, nicotine dependence was low (Mean Fagerström Test for Nicotine Dependence = 4.21, ±2.9). Overall, 62% of smokers did not receive smoking cessation advice from a health professional, although 55% indicated a willingness to engage with this type of service. The before-and-after analysis of Beaumont Hospital showed a reduction in smoking prevalence (17% vs 21%) amongst hospital in-patients, and a 6% increase in reported cessation advice provided following the introduction of the hospital smoke-free policy. Smoke-free hospital policies play a role in decreasing the prevalence of in-patient smokers, but further intervention is needed to increase rates of cessation advice provided. Positive attitudes to smoking cessation, coupled with low average nicotine dependence, suggest that low-intensity interventions would be beneficial for most smokers. A systematic focus on provision of brief smoking cessation advice is needed in hospitals.

",,,,,,,,,,,"","http://www.tandfonline.com/doi/full/10.1080/21642850.2015.1026347","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","3","Health Psychology and Behavioral Medicine","BD , HK2-6 , JP10_2_2 , JT14-4 , VH4-2","B Drugs and alcohol substances > Tobacco (cigarette smoking) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital","VA Geographic area > Europe > Ireland","Tobacco (cigarette smoking) -- Drugs and alcohol disorder treatment method - Cessation of drugs and alcohol use -- Treatment and maintenance - patient attitude toward treatment -- Health care programme or facility - Hospital","Europe - Ireland","Ohakim Adanna , Mellon Lisa , Jafar Bedour , O'Byrne Caroline , McElvaney NG , Cormican Liam , McDonnell Ronan , Doyle Frank","0","no" "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mellon","Lisa","","",,,,,,,,,,,,"HK2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Jafar","Bedour","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Byrne","Caroline","","",,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McElvaney","NG","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cormican","Liam","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McDonnell","Ronan","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24023",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Doyle","Frank","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348","15","archive","1684",,,"disk0/00/02/43/48","2015-07-29 10:15:02","2015-07-30 08:12:51","2015-07-29 10:15:02","article",,,"show",,,,"","","","","","","","","","",,,,"Tuite","Helen","","","","Tuite:Helen::","",,,,,"","","Patients accessing ambulatory care for HIV-infection: epidemiology and prevalence assessment.","pub","AA2","","none",,,,,,,,,"2015",,,"Tuite Helen",,"","",,"Irish Medical Journal","108","7","7","Irish Medical Organisation",,,,,,,,,,,,,"TRUE","","","",,"0332-3102",,,,,,,"","","","","available","","","","","",,"

This study describes the demographics and treatment status of HIV-infected adults accessing ambulatory care in the Republic of Ireland and estimates diagnosed HIV prevalence rates.

",,,,,,,,,,,"","http://www.imj.ie//ViewArticleDetails.aspx?ArticleID=14932","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","108","Irish Medical Journal","AA2 , EF , GH16-12-20-2 , JM , JQ6 , TL4-10-4 , VH4-2","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use -- E Concepts in biomedical areas > Route of administration -- G Health and disease > Disorder by cause > Communicable disease > HIV infection -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem -- T Demographic characteristics > Intravenous / injecting drug user","VA Geographic area > Europe > Ireland","Prevalence of drugs and alcohol use -- Route of administration -- Disorder by cause - Communicable disease - HIV infection -- Patient care management -- Care by type of problem -- Intravenous / injecting drug user","Europe - Ireland","Tuite Helen , Horgan M , Mallom PWG , McConkey SJ , Mooka B , Mulcahy F , Walsh C , O'Hora Aidan , O'Flanagan D , Bergin C , Fleming C","0","no" "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Horgan","M","","",,,,,,,,,,,,"EF",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mallom","PWG","","",,,,,,,,,,,,"GH16-12-20-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McConkey","SJ","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mooka","B","","",,,,,,,,,,,,"JQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mulcahy","F","","",,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Walsh","C","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Hora","Aidan","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Flanagan","D","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bergin","C","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24348",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Fleming","C","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131","17","archive","5",,,"disk0/00/02/31/31","2014-12-10 14:39:26","2014-12-10 14:39:26","2014-12-10 14:39:26","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Public Health England","Young people’s hospital alcohol pathways. Support pack for A&E departments.","pub","BB","","public",,,,,,,,"This document shows how local pathways can work for young people who present to A&E with alcohol-related conditions. It builds on similar publications by the National Institute for Health and Care Excellence (NICE)1 and Alcohol Concern. The pack includes a set of key questions for local professionals in the UK to help them develop effective care pathways within A&E and into other relevant services. It will be most relevant for A&E clinicians, hospital managers, substance misuse and young people’s commissioners. It may also have wider interest for local authority children’s services and organisations that are part of the pathway, such as substance misuse services and other young people’s support agencies.","2014-12","published",,"Public Health England",,"","",,,,,,"Public Health England","London",,"13 p.",,,,,,,,,,,"report","aod_use_harm_reduction","alcohol_drugs_in_general",,,,,,"Public Health England",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , JG26_2_4_2 , JM , JQ8-2 , JS , JT14-4 , TA14 , TL4-6-2 , TT2-12 , TT2-14","B Drugs and alcohol substances > Alcohol -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital -- T Demographic characteristics > Adolescent / youth (teenager / young person) -- T Demographic characteristics > Underage drinker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse",,"Alcohol -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - emergency care -- Health care delivery -- Health care programme or facility - Hospital -- Adolescent / youth (teenager / young person) -- Underage drinker -- Doctor -- Nurse",,"Public Health England Public Health England","0","yes" "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23131",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16619","15","archive","5",,,"disk0/00/01/66/19","2011-12-19 16:04:53","2015-02-06 10:07:44","2011-12-19 16:04:53","guideline",,,"show",,,,"","","","","","","","","","","0",,,"Boyle","Raymond","","","",,"",,,,,"","","Use of electronic health records to support smoking cessation.","pub","NJ","","none",,,,,,,,"Objective: To assess the effectiveness of electronic health record-facilitated interventions on smoking cessation support actions by clinicians and on patient smoking cessation outcomes. Conclusions: At least in the short term, documentation of tobacco status and increased referral to cessation counseling do appear to increase following the introduction of an expectation to use the EHR to record and treat patient tobacco use at medical visits. There is a need for additional research to further understand the effect of EHRs on smoking treatment in healthcare settings.","2014-12","published",,"The Cochrane Library",,"","",,"Cochrane Database of Systematic Reviews",,"12","12","John Wiley & Sons, Ltd","London",,,,,,,"Art. No.: CD008743. DOI: 10.1002/14651858.CD008743.pub3",,,,,,"review","aod_disorder_treatment_method","tobacco",,"ISSN: 1469-493X",,,,"The Cochrane Library",,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD008743.pub3","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","unspecified","Cochrane Database of Systematic Reviews","NJ , JM , BD , HK2-6","N Communication, information and education > Information technology -- J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Tobacco (cigarette smoking) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use",,"Information technology -- Patient care management -- Tobacco (cigarette smoking) -- Drugs and alcohol disorder treatment method - Cessation of drugs and alcohol use",,"Boyle Raymond , Solberg Leif , Fiore Michael","0","yes" "16619",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Solberg","Leif","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"alternative_medical_treatment",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16619",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Fiore","Michael","","",,,,,,,,,,,,"BD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16619",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725","21","archive","5",,,"disk0/00/02/37/25","2015-04-08 07:48:31","2015-04-08 07:55:40","2015-04-08 07:48:31","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug matrix cell B5: Practitioners - safeguarding the community.","pub","AN","","public",,,,,,,,,"2014-11","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings","London",,,,,,,,,,,,,"","aod_disorder","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

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 this cell about? As described in cell A2’s bite, whether medical or psychosocial, chosen positively or under pressure, among the ‘common factors’ affecting treatment’s success is the patient’s relationships with treatment staff. This cell explores research on the client-worker relationship and on the attributes of the worker which affect their clients’ progress in criminal justice and allied settings, where treatment is offered or imposed not because it has been sought by the client, but because it is thought that treating their substance use could reduce offending or otherwise benefit the community. Though across psychotherapy now seen as of at least as much importance, the interpersonal style and other features of staff are much less commonly researched than the intervention they are delivering. From the small number of documents in this cell, you will see this lack is particularly apparent in criminal justice and allied settings. In the expectation that the influences exerted by practitioners in these settings may not differ too much from those elsewhere, for more studies we can refer you back to the other cells dealing with practitioner influences: cell B1 for harm reduction, cell B2 for treatment studies in general, cell B3 for medical treatments, and cell B4 for psychosocial therapies.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/B5.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AN , FR16-6-4-2 , JP10_2_2 , JP10_6 , LN12 , MK12-2 , MQ6-2 , TT2 , TT2-12 , TT2-14 , TT4-4 , TT8-2","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol related societal (social) problems -- F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- L Social psychology and related concepts > Social context > Community environment -- MA-ML Social science, culture and community > Social costs and benefits > Social costs and benefits of drugs and alcohol -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse -- T Demographic characteristics > Counsellor / Therapist -- T Demographic characteristics > Social worker",,"Drugs and alcohol related societal (social) problems -- Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Social context - Community environment -- Social costs and benefits - Social costs and benefits of drugs and alcohol -- Organisational development - Workforce / staff skills and training -- Drug or health care worker -- Doctor -- Nurse -- Counsellor / Therapist -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"FR16-6-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LN12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MK12-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23725",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726","19","archive","5",,,"disk0/00/02/37/26","2015-04-08 07:53:19","2015-04-08 08:10:50","2015-04-08 07:53:19","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug matrix cell C5: Management/supervision - safeguarding the community.","pub","FR16-6-4-2","","public",,,,,,,,,"2014-11","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"","aod_disorder","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

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 this cell about? Therapy (cell A5)and therapists (cell B5) matter of course, but so do 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 get adopted and adequately implemented, and whether staff are able to develop and maintain appropriate attitudes and knowledge, depend on management and supervision. This cell is about the role played by these functions in treatment organised and/or funded by criminal justice and other authorities, when treatment is offered or imposed not because it has been sought by the patient, but because it is thought that treating their substance use problems could cut crime or otherwise benefit the community, including the drugtaker’s family. Studies which document the community and family impacts of treatment in general may also be found in this cell.

",,,,,,,,,,,"","http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/C5.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"FR16-6-4-2 , JP10_2_2 , JP10_6 , LN12 , MQ6 , MQ6-2 , TT2 , TT2-14 , TT4-4 , TT8-2","F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- L Social psychology and related concepts > Social context > Community environment -- MP-MR Policy, planning, economics, work and social services > Organisational development -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Nurse -- T Demographic characteristics > Counsellor / Therapist -- T Demographic characteristics > Social worker",,"Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Social context - Community environment -- Organisational development -- Organisational development - Workforce / staff skills and training -- Drug or health care worker -- Nurse -- Counsellor / Therapist -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"crime_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LN12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "23726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718","18","archive","5",,,"disk0/00/02/27/18","2014-10-01 10:22:39","2014-10-01 10:22:39","2014-10-01 10:22:39","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix cell B4: Practitioners - psychosocial therapies.","pub","HZ","","public",,,,,,,,,"2014-10","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"report","psychosocial_treatment_method","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

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 B4 about?

Every treatment involves direct or indirect human interaction, but this cell is about ‘psychosocial’ therapies in which interaction is intended to be the main active ingredient. These range in form (see cell A4 for more) from brief advice and counselling to extended therapies based on psychological theories, and all-embracing residential communities where clients stay for months. Of course, what is done in therapy matters, but as long as this is a well structured, bona fide treatment which ‘makes sense’, the ‘common factors’ shared by different therapies seem more critical to their success. For the patient, the main embodiment of these factors is how the therapist relates to them, the influence of which we have already seen generally in treatment and in respect of medical treatments. Unsurprisingly, the evidence is stronger still when the structured enactment of that relationship is the treatment. In this cell we focus on the client-worker relationship, and on whether some therapists are more successful because they more strongly forge the right kind of relationships – ‘therapeutic’ relationships.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/B4.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HZ , HZ12 , HZ2-6-6 , HZ26 , HZ8-4 , JP10 , JP10_2_2 , JP10_6 , TT2 , TT4-4","HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Behaviour therapy -- HJ Treatment method > Psychosocial treatment method > Group therapy -- HJ Treatment method > Treatment outcome -- HJ Treatment method > Directive and nondirective therapy > Psychoanalytic therapy -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Counsellor / Therapist",,"Psychosocial treatment method -- Behaviour therapy -- Psychosocial treatment method - Group therapy -- Treatment outcome -- Directive and nondirective therapy - Psychoanalytic therapy -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Drug or health care worker -- Counsellor / Therapist",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HZ12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ8-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22718",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20696","28","archive","1684",,,"disk0/00/02/06/96","2013-10-11 08:43:29","2014-08-25 11:16:52","2013-10-11 08:46:23","article",,,"show",,,,"","","","","","","","","","","0",,,"McMahon","A","","","","McMahon:A::","",,,,,"","","Characteristics of patients admitted to the intensive care unit following self-poisoning and their impact on resource utilisation.","pub","VH4-2","","none",,,,,,,,"Background: Self-poisoning accounts for up to 10 % of hospital admissions, some of whom require admission to ICU. Few studies have looked at the epidemiology of these patients in an Irish setting. Aims: To quantify the proportion of ICU admissions attributable to self-poisoning, to examine the characteristics and outcome of these patients, and to assess their ICU resource utilisation. Methods: Retrospective review of ICU admissions from 2006 to 2010. Data were collected on patient age, sex, admission diagnosis, substances involved, APACHE II score, length of stay, organ support, and outcome. Results: There were 80 admissions to ICU following self-poisoning accounting for 3.8 % of ICU admissions and 13 % of all hospital admissions for self-poisoning. M:F ratio was 0.9:1. Mean age 35 (range 16–75), APACHE II score 14 (2–36). Commonest substances involved were benzodiazepines, opioids, tricycle antidepressants. Median ICU stay was 2 days (IQR 0.96–4.5). 84 % of patients were ventilated, 27.5 % required inotropic support, 14 % renal replacement therapy. When opioids were involved requirement for inotropes and CRRT were higher. ICU mortality was 6.3 %. These patients consumed 280 bed days. Conclusion: Self-poisoning accounted for 3.8 % of ICU admissions. Patients tend to require a short period of ventilation, with a minority requiring additional organ support. The cost of ICU care is calculated based on previously published methodology to be €7,717 per patient. Extrapolated nationally the annual cost for ICU care for self-poisoning is estimated to be in the order of €5 m.","2014-10","published",,"McMahon A",,"","",,"Irish Journal of Medical Science","183","3","3","Springer",,"391-395",,,,,,"DOI 10.1007/s11845-013-1026-7",,,,,"TRUE","","","",,"1863-4362",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","183","Irish Journal of Medical Science","VH4-2 , JV , JM , GC4-6 , JT14-4 , JQ6-4 , MT2","J Health care, prevention and rehabilitation > Health care economics -- J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > Drugs and alcohol disorder > Drug use > Drug intoxication > Drugs and alcohol poisoning (overdose) -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital -- J Health care, prevention and rehabilitation > Care by type of problem > Medical care -- MP-MR Policy, planning, economics, work and social services > Economic aspects of drugs and alcohol (cost / pricing)","VA Geographic area > Europe > Ireland","Health care economics -- Patient care management -- Drugs and alcohol disorder - Drug use - Drug intoxication - Drugs and alcohol poisoning (overdose) -- Health care programme or facility - Hospital -- Care by type of problem - Medical care -- Economic aspects of drugs and alcohol (cost / pricing)","Europe - Ireland","McMahon A , Brohan J , Donnelly M , Fitzpatrick GJ","0","no" "20696",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Brohan","J","","",,,,,,,,,,,,"JV",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20696",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Donnelly","M","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20696",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Fitzpatrick","GJ","","",,,,,,,,,,,,"GC4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20696",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20696",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20696",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21807","20","archive","5",,,"disk0/00/02/18/07","2014-04-23 12:44:48","2014-10-15 08:41:15","2014-04-23 12:44:48","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Scottish Health Action on Alcohol Problems","Alcohol and cancer risks: a guide for health professionals.","pub","AM","","public",,,,,,,,"This guide has been produced to summarise for Health Professionals the links between alcohol consumption and cancers, so that they can use opportunities in their work to intervene to reduce the risks. It was produced following an expert workshop which was convened by SHAAP. Public and professional awareness of the links between alcohol and cancer is low in Scotland. Elsewhere in Europe and in North America and Australia professional and public awareness of cancer risks from alcohol is higher. The role of health professionals Some clinicians can feel uncomfortable about raising the issue of alcohol consumption with patients. However, evidence from many sources suggests that patients are accepting of tactful or empathetic inquiry about aspects of their lifestyle which may have an impact on their health. Health professionals are well placed to raise the level of awareness with their patients and clients as part of a comprehensive review of health and lifestyle. Most patient and clients welcome guidance and support to help them find the motivation to improve their health and wellbeing. Reducing alcohol consumption is often only one of a number of changes that could be made to improve quality of life but it is one that is achievable.","2014-10","published",,"SHAAP",,"","",,,,,,"Scottish Health Action on Alcohol Problems","Edinburgh",,"16 p.",,,,,,,,,,,"report","aod_use_harm_reduction","alcohol",,,,,,"SHAAP",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AM , BB , GA2-2 , JM , NM6-2 , VH4410","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Alcohol -- G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines","VA Geographic area > Europe > United Kingdom > Scotland","Drugs and alcohol effects and consequences -- Alcohol -- State of health - Physical health -- Patient care management -- Recommendations or guidelines - Practice / clinical guidelines","Europe - United Kingdom - Scotland","Scottish Health Action on Alcohol Problems Scottish Health Action on Alcohol Problems","0","yes" "21807",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21807",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21807",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21807",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21807",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4410",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480","17","archive","5",,,"disk0/00/02/24/80","2014-08-14 11:59:38","2014-08-14 11:59:38","2014-08-14 11:59:38","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix cell A3: Interventions - medical treatment.","pub","BL2-3","","public",,,,,,,,,"2014-08","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"other","aod_disorder","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

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 A3 about?

About the treatment of dependence on illegal drugs in a medical context and/or involving medical care, typically by GPs or by drug treatment or psychiatric units in hospitals. Clinical staff are responsible for medications, so the centrality of these to an intervention distinguishes it most clearly as medical. Medications may be intended to help patients withdraw from drugs more comfortably and with a greater chance of completing the process, to sustain longer term abstinence (eg, the opiate-blocking drug naltrexone), or to substitute a safer and medically controlled drug of the same kind more conducive to social stabilisation, such as methadone for dependent heroin users. But medications are never all there is to medical care. Ideally, they promote a stable space free of drug effects and/or the need to chase illicit supplies during which patients can find other ways to cope and construct lives incompatible with a return to dependent illegal drug use. Drug-based treatments also include potentially therapeutic interactions with clinical and other staff and ways to encourage patients to take medications, sometimes enlisting family and others. Medical treatment for drug dependence may consist entirely of advice and medical and psychosocial support.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/A3.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BL2-3 , HJ2 , HK2 , HK2-10-2-2 , HK2-10-2-2-2 , HZ26 , JM , JP10 , TT2 , TT2-12","B Drugs and alcohol substances > Opioids (opiates) > Buprenorphine -- HJ Treatment method > General treatment method concepts -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor",,"Opioids (opiates) - Buprenorphine -- General treatment method concepts -- Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors -- Drug or health care worker -- Doctor",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HJ2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22480",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22470","12","archive","5",,,"disk0/00/02/24/70","2014-08-13 10:47:30","2014-08-13 10:47:30","2014-08-13 10:47:30","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix cell A2: interventions - generic and cross-cutting issues.","pub","AH18","","public",,,,,,,,,"2014-07","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"other","aod_disorder","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

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 A2 about?

Whether medical or psychosocial, chosen positively or under pressure, patients have to decide to get help, find their way to treatment or get sent there. Decisions must be made about treatment objectives and the form, intensity and duration of care, relationships forged, and attention paid to psychological problems and social circumstances which affect the chances of a sustained end to dependent substance use. Seen as important is the very fact that someone or some institution sanctioned by society has identified the patient/client as in need and deserving of help, believes they will benefit, and has the status of an expert in the problem and its solutions. This cell is about these generic functions and ‘common factors’, now widely recognised as at least as important as the particular therapy. Also here we touch on the nature of addiction and the nature of the caseload seen in treatment services, helping place those services in the context of the spectrum of dependent drug use in society and the ‘natural’ processes of recovery which treatment seeks to harness and accelerate.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/A2.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AH18 , HJ2 , HZ26 , JM , JP10","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > General treatment method concepts -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors",,"Natural history of drugs and alcohol use - Drugs and alcohol recovery -- General treatment method concepts -- Treatment outcome -- Patient care management -- Treatment and maintenance - treatment factors",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "22470",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HJ2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22470",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22470",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22470",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22476","14","archive","5",,,"disk0/00/02/24/76","2014-08-14 11:39:59","2014-08-14 11:39:59","2014-08-14 11:39:59","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix cell B2: practitioners: generic and cross-cutting issues.","pub","JP10","","public",,,,,,,,,"2014-07","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"other","aod_disorder","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,"

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 B2 about?

As described in the cell A2 bite, whether medical or psychosocial, chosen positively or under pressure, among the ‘common factors’ affecting treatment’s success is the relationship between patients and treatment staff. Relationships affect whether people want to enter and stay in treatment and the services they receive. In these ways among others (see Key studies for examples), ultimately relationships can affect the degree to which treatment helps patients overcome their drug problems and improve their lives. The interpersonal style and other features of treatment staff are much less commonly researched than the intervention programme; many studies even try to eliminate these influences from the analysis in order to focus on the intervention. In respect particularly of counselling and psychosocial therapies, this risks eliminating what matters, in order to focus on what (see cell A4) very often does not.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/B2.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JP10 , JP10_2_2 , JP10_6 , MQ6-2 , TT2 , TT4-4 , TT8-2","J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Counsellor / Therapist -- T Demographic characteristics > Social worker",,"Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- Organisational development - Workforce / staff skills and training -- Drug or health care worker -- Counsellor / Therapist -- Social worker",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "22476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22366","16","archive","5",,,"disk0/00/02/23/66","2014-07-22 07:58:04","2014-07-22 07:58:08","2014-07-22 07:58:08","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","National Substance Misuse Non-Medical Prescribing Forum","Non-medical prescribing in the management of substance misuse.","pub","HK2","","public",,,,,,,,"Non-medical prescribing (NMP) – namely, the prescribing of medicines by health professionals who are not doctors – allows for increased availability and responsiveness of prescribing interventions. The non-medical management of substance misuse in the UK was revolutionised by 2012’s change to allow non-media prescribers to independently prescribe for the treatment of drug dependence. PHE’s new document is intended for non-medical prescribers and all those with an interest in NMP including aspiring non-medical prescribers, consultants and clinical leads, service managers, NMP leads, colleagues from different professions (eg, doctors, psychologists, and social workers) and service commissioners. Non-medical prescribing in the management of substance misuse was prepared by an expert group convened by PHE alcohol, drugs and tobacco and the National Substance Misuse Non-Medical Prescribing Forum (NSMNMPF). The document defines clear parameters within which non-medical prescribing can be delivered safely and effectively within recovery-orientated drug and alcohol treatment systems.","2014-07","published",,"Public Health England",,"","",,,,,,"Public Health England","London",,"25 p.",,,,,"PHE publications gateway number: 2014205",,,,,,"report","aod_disorder_drug_therapy","alcohol_drugs_in_general",,,,,,"Public Health England",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HK2 , HK2-10 , JM , JS , TT2 , VH4-4","HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Drug or health care worker","VA Geographic area > Europe > United Kingdom","Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Patient care management -- Health care delivery -- Drug or health care worker","Europe - United Kingdom","National Substance Misuse Non-Medical Prescribing Forum National Substance Misuse Non-Medical Prescribing Forum","0","yes" "22366",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22366",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22366",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22366",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22366",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065","22","archive","5",,,"disk0/00/02/00/65","2013-06-24 10:15:01","2014-08-01 08:19:32","2013-06-24 10:15:01","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Drug Matrix: Evidence for effective treatment.","pub","HK2","","none",,,,,,,,"The Drug Matrix is concerned with the treatment of problems related to the use of illegal drugs by adults (a similar table deals with alcohol-related problems). It maps the terrain within which relevant evidence may be found and for each location tries to find the most important UK-relevant research and guidance. In widening contextual circles, across the top of the matrix the 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 whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. At the intersections, inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level.","2014-06","published",,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Consortium","London",,,,,,,,,,,,,"guideline","aod_disorder_drug_therapy","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://findings.org.uk/docs/dmatrix.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HK2 , HZ , HZ26 , JG26_2_4_2 , JM , JP10 , MQ6 , MQ6-2 , VH4-4","HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Treatment outcome -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- MP-MR Policy, planning, economics, work and social services > Organisational development -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training","VA Geographic area > Europe > United Kingdom","Drugs and alcohol disorder treatment method -- Psychosocial treatment method -- Treatment outcome -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Treatment and maintenance - treatment factors -- Organisational development -- Organisational development - Workforce / staff skills and training","Europe - United Kingdom","Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20065",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502","11","archive","5",,,"disk0/00/02/25/02","2014-08-18 14:08:28","2015-03-24 15:43:36","2014-08-18 14:08:28","article",,,"show",,,,"","","","","","","","","","",,,,"Galvin","Rose","","","","Galvin:Rose::","",,,,,"","","Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish longitudinal study on ageing study (TILDA).","pub","BT6-2","","none",,,,,,,,"PURPOSE: We sought to estimate the prevalence of potentially inappropriate prescriptions (PIP) and potential prescribing omissions (PPOs) using a subset of the STOPP/START criteria in a population based sample of Irish adults aged ≥ 65 years using data from The Irish LongituDinal Study on Ageing (TILDA). METHODS: A subset of 26 PIP indicators and 10 PPO indicators from the STOPP/START criteria were applied to the TILDA dataset. PIP/PPO prevalence according to individual STOPP/START criteria and the overall prevalence of PIP/PPO were estimated. The relationship between PIP and PPOs and polypharmacy, age, gender and multimorbidity was examined using logistic regression. RESULTS: The overall prevalence of PIP in the study population (n=3,454) was 14.6 %. The most common examples of PIP identified were NSAID with moderate-severe hypertension (200 participants; 5.8 %) and aspirin with no history of coronary, cerebral, or peripheral vascular symptoms or occlusive event (112 participants; 3.2 %). The overall prevalence of PPOs was 30 % (n=1,035). The most frequent PPO was antihypertensive therapy where systolic blood pressure consistently >160 mmHg (n=341, 9.9 %), There was a significant association between PIP and PPO and polypharmacy when adjusting for age, sex and multimorbidity (adjusted OR 2.62, 95 % CI 2.05-3.33 for PIP and adjusted OR 1.46, 95 % CI 1.23-1.75 for prescribing omissions). CONCLUSION: Our findings indicate prescribing omissions are twice as prevalent as PIP in the elderly using a subset of the STOPP/START criteria as an explicit process measure of potentially inappropriate prescribing and prescribing omissions. Polypharmacy was independently associated with both PPO and PIP. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, healthcare utilisation and cost.","2014-05","published",,"Galvin Rose",,"","",,"European Journal of Clinical Pharmacology","70","5","5","Springer",,"599-606",,,,,,,,,,,"TRUE","","","",,"1432-1041",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://download.springer.com/static/pdf/599/art%253A10.1007%252Fs00228-014-1651-8.pdf?auth66=1408543352_442594688f11f201383e4edf8298e781&ext=.pdf","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","70","European Journal of Clinical Pharmacology","BT6-2 , JM , TA16-6 , TT2-12 , VH4-2","E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Elderly / Older person -- T Demographic characteristics > Doctor","VA Geographic area > Europe > Ireland","Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Patient care management -- Elderly / Older person -- Doctor","Europe - Ireland","Galvin Rose , Moriarty Frank , Cousins Gráinne , Cahir Caitriona , Motterlini Nicola , Bradley Marie , Hughes Carmel M , Bennett Kathleen , Smith Susan M , Fahey Tom , Kenny Rose-Anne","0","yes" "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Moriarty","Frank","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cousins","Gráinne","","",,,,,,,,,,,,"TA16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cahir","Caitriona","","",,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Motterlini","Nicola","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bradley","Marie","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hughes","Carmel M","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bennett","Kathleen","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Smith","Susan M","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Fahey","Tom","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22502",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kenny","Rose-Anne","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21862","13","archive","5",,,"disk0/00/02/18/62","2014-05-07 15:05:36","2017-02-13 11:41:41","2014-05-07 15:05:36","monograph",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Health Information and Quality Authority","Guidance for health and social care providers. Principles of good practice in medication reconciliation.","pub","BT6-2","","public",,"other",,,,,,"Medication management refers to the safe, clinically effective and economic use of medicines to ensure that people using health and social care services get the maximum benefit from the medicines they need, while at the same time minimising potential harm. Medication safety involves giving the right person the right medication in the right dose at the right time and by the correct route. In line with the relevant national standards, service providers are expected to have arrangements in place to ensure the safe and effective use of medicines, including assessing, prescribing, dispensing, administering, documenting, reconciling, reviewing and assisting people with their medications. The Authority has produced this guidance to aid service providers in achieving this. In Ireland, the medication incidents most commonly reported to the Clinical Indemnity Scheme (CIS) in 2012 were medication reconciliation incidents.","2014-05","published",,"Health Information and Quality Authority",,"","",,,,,,"Health Information and Quality Authority","Cork",,"24 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.hiqa.ie/publications/guidance-health-and-social-care-providers-principles-good-practice-medication-reconcili","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"BT6-2 , JM , VH4-2","E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- J Health care, prevention and rehabilitation > Patient care management","VA Geographic area > Europe > Ireland","Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Patient care management","Europe - Ireland","Health Information and Quality Authority Health Information and Quality Authority","0","yes" "21862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22963","12","archive","5",,,"disk0/00/02/29/63","2014-11-11 12:38:16","2014-11-11 12:38:16","2014-11-11 12:38:16","article",,,"show",,,,"","","","","","","","","","",,,,"McVeigh","T","","","","McVeigh:T::","",,,,,"","","Endovascular aneurysm repair for multiple aneurysms as a sequel of hypereosinophilic syndrome.","pub","AM","","none",,,,,,,,"This case represents the first report of multiple arterial aneurysms including aortic, iliac, visceral, and coronary aneurysms associated with hypereosinophilic syndrome. It presents an interesting case of epinephrine abuse and the unfortunate sequelae. This case illustrates novel approaches in emergency repair of internal iliac artery aneurysm rupture and the management of visceral artery aneurysms and exemplifies how multiple endovascular technologies can be utilized even in the high-risk polymorbid patient.","2014-04","published",,"McVeigh T",,"","",,"Vascular and endovascular surgery","48","3","3","Sage",,"277-280",,,,,,,,,,,,"","","",,"1938-9116",,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","48","Vascular and endovascular surgery","AM , BJ , JM , VH4-2","A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > CNS stimulants -- J Health care, prevention and rehabilitation > Patient care management","VA Geographic area > Europe > Ireland","Drugs and alcohol effects and consequences -- CNS stimulants -- Patient care management","Europe - Ireland","McVeigh T , Hynes N , Tawfick W , Sultan S","0","yes" "22963",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hynes","N","","",,,,,,,,,,,,"BJ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22963",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Tawfick","W","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22963",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Sultan","S","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600","34","archive","5",,,"disk0/00/02/16/00","2014-03-25 12:41:18","2015-12-23 11:09:44","2014-03-25 12:41:18","monograph",,,"show",,,,"","","","","","","","","","","0",,,"Barry","Joseph","","","","Barry:Joseph::","",,,,,"","","Evaluation report of the National Drugs Rehabilitation Framework pilot.","pub","VH4-2","","public",,"other",,,,,,,"2014-03","published",,"Barry Joseph",,"","",,,,,,"Health Service Executive","Dublin",,"173 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,"
This is the first external examination of the pilot of the National Drug Rehabilitation Framework (NDRF). A selection of service providers, service users and key informants were interviewed across ten volunteer pilot sites. Of the ten pilot sites six had begun implementing the framework and four had not. There were qualitative and quantitative components to the evaluation.
 
The quantitative findings come from questionnaires filled out by 81 individuals, all from pilot sites implementing the framework. There were 14 service users, 48 key workers/case managers and 19 service managers. All service users had completed an assessment and all had a key worker. Two thirds had a case manager. Overall, service users were satisfied with the service they were receiving. Three quarters of key workers/case managers always engaged in care planning, and the remainder sometimes, with similar ratios for engaging in interagency meetings. Service managers were more likely to experience difficulty implementing comprehensive assessments than initial assessments.
 
All bar one manager said care planning was being implemented but of those doing so all except three reported difficulties. Implementation of confidentiality protocols was in some way difficult for over three quarters of service managers. Service managers reported varying levels of access to support services such as addiction, education and employment, housing, justice and law reform services. All service managers were engaged in interagency working but all reported at least some difficulty implementing service level agreements. Both service managers and frontline staff reported an improvement in communication, sharing of information and referrals following implementation of the framework.
 
The qualitative findings come from interviews with 74 individuals. Interviews took place with 14 service users from the pilot sites that were implementing the framework. In addition, there were interviews with 12 key workers, 8 case managers and 12 service managers from the pilot sites. Ten coordinators from the pilot sites were interviewed. In addition 18 key informants were also interviewed. Fourteen of these were from pilot sites that were not implementing the framework. There was near universal enthusiasm for the framework and optimism that its aims could be achieved if commitments to the framework were re-iterated by all agencies. Better inter-agency working was seen as key. One of the fears expressed by many was that the momentum gained could be lost if all agencies who have an input decided to pull back from the implementation. There is already some evidence of 'missing partners'. When asked about their experience with their key workers and case managers, service users were generally very positive and felt supported in the process. Service users spoke about the benefits of connecting with a service and the direct effect that this had on their lives.
 
In terms of the benefits that were more directly attributable to the framework, care planning was the most recognisable practice for service users; the majority of service users had a clear idea of their goals and aspired to build on the current success. Four sites were not implementing the framework when this evaluation fieldwork was being carried out. While parallel work to the framework was most likely taking place in these sites there were no service users who could be interviewed as possible beneficiaries of the framework. The two most commonly cited reasons for non-implementation were politics and lengthy pre-implementation planning. Some interviewees saw this as a lost opportunity and there was a sense that if people had their time back they would have begun implementing sooner.
 
Notwithstanding the findings and some of the challenges uncovered in the roll-out of the framework there was near universal support and enthusiasm for the framework, even where it was not being implemented yet. The purpose of the evaluation was to provide learning on what was, and was not, working. All findings, both positive and negative, provide a stimulus for increased learning and can be used to advance the implementation of the framework nationally.
",,,,,,,,,,,"",,"http://www.hse.ie/go/ndric/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"VH4-2 , JP10_2_2 , JM , JS , JP10_6 , MQ8-10 , MQ6 , LU6-2 , JP24-4 , JT , LG14-10","J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- MP-MR Policy, planning, economics, work and social services > Programme planning, implementation, and evaluation > Programme evaluation -- MP-MR Policy, planning, economics, work and social services > Organisational development -- L Social psychology and related concepts > Collaboration and conflict > Collaboration (co-operation) -- J Health care, prevention and rehabilitation > Rehabilitation -- J Health care, prevention and rehabilitation > Health care programme or facility -- L Social psychology and related concepts > Marital relations > Family and kinship > Family structure > Family support","VA Geographic area > Europe > Ireland","Treatment and maintenance - patient attitude toward treatment -- Patient care management -- Health care delivery -- Treatment and maintenance - provider attitude toward treatment -- Programme planning, implementation, and evaluation - Programme evaluation -- Organisational development -- Collaboration and conflict - Collaboration (co-operation) -- Rehabilitation -- Health care programme or facility -- Marital relations - Family and kinship - Family structure - Family support","Europe - Ireland","Barry Joseph , Ivers Jo-Hanna H","0","no" "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ivers","Jo-Hanna H","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ8-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LU6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP24-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LG14-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508","21","archive","5",,,"disk0/00/02/15/08","2014-03-11 10:10:54","2014-03-11 10:10:54","2014-03-11 10:10:54","article",,,"show",,,,"","","","","","","","","","","0",,,"Meagan","Geraldine","","","","Meagan:Geraldine::","",,,,,"","","Novel approach to tackle alcohol problems.","pub","VH4-2","","none",,,,,,,,"A recent survey shows that many GPs still feel unsure about their ability to effectively help patients who have issues with alcohol. Results of this survey will be published in 2014. Although a high proportion of GPs think that they are not effective in helping patients to change their drinking habits, the survey is pointing to a large proportion using structured brief intervention in their practices and providing some form of counselling to help patients to reduce their drinking.","2014-03",,,"Meagan Geraldine",,"","",,"Forum","31","3","3","Irish College of General Practitioners",,"23",,,,,,,,,,,"FALSE","","","",,,,,,,,,"","","","","","","","","","",,"

 

",,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","31","Forum","VH4-2 , HZ2-2-2 , JM , BB , TT2-12 , JB2-4 , GC16 , JT8_8_2","HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention -- J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Alcohol -- T Demographic characteristics > Doctor -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- G Health and disease > Drugs and alcohol disorder > Alcohol use -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Psychosocial treatment method - Individual therapy - Brief intervention -- Patient care management -- Alcohol -- Doctor -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Drugs and alcohol disorder - Alcohol use -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","Meagan Geraldine","0","yes" "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21508",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21419","20","archive","5",,,"disk0/00/02/14/19","2014-02-19 08:36:16","2014-02-19 08:36:16","2014-02-19 08:36:16","article",,,"show",,,,"","","","","","","","","","","0",,,"Twomey","C","","","","Twomey:C::","",,,,,"","","Steps towards effective teamworking in community mental health teams.","pub","TT2","","none",,,,,,,,,"2014-03",,,"Twomey C",,"","",,"Irish Journal of Psychological Medicine","31","1","1","Medmedia Group",,"51-59",,,,,,"doi:10.1017/ipm.2013.62",,,,,,"","","",,"0790-9667",,,,,,,"","","","","","","","","","",,"

Objectives: This paper aims to show how effective teamworking can be achieved in Community Mental Health Teams (CMHTs), in the context of recovery-focused care. 

Methods: A narrative review of various governmental policy documents and selected papers relevant to teamworking and recovery-focused care within mental health services, in an Irish context.
 
Findings: Effective teamworking within CMHTs is a prerequisite to the provision of quality, recovery-focused care. It requires the management of various environmental (e.g. adopting a ‘recovery’ model of mental health), structural (e.g. sharing of responsibilities and capabilities) and process (e.g. utilising a clear referral pathway) factors that influence teamworking, as CMHTs develop over time.
 
Conclusions: Completion by CMHT members of teamworking and other evaluative measures can assist teams in highlighting potential interventions that may improve recovery-focused team functioning and effectiveness.
",,,,,,,,,,,"",,"http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9176413&utm_source=Issue_Alert&utm_medium=Email&utm_campaign=IPM","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","31","Irish Journal of Psychological Medicine","TT2 , AH18 , JQ6-8 , VH4-2 , JM , JS , MQ6-2","T Demographic characteristics > Drug or health care worker -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training","VA Geographic area > Europe > Ireland","Drug or health care worker -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Care by type of problem - Mental health care -- Patient care management -- Health care delivery -- Organisational development - Workforce / staff skills and training","Europe - Ireland","Twomey C , Byrne M , Leahy T","0","no" "21419",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Byrne","M","","",,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21419",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Leahy","T","","",,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21419",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21419",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21419",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21419",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524","17","archive","5",,,"disk0/00/02/25/24","2014-08-21 08:40:23","2014-08-21 09:00:11","2014-08-21 08:40:23","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Alcohol Matrix cell A4: Interventions - psychosocial therapies.","pub","BB","","public",,,,,,,,,"2014-02",,,"Drug and Alcohol Findings",,"","",,,,,,"Drug and Alcohol Findings and the Substance Misuse Skills Consortium","London",,,,,,,,,,,,,"","psychosocial_treatment_method","alcohol",,,,,,"Drug and Alcohol Findings",,,"","","","","","","","","","",,"

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-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 the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

What is cell A4 about?

Every treatment involves direct or indirect human interaction, but this cell is about therapies in which interaction is intended to be the main active ingredient. Colloquially referred to as ‘talking therapies’, these are more formally categorised as ‘psychosocial’ because they attempt to change how the patient reacts either directly or via their beliefs and attitudes, how they relate to others, and sometimes too how others relate to them – of which the biggest change may be the experience of being related to in a therapeutic context. Interventions range from brief advice and counselling to extended therapies based on psychological theories, and all-embracing residential communities where clients stay for several months. 

Elements could include rewards and punishments contingent on client behaviour (contingency management), leading the client to see their substance use as contrary to desired self-images or objectives (as in motivational interviewing), harnessing social influences (as in group and family therapies and community living arrangements), teaching the client what triggers their undesired substance use and how to manage or avoid those triggers (as in cognitive-behavioural therapies), and more practical elements such as vocational rehabilitation. Whether based on research and theory, religion, morals or experience, belief systems underlie these approaches. Most prominent in the research are the 12 steps of Alcoholics Anonymous, and the understanding that addiction can be learnt and unlearnt which underpins major psychological therapies.

",,,,,,,,,,,"","http://findings.org.uk/count/downloads/download.php?file=Matrix/Alcohol/A4.htm","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , HZ , HZ16 , HZ2-6-6 , HZ26 , HZ8-18-4-2 , HZ8-20 , JM , TT4-4","B Drugs and alcohol substances > Alcohol -- HJ Treatment method > Psychosocial treatment method -- HJ Treatment method > Twelve-step model -- HJ Treatment method > Psychosocial treatment method > Group therapy -- HJ Treatment method > Treatment outcome -- HJ Treatment method > Directive and nondirective therapy > Psychoanalytic therapy > Cognitive behavioural therapy (CBT) -- HJ Treatment method > Psychosocial treatment method > Motivational interviewing -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Counsellor / Therapist",,"Alcohol -- Psychosocial treatment method -- Twelve-step model -- Psychosocial treatment method - Group therapy -- Treatment outcome -- Directive and nondirective therapy - Psychoanalytic therapy - Cognitive behavioural therapy (CBT) -- Psychosocial treatment method - Motivational interviewing -- Patient care management -- Counsellor / Therapist",,"Drug and Alcohol Findings Drug and Alcohol Findings , Substance Misuse Skills Consortium Substance Misuse Skills Consortium","0","yes" "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Substance Misuse Skills Consortium",,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ2-6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ8-18-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ8-20",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22524",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21455","19","archive","5",,,"disk0/00/02/14/55","2014-02-26 09:39:17","2014-09-09 11:21:25","2014-02-26 09:39:17","article",,,"show",,,,"","","","","","","","","","","0",,,"Nfila","G","","","","Nfila:G::","",,,,,"","","Impact of new UK paracetamol overdose guidelines on patients presenting to the emergency department.","pub","BT6-1","","none",,,,,,,,"Paracetamol is involved in a large proportion of overdoses that present to the Emergency Department (ED), either as lone or mixed overdoses. Non-treatment of toxic levels can lead to fulminant liver failure. This study is to determine the impact the new UK treatment guidelines1 will have on patients presenting with paracetamol overdose. A retrospective review was performed on all patients who had paracetamol levels done in the ED between September 2011 and August 2012. A total of 523 patients were identified, 95(18%) of whom had detectable paracetamol levels. 74 patients from the 95 were evaluated. 18(24%) patients were treated with N-acetylcysteine as per the then paracetamol overdose guidelines. Using the new guidelines would have resulted in 3 more patients being admitted. Our study shows that most patients who present following paracetamol overdose do not require treatment with N-acetylcysteine and suggests that the introduction of the new UK treatment guidelines is likely to result in only a small increase in the number of patients requiring treatment.","2014-02","published",,"Nfila G",,"","",,"Irish Medical Journal","107","2","2","Irish Medical Organisation",,"47",,,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://www.imj.ie//ViewArticleDetails.aspx?ArticleID=12779","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","107","Irish Medical Journal","BT6-1 , VH4-4 , GC4-6 , JM , JQ8-2","E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Over the counter drug (medicine / medication) -- G Health and disease > Drugs and alcohol disorder > Drug use > Drug intoxication > Drugs and alcohol poisoning (overdose) -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care","VA Geographic area > Europe > United Kingdom","Drugs and alcohol substance by legal status - Over the counter drug (medicine / medication) -- Drugs and alcohol disorder - Drug use - Drug intoxication - Drugs and alcohol poisoning (overdose) -- Patient care management -- Care by type of problem - emergency care","Europe - United Kingdom","Nfila G , Lee S , Binchy J","0","no" "21455",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Lee","S","","",,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21455",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Binchy","J","","",,,,,,,,,,,,"GC4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21455",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21455",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24476","16","archive","5",,,"disk0/00/02/44/76","2015-09-04 08:24:54","2015-09-04 08:26:00","2015-09-04 08:24:54","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Health and Safety Authority","Guide to the European Union (Prevention of Sharps Injuries in the Healthcare Sector) Regulations 2014.","pub","JH10-6","","public",,,,,,,,"The purpose of this guide is to provide practical information on the implementation of the European Union (Prevention of Sharps Injuries in the Healthcare Sector) Regulations 2014, hereafter referred to as ‘’the Regulations’’. The information is aimed at employers, managers, employees, safety representatives, health and safety practitioners and other interested parties in the healthcare sector.","2014",,,"HSA",,"","",,,,,,"Health and Safety Authority","Dublin",,"16 p.",,,,,,,,,,,"guideline","aod_use_harm_reduction","opioid",,,,,,"HSA",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.hsa.ie/eng/Legislation/New_Legislation/S_I_135_of_2014.pdf","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JH10-6 , JH10-6-4 , JM , TT2-12 , TT2-14 , VH4-2 , VQ6","J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control > Needle distribution and exchange -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse","VA Geographic area > Europe > Ireland -- VA Geographic area > Europe > European Union","Health-related prevention - Health information and education - Communicable disease control -- Health-related prevention - Health information and education - Communicable disease control - Needle distribution and exchange -- Patient care management -- Doctor -- Nurse","Europe - Ireland -- Europe - European Union","Health and Safety Authority Health and Safety Authority","0","yes" "24476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://www.hpsc.ie/A-Z/MicrobiologyAntimicrobialResistance/InfectionControlandHAI/EducationConferencesrelatingtoInfectionControl/2015RCSIHPSCFoundationCourseonInfectionPreventionControl/CoursePresentations/",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24476",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143","21","archive","5",,,"disk0/00/02/41/43","2015-06-19 10:28:03","2015-06-19 10:29:01","2015-06-19 10:28:03","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","National Institute for Health and Care Excellence","Drug misuse overview.","pub","B6","","none",,,,,,,,,"2014","published",,"NICE",,"","",,,,,,"National Institute for Health and Care Excellence","London",,,,,,,"NICE Pathways",,,,,,"","aod_disorder","alcohol_drugs_in_general",,,,,,"NICE",,,"","","","","","","","","","",,"

This pathway covers psychosocial interventions and opioid detoxification for drug misuse.

 

The pathway makes recommendations for the use of psychosocial interventions in the treatment of people who misuse opioids, stimulants and cannabis in the healthcare and criminal justice systems. It also covers treatment of people who are undergoing detoxification for opioid dependence arising from the misuse of illicit drugs. Opioid detoxification refers to the process by which the effects of opioid drugs are eliminated from dependent opioid users in a safe and effective manner, such that withdrawal symptoms are minimised.

 

This pathway should be used in conjunction with 'Drug misuse and dependence – UK guidelines on clinical management: update 2007', also known as the 'Orange Book', which provides advice to healthcare professionals on the delivery and implementation of a broad range of interventions for drug misuse, including those interventions covered in the present guideline.

",,,,,,,,,,,"","http://pathways.nice.org.uk/pathways/drug-misuse","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"B6 , BJ , BL , HK2 , HK2-10 , HK2-10-2-2-2 , HK2-4 , HZ , JG26_2_4_2 , JM , LG14-10 , TT2 , TT2-14 , TT6 , TT8-2","B Drugs and alcohol substances > Cannabis / Marijuana -- B Drugs and alcohol substances > CNS stimulants -- B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > Drugs and alcohol disorder treatment method -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- HJ Treatment method > Drugs and alcohol disorder treatment method > Detoxification method -- HJ Treatment method > Psychosocial treatment method -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- L Social psychology and related concepts > Marital relations > Family and kinship > Family structure > Family support -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Nurse -- T Demographic characteristics > Prevention worker -- T Demographic characteristics > Social worker",,"Cannabis / Marijuana -- CNS stimulants -- Opioids (opiates) -- Drugs and alcohol disorder treatment method -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Drugs and alcohol disorder treatment method - Detoxification method -- Psychosocial treatment method -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Marital relations - Family and kinship - Family structure - Family support -- Drug or health care worker -- Nurse -- Prevention worker -- Social worker",,"National Institute for Health and Care Excellence National Institute for Health and Care Excellence","0","yes" "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BJ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method","cannabis",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention","cns_depressants",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction","cns_stimulants",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation","cocaine",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening","inhale_solvent",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"opioid",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychoactive",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LG14-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24143",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793","17","archive","5",,,"disk0/00/02/27/93","2014-10-16 07:27:40","2014-10-16 07:27:40","2014-10-16 07:27:40","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Public Health England","A framework for personalised care and population health for nurses, midwives, health visitors and allied health professionals.","pub","BB","","public",,,,,,,,"This framework has been developed to underpin the UK national programme to maximise nurses, midwives, health visitors (HVs) and allied health professionals (AHPs) impact on improving health outcomes and reducing inequalities. The framework supports and shapes health promoting practice and embeds personalised care and population health across all ages, care places and with individuals, families and communities. It is a resource to support practitioners’ access to best evidence for practice and to support nurse managers and commissioners to develop services which use the knowledge and skills that nurses, midwives, HVs and AHPs use to deliver the best health outcomes for the populations they serve. There are six key areas of population health activity in the framework. In each population health activity area are one or more worked examples on national health priority areas that illustrate how the framework should be used. • Wider determinants of health • Health improvement • Health protection • Healthcare public health • Health, wellbeing & independence • Lifecourse [Alcohol section on page 32-36; also contains references to smoking throughout the document]","2014","published",,"Public Health England",,"","",,,,,,"Department of Health","London",,"82 p.",,,,,,,,,,,"report","aod_prevention","alcohol",,,,,,"Public Health England",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BB , ED4-12 , GA4 , JH2-2 , JM , JS , TT2 , TT2-14 , TT8-2 , VH4-4","B Drugs and alcohol substances > Alcohol -- E Concepts in biomedical areas > Pregnancy -- G Health and disease > Public health -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Health promotion -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Nurse -- T Demographic characteristics > Social worker","VA Geographic area > Europe > United Kingdom","Alcohol -- Pregnancy -- Public health -- Health-related prevention - Health information and education - Health promotion -- Patient care management -- Health care delivery -- Drug or health care worker -- Nurse -- Social worker","Europe - United Kingdom","Public Health England Public Health England","0","yes" "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"ED4-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction","tobacco",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22793",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21100","22","archive","5",,,"disk0/00/02/11/00","2013-12-19 10:28:27","2014-04-09 22:08:36","2013-12-19 10:28:27","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Recovery Orientated Drug Treatment Expert Group","Medications in recovery: best practice in reviewing treatment.","pub","AH18","","public",,,,,,"Supplementary advice from the Recovery Orientated Drug Treatment Expert Group.",,"In 2012, the Recovery Orientated Drug Treatment Expert Group published its report, Medications in recovery: re-orientating drug dependence treatment. The report supports a radical ambition to place prescribing within a fully recovery-orientated system of care, with changes at system, service and individual levels. The report makes clear that this involves treatment services continuing to re-orient their delivery of care to provide active and visible support for recovery from the point of entry to treatment, during treatment and after exit, and that successful recovery also relies on support from others, including mutual aid, employment and housing services. In the summer of 2013, the Chief Medical Officer (CMO) asked for further advice from the expert group on: • the frequency at which an individual receiving treatment for addiction should be reviewed (to determine the benefit of the treatment and thus whether alternative treatments should be tried) • the structure of the review meetings (what should be considered, how to assess the benefit a patient is receiving, tools for decision making, etc) The group responded to CMO in September 2013 and, following her review of their advice, she has agreed with the group that PHE should publish the advice for the benefit of the field. The group’s advice makes clear that: • care planning, with its ongoing and planned reviews of specific goals and actions, should be part of a phased and layered treatment programme • a strategic review of the client’s recovery pathway will normally be necessary within three months (and no later than six months) of treatment entry, and will then usually be repeated at six-monthly intervals • a strategic review should always revisit recovery goals and pathways (to support clients to move towards a drug-free lifestyle) • drug treatment should be reviewed based on an assessment of improvement (or preservation of benefit) across the core domains of successful recovery.","2013-12","published",,"Public Health England",,"","",,,,,,"Public Health England","London",,"20 p.",,,,,,,,,,,"review","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"Public Health England",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://www.drugsandalcohol.ie/18123/","pubn",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"AH18 , HZ26 , HK2 , VH4-4 , JM , JP10 , HK2-10","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > Treatment outcome -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy","VA Geographic area > Europe > United Kingdom","Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Treatment outcome -- Drugs and alcohol disorder treatment method -- Patient care management -- Treatment and maintenance - treatment factors -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy","Europe - United Kingdom","Recovery Orientated Drug Treatment Expert Group Recovery Orientated Drug Treatment Expert Group","0","yes" "21100",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21100",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21100",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21100",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21100",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "21100",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20671","21","archive","5",,,"disk0/00/02/06/71","2013-10-07 07:50:19","2014-04-09 22:07:57","2013-10-07 07:50:19","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Health Protection Surveillance Centre","Infection with Bacillus anthracis - Injecting drug users potential presentations and case definitions.","pub","TL4-10-4","","public",,,,,,,,"In Scotland in December 2009, an outbreak of anthrax was identified among injecting drug user (IDUs) centred in Glasgow. The initial Scottish cluster of infection in IDUs began in 2009 and resulted in 119 patients being classed as having anthrax, with 47 of these being confirmed. Fourteen of these cases died. In addition, there were three related cases in England. The responsible isolates had an indistinguishable genetic signature (Ba4599 single-nucleotide polymorphism genotype). In investigating strain origin, it was subsequently determined that this clone was prevalent in Turkey. Initial UK police and Europol investigations suggested that hide bags used to transport raw opium from production areas in Afghanistan to processing plants (most likely in Turkey) were the source of the anthrax spores. After a lull, in summer 2012, a cluster of five anthrax bloodstream infection cases was identified in Germany, Denmark and France (this cluster was suspected as being caused by illegal importation of heroin from Scotland to Germany). This low-grade outbreak is continuing; to date (March 2013) 13 cases now identified since early June 2012. Seven cases have been affected in the UK – five in England (including four fatalities), one in Scotland and one in Wales. The causative strain of this cluster was again indistinguishable from that responsible for the Scottish cluster. To date, there have been no similar cases in Ireland. The aim of this guidance is to assist clinicians in Ireland in clinical and microbiological assessment of suspected cases of infection with B. anthracis in IDUs.","2013-09","published",,"HSE Website",,"","",,,,,,"Health Protection Surveillance Centre","Dublin",,"6 p.",,,,,,,,,,,"guideline","aod_use_harm_reduction","opioid",,,,,,"HSE Website",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://www.hpsc.ie/hpsc/","author",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"TL4-10-4 , VH4-2 , JM , GH16-14 , JH10-6 , JB2-4","T Demographic characteristics > Intravenous / injecting drug user -- J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > Disorder by cause > Communicable disease > Bacterial disease -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction","VA Geographic area > Europe > Ireland","Intravenous / injecting drug user -- Patient care management -- Disorder by cause - Communicable disease - Bacterial disease -- Health-related prevention - Health information and education - Communicable disease control -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction","Europe - Ireland","Health Protection Surveillance Centre Health Protection Surveillance Centre , Health Service Executive Health Service Executive","0","no" "20671",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Health Service Executive",,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20671",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20671",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20671",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20671",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447","27","archive","5",,,"disk0/00/02/04/47","2013-08-15 15:00:14","2015-09-04 13:17:30","2013-08-15 15:00:14","article",,,"show",,,,"","","","","","","","","","","0",,,"Field","Catherine-Anne","","","","Field:Catherine-Anne::","",,,,,"","","Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment.","pub","VH4-2","","none",,,,,,,,"Background: Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients’ experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care. Methods: This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland’s Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer. Results: We identified three overarching themes relevant to the purpose of this paper: (1) patients’ experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment. Conclusions: Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored.","2013-07","published",,"Field Catherine-Anne",,"","",,"BMC Family Practice","14",,,"BioMed Central",,"98",,,,,,"doi:10.1186/1471-2296-14-98",,,,,,"","","",,"1471-2296",,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://www.biomedcentral.com/1471-2296/14/98/","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","14","BMC Family Practice","VH4-2 , JP10_2_2 , JG26_2_4_2 , BB , AD12-6 , GC14 , HC , GC16-6 , JT8_8_2","J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- B Drugs and alcohol substances > Alcohol -- A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Drugs and alcohol use behaviour > Alcohol consumption -- G Health and disease > Drugs and alcohol disorder > Multiple drugs and alcohol use (Polydrug) -- HA Screening, identification, and diagnostic method > Medical screening and diagnostic method -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Treatment and maintenance - patient attitude toward treatment -- Identification and screening - Identification and screening for drugs and alcohol use -- Alcohol -- Prevalence of drugs and alcohol use - Drugs and alcohol use behaviour - Alcohol consumption -- Drugs and alcohol disorder - Multiple drugs and alcohol use (Polydrug) -- Medical screening and diagnostic method -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","Field Catherine-Anne , Klimas Jan , Barry Joseph , Bury Gerard , Keenan Eamon , Smyth Bobby P , Cullen Walter","0","no" "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Klimas","Jan","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Barry","Joseph","","",,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bury","Gerard","","",,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Keenan","Eamon","","",,,,,,,,,,,,"AD12-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Smyth","Bobby P","","",,,,,,,,,,,,"GC14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cullen","Walter","","",,,,,,,,,,,,"HC",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20447",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862","28","archive","5",,,"disk0/00/02/08/62","2013-11-07 10:51:22","2013-11-07 10:51:22","2013-11-07 10:51:22","guideline",,,"show",,,,"","","","","","","","","","","0",,,"Finnegan","Loretta","","","",,"",,,,,"","","Licit and illicit drug use during pregnancy: maternal, neonatal and early childhood consequences.","pub","GJ2-16-2-4-6","","public",,,,,,,,"Introduction p.5 1.0 Epidemiology of maternal drug use p.8 2.0 Medical and obstetrical consequences of drug use in women p.14 3.0 Psychosocial issues and victimization in pregnant women using drugs p.26 4.0 Outcomes of newborns of pregnant women using drugs p.34 5.0 Comprehensive treatment approaches for pregnant women using drugs p.62 6.0 Early childhood outcomes p.90 7.0 A Call to action by Franco Vaccarino and Colleen Dell p.106 Appendices p.112","2013","published",,"CCSA",,"","",,,,,,"Canadian Centre on Substance Abuse","Ottawa",,"116 p.",,,,,,,,,,,"report","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"CCSA",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"GJ2-16-2-4-6 , ED4-12 , HK2 , JM , T10-4-2 , GJ , FR16-6-4-2 , JP10_6 , VC4","G Health and disease > Disorder by cause > Developmental disorder > Foetal (fetal) alcohol syndrome -- E Concepts in biomedical areas > Pregnancy -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Pregnant woman -- G Health and disease > Disorder by cause > Developmental disorder -- F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol > Attitude toward drugs and alcohol addict or user -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment","VA Geographic area > Canada","Disorder by cause - Developmental disorder - Foetal (fetal) alcohol syndrome -- Pregnancy -- Drugs and alcohol disorder treatment method -- Patient care management -- Pregnant woman -- Disorder by cause - Developmental disorder -- Attitude and behaviour - Attitude toward drugs and alcohol - Attitude toward drugs and alcohol addict or user -- Treatment and maintenance - provider attitude toward treatment","Canada","Finnegan Loretta","0","yes" "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"ED4-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"T10-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GJ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"FR16-6-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20862",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VC4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19944","28","archive","1684",,,"disk0/00/01/99/44","2013-05-31 12:06:20","2014-04-09 22:06:36","2013-05-31 12:06:20","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","","Leading for outcomes integrated working.","pub","VH4410","","public",,,,,,,,"This guide forms part of the IRISS Leading for Outcomes series. The guides are designed to support team leaders, managers and trainers to lead teams in the adoption and implementation of personal outcomes-focused approach. • The guide is aimed at those committed to leading an outcomes-focused approach to integrated working, including team leaders, managers and those in training roles. It should be relevant to those from a range of health, housing and social care backgrounds. • The guide provides a framework for training and is designed to be adapted to the time and resources available and to the specific needs of your team. The guide builds on the material offered in the parent guide. We suggest you familiarise yourself with this guide before leading with this more specialist guide. Cross-references are made to the parent guide as appropriate in this document. The guide includes a range of training materials and exercises and is divided into three parts. Part one focuses on understanding what is meant by integrated working. Part two focuses on understanding and promoting a personal outcomes approach within integrated working across health, housing and social care and beyond. Part three focuses on putting the approach into practice and on ensuring it is sustained.","2013","published",,"Institute for Research and Innovation in Social Services",,"","",,,,,,"Institute for Research and Innovation in Social Services","Glasgow",,"64 p.",,,,,,,,,,,"guideline","rehabilitation","alcohol_drugs_in_general",,,,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://www.iriss.org.uk/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","do_not_display",,"3",,,"VH4410 , HZ26 , MQ6 , JM , JP24-4","HJ Treatment method > Treatment outcome -- MP-MR Policy, planning, economics, work and social services > Organisational development -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Rehabilitation","VA Geographic area > Europe > United Kingdom > Scotland","Treatment outcome -- Organisational development -- Patient care management -- Rehabilitation","Europe - United Kingdom - Scotland",,"0","yes" "19944",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19944",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19944",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19944",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP24-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19335","22","archive","1684",,,"disk0/00/01/93/35","2013-02-21 09:30:13","2015-09-17 08:54:32","2013-02-21 09:30:13","article",,,"show",,,,"","","","","","","","","","","0",,,"Maguire","Aideen","","","","Maguire:Aideen::","",,,,,"","","Psychotropic medications and the transition into care: a national data linkage study.","pub","VH4-4-8","","none",,,,,,,,"Objectives To determine whether excessive and often inappropriate or dangerous psychotropic drug dispensing to older adults is unique to care homes or is a continuation of community treatment. Design Population-based data-linkage study using prescription drug information. Setting Northern Ireland's national prescribing database and care home information from the national inspectorate. Participants Two hundred fifty thousand six hundred seventeen individuals aged 65 and older. Measurements Prescription information was extracted for all psychotropic drugs included in the British National Formulary (BNF) categories 4.1.1, 4.1.2, and 4.2.2 (hypnotics, anxiolytics, and antipsychotics) dispensed over the study period. Repeated cross-sectional analysis was used to monitor changes in psychotropic drug dispensing over time. Results Psychotropic drug use was higher in care homes than the community; 20.3% of those in care homes were dispensed an antipsychotic in January 2009, compared with 1.1% of those in the community. People who entered care had higher use of psychotropic medications before entry than those who did not enter care, but this increased sharply in the month of admission and continued to rise. Antipsychotic drug dispensing increased from 8.2% before entry to 18.6% after entering care (risk ratio (RR) = 2.26, 95% confidence interval (CI)=1.96–2.59) and hypnotic drug dispensing from 14.8% to 26.3% (RR=1.78, 95% CI=1.61–1.96). Conclusion A continuation of high use before entry cannot wholly explain the higher dispensing of psychotropic drugs to individuals in care homes. Although drug dispensing is high in older people in the community, it increases dramatically","2013",,,"Maguire Aideen",,"","",,"Journal of the American Geriatrics Society","61",,,,,"215-221",,,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","61","Journal of the American Geriatrics Society","VH4-4-8 , JM , TA16-6 , JT , BT6-2 , JQ6-4","J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Elderly / Older person -- J Health care, prevention and rehabilitation > Health care programme or facility -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- J Health care, prevention and rehabilitation > Care by type of problem > Medical care","VA Geographic area > Europe > Northern Ireland","Patient care management -- Elderly / Older person -- Health care programme or facility -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Care by type of problem - Medical care","Europe - Northern Ireland","Maguire Aideen , Hughes Carmel M , Cardwell Chris , O'Reilly Dermot","0","yes" "19335",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hughes","Carmel M","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19335",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cardwell","Chris","","",,,,,,,,,,,,"TA16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19335",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Reilly","Dermot","","",,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19335",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19335",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22061","13","archive","1684",,,"disk0/00/02/20/61","2014-06-11 11:09:10","2014-06-11 11:09:10","2014-06-11 11:09:10","monograph",,,"show",,,,"","","","","","","","","","",,,,"O'Heaire","Gary","","","","O'Heaire:Gary::","",,,,,"","","Urine Analysis, an exploratory case study from the perspective of participants in a rehabilitation day programme.","pub","AH18","","public",,"other",,,,,,"Urine analysis has been the preferred screening method used by many drug treatment agencies for a considerable time now. However this particular screening method has been viewed by some to be an intrusion of their human rights and its effectiveness in reducing illicit drug use has come in to question in recent times. This exploratory case study focused on the views of participants from the Bawnogue Youth and Family Support Group Rehabilitation Day Programme “Station One” in relation to their perspective of urine analysis. What is clear from the findings presented in this study is that urine analysis is viewed to be an important part of the participant’s recovery. If given the choice the majority of the participants would choose to continue to give urine samples as part of their recovery plan. This study includes the participant’s individual responses in relation to their perspective of urine analysis in the context of a rehabilitation day programme.","2013","published",,"O'Heaire Gary",,"","",,,,,,"Bawnogue Youth and Family Support Group","Dublin",,"24 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"AH18 , JG26_2_4_2 , JP10 , JP10_2_2 , JT14-4-12-4 , VH4-2-5","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Health care programme or facility > Drugs and alcohol disorder treatment unit","VA Geographic area > Europe > Ireland > Dublin","Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Identification and screening - Identification and screening for drugs and alcohol use -- Treatment and maintenance - treatment factors -- Treatment and maintenance - patient attitude toward treatment -- Health care programme or facility - Drugs and alcohol disorder treatment unit","Europe - Ireland - Dublin","O'Heaire Gary","0","yes" "22061",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22061",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22061",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22061",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4-12-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "22061",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2-5",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20726","13","archive","5",,,"disk0/00/02/07/26","2013-10-15 12:57:40","2013-10-15 12:57:40","2013-10-15 12:57:39","article",,,"show",,,,"","","","","","","","","","","0",,,"Pike","Brigid","","","","Pike:Brigid::","",,,,,"","","BYAP values individuality and people’s potential for change.","pub","VH4-2","","public",,,,,,,,,"2013","published",,"Pike Brigid",,"","",,"Drugnet Ireland","Issue 47, Autumn 2013",,,"Health Research Board",,"3-4",,,,,,,,,,,,"","","",,,,,,,,,"","","","","electronic_only","","","","","",,"
Founded in 1981, the Ballymun Youth Action Project (BYAP) is a community-based response to drug and alcohol misuse. It works with individuals, supports families and communities, and builds capacity through training and research.  At its seminar on austerity, described in a separate item in this issue of Drugnet Ireland, BYAP invited Róisín Shortall TD, former Minister of State with responsibility for drugs, to launch its annual report for 2012 and its strategic plan for 2013–2015.1 
 
In 2012 BYAP provided services to well over 1,000 people, as the following selection from the annual report shows.
 

BYAP also collaborated with other local groups in the delivery of services, including the Ballymun Educational Support Team (BEST), the Ballymun Regional Youth Resource (BRYR), Youthreach Ballymun, and the Community and Family Training Agency (CAFTA). 

In 2012 BYAP lost its funding from the City of Dublin Youth Services Board (CDYSB),2 which opted to redirect funds to ‘mainstream youth services’, and had to make two staff members redundant and reduce the working hours of 10 others as a direct result of cutbacks. However, BYAP continued to evolve to meet local needs, becoming part of the Community Detox Pilot Programme, participating in the Network for Assisting Children and Young People (NACYP), and creating a new position of ‘infant parent support worker’, which is funded by the Ballymun LDTF.  The aim of this new role is to meet the needs of children and parents where there are issues related to problem drug and/or alcohol use in the infant stages of the child’s life. Finally, in 2012 BYAP began using the eCASS (electronic Consolidated Automated Support System) data system and reported that it became much easier to monitor and report on work done. It plans to develop eCASS further in the coming years, to maximise effectiveness of interventions and capture outcomes.
In its strategic plan for 2013–2015, BYAP sets out its way of working. Its approach is rooted in an ethos of valuing individuality and the capacity of individuals, families and communities. It commits to:
-    respecting where people have come from, where they are at now, and where they see they could be;
-    supporting the possibility of change; and
-    addressing where necessary the bigger issues that are presented by the many cross-cutting systems within which each individual has to make their way in life, including their family, the education system, the justice system, and the health system.
 
These values and commitments are reflected in the three strategic objectives and actions that BYAP has set for the next three years, which are summarised in the following table.

1. Ballymun Youth Action Project (2013) Annual report 2012. Dublin: The Ballymun Youth Action Project Ltd, and Ballymun Youth Action Project (2013) Strategic plan 2013–2015. Dublin: The Ballymun Youth Action Project Ltd. www.drugsandalcohol.ie/20081
2. The CDYSB is the youth development agency of the City of Dublin Education and Training Board (CDETB), formerly the City of Dublin Vocational Education Committee. 
",,,,,"Issue 47, Autumn 2013",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 47, Autumn 2013","Drugnet Ireland","VH4-2 , JP10_2_2 , JT , JP10_6","J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Health care programme or facility -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment","VA Geographic area > Europe > Ireland","Treatment and maintenance - patient attitude toward treatment -- Health care programme or facility -- Treatment and maintenance - provider attitude toward treatment","Europe - Ireland","Pike Brigid","0","yes" "20726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "20726",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942","27","archive","1684",,,"disk0/00/01/69/42","2012-02-09 09:14:30","2013-02-01 12:15:42","2012-02-09 09:14:30","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","European Monitoring Centre for Drugs and Drug Addiction","Standards and guidelines for practices. Web resource.","pub","HK2","","none",,,,,,,,"This page contains a listing of national drug prevention guidelines and standards in Europe. The title, the methodological basis and the types of treatment covered by each guideline are provided, along with a download link where available.","2012-12",,,"EMCDDA",,"","",,,,,,"European Monitoring Centre for Drugs and Drug Addiction","Lisbon",,,,,,,,,,,,,"guideline","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"EMCDDA",,,"","","","","electronic_only","","","","","",,"

 

",,,,,,,,,,,"","http://www.emcdda.europa.eu/themes/best-practice/standards","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HK2 , NM6-2 , JM , JA2 , JB2-4 , JS , JU10 , JB2 , VH","HJ Treatment method > Drugs and alcohol disorder treatment method -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health services, drugs and alcohol research -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention","VA Geographic area > Europe","Drugs and alcohol disorder treatment method -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Health services, drugs and alcohol research -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Health care delivery -- Health care administration - Health care quality control -- Drugs and alcohol prevention","Europe","European Monitoring Centre for Drugs and Drug Addiction European Monitoring Centre for Drugs and Drug Addiction","0","no" "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_prevention",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16942",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809","37","archive","5",,,"disk0/00/01/88/09","2012-11-20 13:26:03","2017-02-10 13:55:31","2012-11-20 13:26:02","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","National Institute for Health and Clinical Excellence","Quality standard for drug use disorders.","pub","HK2","","public",,,,,,,,"This quality standard defines clinical best practice within this topic area. It provides specific, concise quality statements, measures and audience descriptors to provide the public, health and social care professionals, commissioners and service providers in the UK with definitions of high-quality care. This quality standard covers the treatment of adults (18 years or over) who misuse opioids, cannabis, stimulants or other drugs in all settings in which care is received, in particular inpatient and specialist residential and community-based treatment settings. This includes related organisations such as prison services and the interface with other services, for example those provided by the voluntary sector. List of quality statements Statement 1. People who inject drugs have access to needle and syringe programmes in accordance with NICE guidance. Statement 2. People in drug treatment are offered a comprehensive assessment. Statement 3. Families and carers of people with drug use disorders are offered an assessment of their needs. Statement 4. People accessing drug treatment services are offered testing and referral for treatment for hepatitis B, hepatitis C and HIV and vaccination for hepatitis B. Statement 5. People in drug treatment are given information and advice about the following treatment options: harm-reduction, maintenance, detoxification and abstinence. Statement 6. People in drug treatment are offered appropriate psychosocial interventions by their keyworker. Statement 7. People in drug treatment are offered support to access services that promote recovery and reintegration including housing, education, employment, personal finance, healthcare and mutual aid. Statement 8. People in drug treatment are offered appropriate formal psychosocial interventions and/or psychological treatments. Statement 9. People who have achieved abstinence are offered continued treatment or support for at least 6 months. Statement 10. People in drug treatment are given information and advice on the NICE eligibility criteria for residential rehabilitative treatment.","2012-11","published",,"EMCDDA",,"","",,,,,,"National Institute for Health and Clinical Excellence","London",,"48 p.",,,,,,,,,,,"guideline","aod_disorder","alcohol_drugs_in_general",,,,,,"EMCDDA",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"https://www.nice.org.uk/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HK2 , NM6-2 , JM , JH10-6 , JS , JU10 , JH10-6-4 , AH18 , HZ , VH4-4 , JT , MN10-2-2 , TL4","HJ Treatment method > Drugs and alcohol disorder treatment method -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control > Needle distribution and exchange -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > Psychosocial treatment method -- J Health care, prevention and rehabilitation > Health care programme or facility -- MM-MO Crime and law > Legal rights > Rights of drugs and alcohol users -- T Demographic characteristics > Drug user","VA Geographic area > Europe > United Kingdom","Drugs and alcohol disorder treatment method -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Health-related prevention - Health information and education - Communicable disease control -- Health care delivery -- Health care administration - Health care quality control -- Health-related prevention - Health information and education - Communicable disease control - Needle distribution and exchange -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Psychosocial treatment method -- Health care programme or facility -- Legal rights - Rights of drugs and alcohol users -- Drug user","Europe - United Kingdom","National Institute for Health and Clinical Excellence National Institute for Health and Clinical Excellence","0","no" "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MN10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18809",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557","47","archive","5",,,"disk0/00/01/85/57","2012-10-08 07:49:27","2014-04-09 22:04:03","2012-10-08 07:49:27","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Drug and Alcohol Findings","Effectiveness Bank Bulletin [Strategies for improving outcomes of services]","pub","HZ26","","public",,,,,,,,"A policy-oriented review of strategies for improving the outcomes of services for substance use disorder patients. Humphreys K., McLellan T. Addiction: 2011, 106, p.2058–2066. Improving performance of substance use disorder treatment systems is no easy matter and one prone to unintended consequences. All the more welcome then is guidance from leading US experts with top-level experience in the UK and the USA; their favourite tactic, rewarding services for patient progress during treatment, is featured in UK payment-by-results schemes. Summary Two US experts who worked at top levels on drug policy for the current US president and have advised the UK government draw on scientific literature and their experiences to offer policy makers an overview of system-level strategies to improve the outcomes of services for substance use disorder patients. Their aim was to stimulate discussion rather than conduct a systematic and comprehensive review of the evidence. Though they may be used together, the review divides the strategies in to process-focused quality improvement strategies which change how treatment staff work in the expectation that this will improve patient outcomes, and patient-focused strategies which concentrate on outcomes without specifying how those are to be achieved. Also reviewed in this bulletin (click on URL link above): • A randomized controlled study of a web-based performance improvement system for substance abuse treatment providers. Crits-Christoph P., Ring-Kurtz S., McClure Bridget. et al. Journal of Substance Abuse Treatment: 2010, 38, p. 251–262. It should have improved relationships between counsellors and clients and between counsellors and their clinics, but a sophisticated system for feeding back client progress made no positive difference on any of these measures. A later study helped establish why: counsellors were not told which patient the feedback related to and what they might do about it. • A preliminary study of the effects of individual patient-level feedback in outpatient substance abuse treatment programs. Crits-Christoph P., Ring-Kurtz S., Hamilton J.L. et al. Journal of Substance Abuse Treatment: 2012, p. 301–309. Confirmation that the failure to improve outcomes of a system for feeding back client progress to counsellors was probably due to aggregating outcomes across the counsellor's caseload rather than enabling them to identify and take recommended actions in respect of individuals doing poorly. Remedying these deficits significantly improved outcomes. • Does meeting the HEDIS substance abuse treatment engagement criterion predict patient outcomes? Harris A.H.S , Humphreys K., Bowe T. et al. Journal of Behavioral Health Services and Research: 2010, 37(1), p. 25–39. This first major multi-modality test of a treatment engagement indicator widely used as a quality control yardstick in the USA found it was only very weakly related to patient improvement seven months after starting treatment, confirmation that simple measures of what happens during treatment struggle to capture what really makes treatment effective. • Performance-based contracting within a state substance abuse treatment system: a preliminary exploration of differences in client access and client outcomes. Brucker D.L., Stewart M. Journal of Behavioral Health Services and Research: 2011, 38(3), p. 383–397. In 2007–08 the US state of Maine introduced a new scheme directly linking funding for outpatient treatment services to performance in terms of waiting times and retention, but financial and service delivery impacts were negligible. Were the incentives too weak, or were services already doing as well as they could? • Advancing recovery: implementing evidence-based treatment for substance use disorders at the systems level. Schmidt L.A., Rieckmann T., Abraham A. et al. Journal of Studies on Alcohol and Drugs: 2012, 73(3), p. 413–422. In the US homeland of competition and private health care, it was cooperation and coordination which led to the introduction of new medications and innovations to promote continuing care – plus the exercise of regulatory and financial muscle and the salutary experience of senior staff who placed themselves in the patient's shoes.","2012-10-08","published",,"Drug and Alcohol Findings",,"","",,"Effectiveness Bank Bulletin","8 Octo",,,"Drug and Alcohol Findings",,,,,,,,,,,,,,"review","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://findings.org.uk/docs/bulletins/Bull_08_10_12.php","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","8 Octo","Effectiveness Bank Bulletin","HZ26 , HK2 , JP10_2_2 , JS , JU10 , AH18 , NJ , JT , JP10 , TT4-4 , MP18-2 , ND14","HJ Treatment method > Treatment outcome -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- N Communication, information and education > Information technology -- J Health care, prevention and rehabilitation > Health care programme or facility -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- T Demographic characteristics > Counsellor / Therapist -- MP-MR Policy, planning, economics, work and social services > Policy > Policy on drugs and alcohol -- N Communication, information and education > Information use and impact",,"Treatment outcome -- Drugs and alcohol disorder treatment method -- Treatment and maintenance - patient attitude toward treatment -- Health care delivery -- Health care administration - Health care quality control -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Information technology -- Health care programme or facility -- Treatment and maintenance - treatment factors -- Counsellor / Therapist -- Policy - Policy on drugs and alcohol -- Information use and impact",,"Drug and Alcohol Findings Drug and Alcohol Findings","0","yes" "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NJ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MP18-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18557",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"ND14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232","24","archive","5",,,"disk0/00/01/82/32","2012-08-10 09:40:50","2014-04-09 22:03:24","2012-08-10 09:40:50","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","","Effectiveness Bank Bulletin [Community drug team prescribing and client views]","pub","VH4-4-12","","public",,,,,,,,"A survey of community drug team prescribing policies and client views. Luty J., O'Gara C., Sessay M. et al. Journal of Substance Use: 2010, 15(1), p. 51–59. Contrary to national guidelines, in the mid-2000s in England and Wales, prescribed doses of the heroin substitute methadone were generally low, and often even new patients were not required to take it under supervision at the pharmacy. Patients in Essex also generally favoured low doses and opposed supervised consumption. Summary: Based on data from the mid-2000s, this report relates the findings of a survey of usual prescribing practices at NHS community drug teams in England and Wales (which treat addiction to drugs including heroin) to a companion survey of the opinions on these policies of patients from one area.","2012-08-09","published",,"Drug and Alcohol Findings",,"","",,"Drug and Alcohol Findings","09 Aug",,,"Drug and Alcohol Findings",,,,,,,,,,,,,,"review","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","09 Aug","Drug and Alcohol Findings","VH4-4-12 , HK2 , VH4-4-2 , JP10_2_2 , BT6-2 , HK2-10 , TL4 , JT8_8_2","HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- T Demographic characteristics > Drug user -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > United Kingdom > Wales -- VA Geographic area > Europe > United Kingdom > England","Drugs and alcohol disorder treatment method -- Treatment and maintenance - patient attitude toward treatment -- Drugs and alcohol substance by legal status - Prescription drug (medicine / medication) -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Drug user -- Health care programme or facility - Community-based treatment (primary care)","Europe - United Kingdom - Wales -- Europe - United Kingdom - England",,"0","yes" "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy","opioid",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BT6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18232",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18124","26","archive","5",,,"disk0/00/01/81/24","2012-07-20 13:52:11","2014-04-09 22:03:11","2012-07-20 13:52:11","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","","Effectiveness Bank Bulletin (Heart screening in methadone maintenance treatment).","pub","JM","","public",,,,,,,,"1. QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel. Martin J.A., Campbell A., Killip T. et al. Journal of Addictive Diseases: 2011, 30, p. 283–306. Concerned that this might on balance cause more deaths by limiting an effective treatment for opiate addiction, an expert panel convened by the US government has changed its mind on whether the risk of a fatal heart attack potentially posed by methadone justifies routine electrocardiogram screening of patients. Summary: The QT interval (or QTc as corrected for the heart rate) is an indicator of heart function derived from electrocardiogram measures. It refers to the delay between two phases of the electrical activity of the heart which drives it in pumping blood round the body. The health risks associated with a prolonged interval are not clear. It can lead to torsades de pointes, a potentially life threatening heart attack, but some medications prolong the interval yet rarely cause this condition, and it can occur even when the interval is normal. The risk threshold has been set variously at for example 450ms (0.45 seconds) for men and 460ms to 470ms for women or 450ms for both, though it is generally accepted that intervals greater than 500ms pose a significant risk of torsades de pointes. Some studies have reported that methadone may contribute to the elongation of the QT interval, heightening the risk of torsades de pointes. In response the US government convened an expert panel to assess the risk to patients and make recommendations to enhance their cardiac safety. The featured article is the latest report of that panel, superseding an earlier version. The panel framed its recommendations on the understanding that methadone must remain widely available because it has been associated with an overall reduction in deaths, there are few therapeutic alternatives, and it is cost-effective. Treatment providers are encouraged to consider the report and take action to the extent that they are clinically, administratively, and financially able to do so, but nothing in the report is intended to create a legal standard of care or accreditation requirement, or to interfere with the judgment of the clinicians treating the patients. 2. Methadone maintenance, QTc and torsade de pointes: who needs an electrocardiogram and what is the prevalence of QTc prolongation? Mayet S., Gossop M., Lintzeris N. et al. Drug and Alcohol Review: 2011, 30(4), p. 388–396. British guidelines suggest electrocardiogram screening of methadone patients at heightened risk of a form of possibly methadone-aggravated cardiac disorder which can result in sudden death. But a London clinic found this would still mean testing most patients, with huge resource implications yet uncertain benefits. Summary: The QTc interval is an indicator of heart function derived from electrocardiogram measures. It refers to the delay between two phases of the electrical activity of the heart which drives it in pumping blood round the body. Extended intervals may lead to torsades de pointes, a potentially life threatening irregular heartbeat. Several studies have reported that methadone may contribute to the elongation of this interval, heightening the risk. The risk threshold has been variously set at 450ms (0.45 seconds) for men and 470ms for women or 450ms for both, though it is generally accepted that intervals greater than 500ms constitute a significant risk of abnormal heart function. UK addiction treatment guidance dating from 2007 says that electrocardiograms ""might be considered before induction onto methadone or before increases in methadone dose and subsequently after stabilisation – at least with doses over 100mg per day and in those with substantial risk factors"". According to UK medicines regulators, these factors include ""heart or liver disease, electrolyte abnormalities, concomitant treatment with CYP 3A4 inhibitors, or other drugs with the potential to cause QT interval prolongation"". An addiction clinic in London assessed 155 methadone patients stabilised on their doses for at least four weeks to determine what proportion would qualify for electrocardiogram monitoring according to these criteria, and conducted electrocardiograms on 83 of the patients who attended for testing to determine whether they were at risk according to the readings of their QT intervals. 3. Onsite QTc interval screening for patients in methadone maintenance treatment. Fareed A., Vayalapalli S., Byrd-Sellers J. et al. Journal of Addictive Diseases: 2010, 29(1), p. 15–22. Does the small risk of fatal heart attack potentially posed by methadone justify routine electrocardiogram screening of patients, or will this cause more deaths by limiting an effective treatment for opiate addiction? A US clinic tried it and found three at-risk patients in three years. Summary: The QTc interval is an indicator of heart function derived from electrocardiogram measures. It refers to the delay between two phases of the electrical activity of the heart which drives it in pumping blood round the body. Extended intervals may lead to torsades de pointes, a potentially life threatening heart attack. Several studies have reported that methadone may contribute to the elongation of this interval, heightening the risk. The risk threshold has been variously set at 450ms (0.45 seconds) for men and 470ms for women or 450ms for both, though it is generally accepted that intervals greater than 500ms constitute a significant risk of abnormal heart function. Given the risk, an expert US panel recommended electrocardiogram screening of all methadone patients when they start treatment and then a month and a year later, with extra tests as indicated. A medical clinic for former US military personnel instigated such screening at the clinic itself to identify high risk patients. Alongside it offered brief on-site counselling for patients about the risks of cardiac arrhythmias associated with methadone and how to spot the symptoms of any impending problems. Electrocardiogram results were reviewed by the clinic's psychiatrist, who provided feedback for each patient and arranged for appropriate referrals as needed. Patients with automated readings between 450ms and 500ms received more education and further electrocardiogram monitoring. If the interval reading exceeded 500ms, methadone dose was reduced and the patient was referred to a cardiology clinic. The featured article reports on the feasibility and effectiveness of these procedures instigated in 2007 based on the records of 55 patients treated between 2002 and 2009 who were among the clinic's established caseload and had been retained in methadone treatment for at least six months and not dropped out. These patients averaged 90mg methadone daily.","2012-07-18","published",,"Drug and Alcohol Findings",,"","",,,"18 Jul",,,"Drug and Alcohol Findings",,,"6 p.",,,,,,,,,,,"review","aod_disorder_treatment_method","opioid",,,,,,"Drug and Alcohol Findings",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://findings.org.uk/docs/bulletins/Bull_18_07_12.php","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"3",,,"JM , JA8-2 , BL2-1 , GA2-2 , HK2-10-2-2-2","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Risk and needs assessment > Risk assessment -- B Drugs and alcohol substances > Opioids (opiates) > Methadone -- G Health and disease > State of health > Physical health -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance",,"Patient care management -- Risk and needs assessment - Risk assessment -- Opioids (opiates) - Methadone -- State of health - Physical health -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance",,,"0","yes" "18124",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18124",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL2-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18124",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18124",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885","45","archive","5",,,"disk0/00/01/78/85","2012-07-02 09:22:45","2012-12-19 09:56:02","2012-07-02 09:22:45","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"","Bevington:Dickon::","",,,,,"","","Practice standards for young people with substance misuse problems.","pub","TA14","","public",,,,,,,,"Drug and alcohol misuse among young people is a major problem, although overall use is starting to decline. The UK has one of the highest rates of young people’s cannabis use and binge drinking in Europe, with some 13,000 hospital admissions linked to young people’s drinking each year. In recent years the number of specialist services for drug and alcohol misuse has increased so that young people can get the treatment they need. In 2010-2011 the number of under-18s accessing these services was 21,955. The new standards have been developed by the Royal College of Psychiatrists’ Centre for Quality Improvement (CCQI) in partnership with substance misuse organisations, paediatricians, psychologists and nurses.They are aimed at all staff in contact with young people aged 18 or under (in universal, targeted and specialist services) across health, social care, education, youth justice system, and the voluntary and community sector. The standards propose that services invest in the psychosocial development and well-being of young people with substance misuse problems to give them the best chance of a normal life through:  engagement of the young person, and their family where possible  skilled initial analysis of the young person’s difficulties, including mental disorders and developmental problems such as learning disability, and life circumstances  engaging local systems so that they work together  co-ordinated, well-led interventions that mobilise the resources of local communities as required, including safeguarding, education, training, mental health and accommodation  active follow-up to detect further episodes of support or intervention  prioritising and delivering the training and support of staff Dr Dickon Bevington, of the Royal College of Psychiatrists, said: ""Many of our most vulnerable young people have their lives further blighted by substance misuse. From a position just a decade ago of having minimal evidence for effectiveness, substance use disorder services for young people are now guiding many young people toward fuller lives. These standards should be read as the next chapter in a conversation that has been gathering pace, where genuine collaboration between experts, agencies, and different professional groupings has been a founding principle."" Martin Barnes, chief executive of DrugScope, said: ""These practice standards have a vital role to play in supporting the development of procedures, interventions and services that are both efficient and effective. I hope they will become a key reference resource for everyone working with young people affected by substance misuse problems, and will be used to inform workforce development, strategic planning and development, and delivery of care and treatment.""","2012-06","published",,"Royal College of Psychiatrists",,"","",,,,,,"Royal College of Psychiatrists","London",,"53 p.",,,,,,,,,,,"guideline","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"Royal College of Psychiatrists",,,"","","","","electronic_only","","","","","",,"

 

",,,,,,,"Gilvarry","Eilish","","","",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"TA14 , JQ6-8 , NM6-2 , HK2 , JM , LG2-6 , GD2 , VH4-4 , HZ , LG14-10 , TL4-6 , JP , JT8_8_2","T Demographic characteristics > Adolescent / youth (teenager / young person) -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- L Social psychology and related concepts > Marital relations > Family and kinship > Family and drugs and alcohol > Drugs and alcohol related family problems -- G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder -- HJ Treatment method > Psychosocial treatment method -- L Social psychology and related concepts > Marital relations > Family and kinship > Family structure > Family support -- T Demographic characteristics > Young drug user -- J Health care, prevention and rehabilitation > Treatment and maintenance -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > United Kingdom","Adolescent / youth (teenager / young person) -- Care by type of problem - Mental health care -- Recommendations or guidelines - Practice / clinical guidelines -- Drugs and alcohol disorder treatment method -- Patient care management -- Marital relations - Family and kinship - Family and drugs and alcohol - Drugs and alcohol related family problems -- Drugs and alcohol related disorder - Drugs and alcohol related mental disorder -- Psychosocial treatment method -- Marital relations - Family and kinship - Family structure - Family support -- Young drug user -- Treatment and maintenance -- Health care programme or facility - Community-based treatment (primary care)","Europe - United Kingdom","Gilvarry Eilish , McArdle Paul , O’Herlihy Anne , Mirza Kah , Bevington Dickon , Malcolm Norman","0","yes" "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,"McArdle","Paul","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,"O’Herlihy","Anne","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder",,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mirza","Kah","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Bevington","Dickon","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LG2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Malcolm","Norman","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GD2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LG14-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17885",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16600","16","archive","5",,,"disk0/00/01/66/00","2011-12-19 15:56:20","2015-12-22 13:55:19","2011-12-19 15:56:20","guideline",,,"show",,,,"","","","","","","","","","","0",,,"Rigotti","Nancy A.","","","",,"",,,,,"","","Interventions for smoking cessation in hospitalised patients.","pub","JM","","none",,,,,,,,"Objectives: To determine the effectiveness of interventions for smoking cessation that are initiated for hospitalised patients. Conclusion: High intensity behavioural interventions that begin during a hospital stay and include at least one month of supportive contact after discharge promote smoking cessation among hospitalised patients. The effect of these interventions was independent of the patient's admitting diagnosis and was found in rehabilitation settings as well as acute care hospitals. There was no evidence of effect for interventions of lower intensity or shorter duration. This update found that adding NRT to intensive counselling significantly increases cessation rates over counselling alone. There is insufficient direct evidence to conclude that adding bupropion or varenicline to intensive counselling increases cessation rates over what is achieved by counselling alone.","2012-03","published",,"The Cochrane Library",,"","",,"Cochrane Database of Systematic Reviews",,"5","5","John Wiley & Sons, Ltd","London",,,,,,,"DOI: 10.1002/14651858.CD001837.pub3",,,,,,"review","aod_disorder","tobacco",,"ISSN: 1469-493X",,,,"The Cochrane Library",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001837.pub3/abstract","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","unspecified","Cochrane Database of Systematic Reviews","JM , BD , HK2-6 , JT14-4","J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Tobacco (cigarette smoking) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use -- J Health care, prevention and rehabilitation > Health care programme or facility > Hospital",,"Patient care management -- Tobacco (cigarette smoking) -- Drugs and alcohol disorder treatment method - Cessation of drugs and alcohol use -- Health care programme or facility - Hospital",,"Rigotti Nancy A. , Clair Carole , Munafo Marcus R , Stead Lindsay F","0","yes" "16600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Clair","Carole","","",,,,,,,,,,,,"BD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Munafo","Marcus R","","",,,,,,,,,,,,"HK2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16600",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Stead","Lindsay F","","",,,,,,,,,,,,"JT14-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17805","23","archive","5",,,"disk0/00/01/78/05","2012-06-22 08:45:22","2014-04-09 22:02:33","2012-06-22 08:45:22","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","","Effectiveness Bank Bulletin. [Care management & employment]","pub","VD","","public",,,,,,,,"Does coordinated care management improve employment for substance-using welfare recipients? Morgenstern J., Hogue A., Dauber S. et al. Journal of Studies on Alcohol and Drugs: 2009, 70, p. 955–963. In New York intensive case management coordinating multiple sources of support helped resolve the substance use problems of welfare applicants, but only among the women – who faced the greatest barriers to working – did this promote employment. Perhaps men would have done better being helped to rapidly enter the job market. Summary Focusing on employment and training outcomes, the featured report complements an earlier report from the same US study which focused on substance use treatment participation and substance use outcomes. The study tested whether relatively intensive case management support helps welfare applicants overcome substance use problems and gain employment. A particular issue was whether welfare recipients who despite recent reforms have yet to find work can be helped to do so, or whether this caseload faces barriers too great to overcome, even with intensive help. Implemented in New York's Bronx district in partnership with the city's welfare agency, it was designed to be a practical trial which maximised real-world applicability while maintaining research integrity. Participants were 421 substance using single adults and adults with dependent children applying for welfare benefits. They were selected from 1519 such applicants on the basis of their reporting a substance use problem and being motivated to receive treatment. Initially they had been identified by welfare workers using a short questionnaire which screened applicants for substance use problems. Depending solely on where the next assessment slot was available, the workers transferred substance users for further assessment at one of the two offices in the study. One of the offices offered usual assessment and care services: assessment by an addiction counsellor focused on substance use problems in relation to employability, followed by allocation to a generic welfare worker whose role was to assess eligibility for welfare payments and deal with non-compliance with the welfare system's requirements. They also referred the beneficiary to services, but only during infrequent meetings limited by a large caseload. At the other office, more rounded and detailed assessments were conducted by a multidisciplinary team. After referring applicants to a range of services to meet identified needs, they transferred them to case managers. Their role was to maintain intensive contact with the beneficiary and with the agencies providing them with services, and to ensure that these agencies matched the individual's needs and performed acceptably. In the usual care option, quarterly reassessments focused on welfare system requirements, but in the case management option the focus was on client progress and adjusting the service mix accordingly. All 108 applicants who were in methadone maintenance treatment during the study were already in this treatment at the time they applied for benefits, and generally simply continued. Beyond these existing methadone patients, there were few if any heroin dependent applicants who might benefit from initiating treatment. Welfare case workers had more latitude to initiate or change other sorts of substance use treatments. Diagnostic interviews found that about 6 in 10 of the sample met criteria for substance dependence, mainly in respect of cocaine, alcohol or heroin, and another fifth for substance abuse. Psychological problems and criminal justice involvement were common. About 1 in 6 had some degree of responsibility for dependent children.","2012-01-10","published",,"Drug and Alcohol Findings",,"","",,"Drug and Alcohol Findings","10 Jan",,,"Drug and Alcohol Findings",,,,,,,,,,,,,,"review","rehabilitation","alcohol_drugs_in_general",,,,,,"Drug and Alcohol Findings",,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"","http://findings.org.uk/docs/bulletins/Bull_10_01_12.php","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","10 Jan","Drug and Alcohol Findings","VD , AH18 , MV , LC2-4 , JM , JP24-4-1 , MU6-4","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- MP-MR Policy, planning, economics, work and social services > Social services -- L Social psychology and related concepts > Interpersonal interaction and group dynamics > Social support -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Rehabilitation > Vocational rehabilitation (employment / occupation) -- MP-MR Policy, planning, economics, work and social services > Labour and work > Employment and unemployment","VA Geographic area > United States","Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Social services -- Interpersonal interaction and group dynamics - Social support -- Patient care management -- Rehabilitation - Vocational rehabilitation (employment / occupation) -- Labour and work - Employment and unemployment","United States",,"0","yes" "17805",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17805",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MV",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17805",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"LC2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17805",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17805",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP24-4-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17805",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MU6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404","16","archive","5",,,"disk0/00/02/44/04","2015-08-11 09:24:35","2015-08-11 09:25:25","2015-08-11 09:24:35","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","Health Information and Quality Authority","National standards for safer better healthcare.","pub","JM","","public",,,,,,,,"The National Standards for Safer Better Health will provide the building blocks for a standards-driven health service, creating a common understanding of quality and safety. The standards will give healthcare providers a structure to systematically and continuously improve the safety and quality of services delivered. The National Standards will: • place patients at the heart of the care process • be a benchmark for change for safety • give patients a clear expectation of the standard of care they can expect to receive • ensure services will be clear on what is expected of them • provide a strategic approach to improving safety, quality and reliability in our health service","2012",,,"HIQA",,"","",,,,,,"Health Information and Quality Authority","Dublin",,"168 p.",,,,,,,,,,,"guideline","education_and_training","",,,,,,"HIQA",,,"","","","","","","","","","",,,,,,,,,,,,,"",,"http://www.hiqa.ie/standards/health/safer-better-healthcare","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JM , JS , JU10 , MQ6 , MQ6-2 , TT2 , TT2-12 , TT2-14","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- MP-MR Policy, planning, economics, work and social services > Organisational development -- MP-MR Policy, planning, economics, work and social services > Organisational development > Workforce / staff skills and training -- T Demographic characteristics > Drug or health care worker -- T Demographic characteristics > Doctor -- T Demographic characteristics > Nurse",,"Patient care management -- Health care delivery -- Health care administration - Health care quality control -- Organisational development -- Organisational development - Workforce / staff skills and training -- Drug or health care worker -- Doctor -- Nurse",,"Health Information and Quality Authority Health Information and Quality Authority","0","yes" "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24404",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15788","21","archive","5",,,"disk0/00/01/57/88","2011-08-23 14:07:59","2012-05-29 11:48:44","2011-08-23 14:07:59","article",,,"show",,,,"","","","","","","","","","","0",,,"Kenny","Kevin","","","","Kenny:Kevin::","",,,,,"","","The use of psychotherapeutic interventions by primary care GPs in Ireland in the treatment of their methadone patients: a grounded theory study.","pub","VH4-2","","none",,,,,,,,"BACKGROUND: The methadone protocol placed responsibility on general practitioners (GPs) for the methadone treatment of stabilised drug-addicted patients. The protocol emphasised a medico-pharmacological model with minor reference to psychotherapeutic treatment. AIM: This qualitative study investigated how primary care GPs in Ireland use psychotherapeutic interventions in the treatment of methadone patients. METHOD: A grounded theory methodology was used. FINDINGS: There is a wide variation in the beliefs and knowledge of methadone-prescribing GPs regarding the efficacy of psychotherapeutic interventions for patients on methadone maintenance. GPs do not formally integrate psychotherapeutic interventions into methadone patient treatment. Accessing psychotherapeutic services raises concerns for GPs in terms of availability, location and quality. Primary care GPs who offer methadone maintenance view opiate abuse as a health issue similar to other such issues within their community. They take a holistic view of their methadone patient and, without formal guidelines, develop individual approaches to the use of psychotherapeutic interventions. The absence of a framework for the use of psychotherapeutic interventions in primary care methadone treatment in Ireland militates against the development of a basis for improving practice.","2012","published",,"Kenny Kevin",,"","",,"Irish Journal of Medical Science","181","1","1","Springer",,"43-48",,,,,,"DOI: 10.1007/s11845-011-0745-x",,,,,,"","","",,"1863-4362",,,,,,,"","","","","electronic_only","","","","","",,"

 

",,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","181","Irish Journal of Medical Science","VH4-2 , HZ , JM , TT2-12 , HK2-10-2-2-2 , JT8_8_2 , JS","HJ Treatment method > Psychosocial treatment method -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Doctor -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care) -- J Health care, prevention and rehabilitation > Health care delivery","VA Geographic area > Europe > Ireland","Psychosocial treatment method -- Patient care management -- Doctor -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Health care programme or facility - Community-based treatment (primary care) -- Health care delivery","Europe - Ireland","Kenny Kevin , O'Carroll Austin","0","no" "15788",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Carroll","Austin","","",,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15788",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15788",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15788",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15788",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15788",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679","27","archive","5",,,"disk0/00/01/76/79","2012-06-08 09:49:37","2012-06-08 09:49:37","2012-06-08 09:49:37","article",,,"show",,,,"","","","","","","","","","","0",,,"Kiernan","Claire","","","","Kiernan:Claire::","",,,,,"","","Nurses' role in managing alcohol misuse among adolescents.","pub","AA2-4","","none",,,,,,"PMID: 22585075",,"Over the past decade, there has been an increase in the amount of alcohol consumed by young people, aged 11-17 years, in the UK and Ireland, which has implications for all health professionals caring for adolescents. Alcohol misuse is increasingly common among adolescents and is a significant concern for families, communities and society. Health professionals need to be aware of the dangers involved with underage drinking, how to recognise the signs of alcohol misuse, and how to intervene appropriately. Over the past few years, there has been a noticeable increase in the number of adolescents presenting to emergency departments (EDs) owing to alcohol-related injuries. This increase means that all nurses and other health professionals are suitably placed to provide education and support to adolescents who are consuming excessive alcohol. Regular alcohol misuse can lead to adverse health outcomes, and therefore nurses need to take an active role in health promotion to ensure that adolescents are aware of the associated dangers. This article summarises the harmful effects of underage drinking, the influencing factors and outlines the current guidelines on alcohol misuse in young people. It discusses strategies that nurses can use in the ED setting, and all healthcare settings, to motivate adolescents to change health-damaging behaviours.","2012","published",,"Kiernan Claire",,"","",,"British Journal of Nursing","21","8","8","MA Healthcare",,"474-478",,,,,,,,,,,,"","","",,,,,,,,,"","","","","not_in_collection","","","","","",,"

 

",,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","21","British Journal of Nursing","AA2-4 , TA14 , VH4-2 , JG26_2_4_2 , JM , JQ8-2 , JB2-4 , TT2-14 , GC16","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Problem drugs and alcohol use -- T Demographic characteristics > Adolescent / youth (teenager / young person) -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- T Demographic characteristics > Nurse -- G Health and disease > Drugs and alcohol disorder > Alcohol use","VA Geographic area > Europe > Ireland","Prevalence of drugs and alcohol use - Problem drugs and alcohol use -- Adolescent / youth (teenager / young person) -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - emergency care -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Nurse -- Drugs and alcohol disorder - Alcohol use","Europe - Ireland","Kiernan Claire , Ni Fhearail Aislinn , Coyne Imelda","0","no" "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ni Fhearail","Aislinn","","",,,,,,,,,,,,"TA14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Coyne","Imelda","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17679",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18991","26","archive","5",,,"disk0/00/01/89/91","2012-12-13 12:28:14","2014-04-09 22:04:53","2012-12-13 12:28:14","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Epidemiology and Research Branch","Mental health, drug and alcohol - emergency department and ambulance monitoring.","pub","JQ6-8","","public",,,,,,,,"This guideline relates to increases in Emergency Department visits or NSW Ambulance Service calls for mental health, drug and alcohol problems identified by the Public Health Real-time Emergency Department Surveillance System (PHREDSS). It describes the flow of information via a situation report, from PHREDSS to the Office of the Chief Health Officer and the Mental Health and Drug and Alcohol Office. It identifies the situations in which each of these bodies has primary responsibility for deciding how to respond to the increase.","2012","published",,"NSW Department of Health",,"","",,,,,,"NSW Department of Health","Sydney",,"6 p.",,,,,,,,,,,"guideline","screening","alcohol_drugs_in_general",,,,,,"NSW Department of Health",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JQ6-8 , NM6-2 , JG26_2_4_2 , JM , JQ8-2 , VK2 , GD2","J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > emergency care -- G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder","VA Geographic area > Australia and Oceania > Australia","Care by type of problem - Mental health care -- Recommendations or guidelines - Practice / clinical guidelines -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Care by type of problem - emergency care -- Drugs and alcohol related disorder - Drugs and alcohol related mental disorder","Australia and Oceania - Australia","Epidemiology and Research Branch Epidemiology and Research Branch","0","yes" "18991",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"alcohol",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18991",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18991",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18991",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18991",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18991",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GD2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17444","22","archive","1684",,,"disk0/00/01/74/44","2012-04-25 12:09:26","2012-11-20 08:12:30","2012-04-25 12:09:26","article",,,"show",,,,"","","","","","","","","","","0",,,"Ní Chróinín","D","","","","Ní Chróinín:D::","",,,,,"","","Crack-ing the case: a patient with persistent delirium due to body packing with cocaine.","pub","BK","","none",,,,,,,,"A 36-year-old male presented acutely with encephalopathy, following his return to Ireland from a visit to West Africa. Clinical findings included confusion, agitation and tonic-clonic seizures. Difficulties in weaning sedation prompted repeat urine toxicology screening at day 8, which was positive for cocaine. Work-up for a source of continued cocaine exposure led to the discovery of cocaine-containing packages in the gastrointestinal tract. An index of suspicion should be maintained in patients presenting with drug toxicity following cross-border travel.","2012",,,"Ní Chróinín D",,"","",,"Irish Medical Journal","105","4","4","Irish Medical Organisation",,"118-119",,,,,,,,,,,,"","","",,"0332-3102",,,,,,,"","","","","electronic_only","","","","","",,"

 

",,,,,,,,,,,"","http://www.imj.ie//IMJPage_0_1.aspx?issueid=441","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","105","Irish Medical Journal","BK , VH4-2 , GA2-2 , JM , MM20-10-4-4 , AM","B Drugs and alcohol substances > Cocaine -- G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Patient care management -- MM-MO Crime and law > Drugs and alcohol offence > Drug offence > Illegal transportation of drugs (smuggling / trafficking) -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences","VA Geographic area > Europe > Ireland","Cocaine -- State of health - Physical health -- Patient care management -- Drugs and alcohol offence - Drug offence - Illegal transportation of drugs (smuggling / trafficking) -- Drugs and alcohol effects and consequences","Europe - Ireland","Ní Chróinín D , Gaine S","0","no" "17444",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gaine","S","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17444",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17444",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17444",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MM20-10-4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17444",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19882","18","archive","5",,,"disk0/00/01/98/82","2013-05-21 09:06:09","2014-01-14 10:01:10","2013-05-21 09:06:09","article",,,"show",,,,"","","","","","","","","","","0",,,"O'Riordan","Margaret","","","","O'Riordan:Margaret::","",,,,,"","","College ready to tackle alcohol-related problems.","pub","VH4-2","","none",,,,,,,,"The ICGP's primary aim is to serve the patient and the GP by encouraging and maintaining the highest standards of general medical practice. It is the representative organisation for education, training and standards in general practice. Excessive consumption of alcohol in Irish society has generated well-documented problems for individuals, families and society. The ICGP supports an evidence-based approach to the prevention of alcohol-related problems. It will continue to educate its members on skills related to alcohol screening and brief intervention in providing an accessible, effective, timely and efficient service to patients and their families experiencing alcohol-related problems.","2012","published",,"O'Riordan Margaret",,"","",,"Forum","30","12","12","Irish College of General Practitioners",,"21-22",,,,,,,,,,,,"","","",,,,,,,,,"","","","","","","","","","",,"

 

",,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","30","Forum","VH4-2 , JM , GC16 , BB , TT2-12 , NF16-2","J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > Drugs and alcohol disorder > Alcohol use -- B Drugs and alcohol substances > Alcohol -- T Demographic characteristics > Doctor -- N Communication, information and education > Education by subject > AOD education","VA Geographic area > Europe > Ireland","Patient care management -- Drugs and alcohol disorder - Alcohol use -- Alcohol -- Doctor -- Education by subject - AOD education","Europe - Ireland","O'Riordan Margaret , Finegan Pearse","0","yes" "19882",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Finegan","Pearse","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19882",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19882",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19882",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "19882",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NF16-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001","31","archive","5",,,"disk0/00/01/80/01","2012-07-06 14:24:05","2017-02-16 13:01:11","2012-07-06 14:24:05","article",,,"show",,,,"","","","","","","","","","","0",,,"Perk","Joep","","","","Perk:Joep::","",,,,,"","","European guidelines on cardiovascular disease prevention in clinical practice (version 2012).","pub","VH4-2","","none",,,,,,,,"Examines Cardiovascular disease:  Prevention  Risk assessment  Risk management  Smoking  Nutrition  Physical activity  Psychosocial factors","2012","published",,"Perk Joep",,"","",,"European Heart Journal","33",,,"American Heart Association",,"1635-1701",,,,,,,,,,,,"","","",,,,,,,,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"","http://eurheartj.oxfordjournals.org/content/ehj/33/13/1635.full.pdf","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","do_not_display",,"1","33","European Heart Journal","VH4-2 , JM , GA2-2 , NM6-2 , VH , BD","J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > State of health > Physical health -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- B Drugs and alcohol substances > Tobacco (cigarette smoking)","VA Geographic area > Europe > Ireland -- VA Geographic area > Europe","Patient care management -- State of health - Physical health -- Recommendations or guidelines - Practice / clinical guidelines -- Tobacco (cigarette smoking)","Europe - Ireland -- Europe","Perk Joep , De Backer Guy , Gohlke Helmut , Graham Ian , Reiner Aeljko , Verschuren WM Monique , Albus Christian , Benlian Pascale , Boysen Gudrun , Cifkova Renata , Deaton Christi , Ebrahim Shah , Fisher Miles , Germano Guiseppe , Hobbs Richard , Hoes Ar","0","yes" "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"De Backer","Guy","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Gohlke","Helmut","","",,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Graham","Ian","","",,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Reiner","Aeljko","","",,,,,,,,,,,,"VH",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Verschuren","WM Monique","","",,,,,,,,,,,,"BD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Albus","Christian","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Benlian","Pascale","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Boysen","Gudrun","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cifkova","Renata","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Deaton","Christi","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ebrahim","Shah","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Fisher","Miles","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Germano","Guiseppe","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hobbs","Richard","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hoes","Arno","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Karadeniz","Sehnaz","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mezzani","Alessandro","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Prescott","Eva","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ryden","Lars","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Scherer","Martin","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Syvanne","Mikko","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Scholte Op Reimer","Wilma JM","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Vrints","Christian","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Wood","David","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Zamorano","Jose Luis","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18001",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Zannad","Faiez","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228","32","archive","5",,,"disk0/00/01/72/28","2012-03-27 08:50:06","2012-12-19 09:58:02","2012-03-27 08:50:05","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Substance Abuse and Mental Health Services Administration","Managing chronic pain in adults with or in recovery from substance use disorders. Treatment Improvement Protocol (TIP) Series 54.","pub","HK2","","public",,,,,,,,"Chronic noncancer pain (CNCP) is common in the general population as well as in people who have a substance use disorder (SUD. Chronic pain is not harmless; it has physiological, social, and psychological dimensions that can seriously harm health, functioning, and well-being. As a multidimensional condition with both objective and subjective aspects, CNCP is difficult to assess and treat. Although CNCP can be managed, it usually cannot be completely eliminated. When patients with CNCP have comorbid SUD or are recovering from SUD, a complex condition becomes even more difficult to manage. This Treatment Improvement Protocol (TIP) is for primary care providers who treat or are likely to treat adult patients with or in recovery from SUDs who present with CNCP. Given the prevalence of CNCP in the population, this audience includes virtually all primary care providers. Addiction specialists, psychiatrists, nurses, and other clinicians may find information here that will help them ensure that their patients with CNCP receive adequate pain treatment. By providing a shared basic understanding of and a common language for these two chronic conditions, this TIP facilitates cooperation and communication between healthcare professionals treating pain and those treating addiction. This TIP equips clinicians with practical guidance and tools for treating CNCP in adults with histories of SUDs. It does not describe how to treat SUDs or other behavioural health disorders in patients with CNCP; however, it provides readers with information about SUD assessments and referrals for further evaluation. For patients with histories of SUDs, the most controversial and possibly hazardous pain treatment in widespread use is opioid treatment. For this reason, this topic receives significant attention in Chapters 3 and 4.","2012","published",,"SAMHSA, US",,"","",,,,,,"Substance Abuse and Mental Health Services Administration","Rockville, MD",,"129 p.",,,,,"HHS publication no. (SMA) 12-4671",,,,,,"protocol","aod_disorder_treatment_method","opioid",,,,,,"SAMHSA, US",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://updates.pain-topics.org/2012/03/samhsa-tip-on-pain-addiction-reader.html",,,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HK2 , NM6-2 , JM , JQ6-4 , JS , JU10 , GA2 , AH18 , HT6 , HZ , GA2-2 , AM","HJ Treatment method > Drugs and alcohol disorder treatment method -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Medical care -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- G Health and disease > State of health -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > Other medical treatment method > Alternative medical treatment -- HJ Treatment method > Psychosocial treatment method -- G Health and disease > State of health > Physical health -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences",,"Drugs and alcohol disorder treatment method -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Care by type of problem - Medical care -- Health care delivery -- Health care administration - Health care quality control -- State of health -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Other medical treatment method - Alternative medical treatment -- Psychosocial treatment method -- State of health - Physical health -- Drugs and alcohol effects and consequences",,"Substance Abuse and Mental Health Services Administration Substance Abuse and Mental Health Services Administration","0","yes" "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://store.samhsa.gov/list/series?name=TIP-Series-Treatment-Improvement-Protocols","pub",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"alternative_medical_treatment",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HT6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17228",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16609","19","archive","5",,,"disk0/00/01/66/09","2011-12-19 15:59:38","2012-12-13 13:37:40","2011-12-19 15:59:38","guideline",,,"show",,,,"","","","","","","","","","","0",,,"Bize","Raphaël","","","","Bize:Raphaël::","",,,,,"","","Biomedical risk assessment as an aid for smoking cessation.","pub","HK2","","none",,,,,,,,"Objective: To determine the efficacy of biomedical risk assessment provided in addition to various levels of counselling, as a contributing aid to smoking cessation. Conclusion: There is little evidence about the effects of most types of biomedical tests for risk assessment. Spirometry combined with an interpretation of the results in terms of 'lung age' had a significant effect in a single good quality trial. Mixed quality evidence does not support the hypothesis that other types of biomedical risk assessment increase smoking cessation in comparison to standard treatment. Only two pairs of studies were similar enough in term of recruitment, setting, and intervention to allow meta-analysis.","2012","published",,"The Cochrane Library",,"","",,"Cochrane Database of Systematic Reviews",,"12","12","John Wiley & Sons, Ltd","London",,,,,,,"DOI: 10.1002/14651858.CD004705.pub4.",,,,,,"review","aod_disorder_treatment_method","tobacco",,"ISSN: 1469-493X",,,,"The Cochrane Library",,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"","http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004705.pub4/full","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","unspecified","Cochrane Database of Systematic Reviews","HK2 , GA2-2 , HZ , JM , HK2-6 , BD","HJ Treatment method > Drugs and alcohol disorder treatment method -- G Health and disease > State of health > Physical health -- HJ Treatment method > Psychosocial treatment method -- J Health care, prevention and rehabilitation > Patient care management -- HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use -- B Drugs and alcohol substances > Tobacco (cigarette smoking)",,"Drugs and alcohol disorder treatment method -- State of health - Physical health -- Psychosocial treatment method -- Patient care management -- Drugs and alcohol disorder treatment method - Cessation of drugs and alcohol use -- Tobacco (cigarette smoking)",,"Bize Raphaël , Burnand Bernard , Mueller Yolanda , Rège Walther Miriam , Camain Jean Yves , Cornuz Jacques","0","yes" "16609",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Burnand","Bernard","","",,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"rehabilitation",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16609",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Mueller","Yolanda","","",,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16609",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Rège Walther","Miriam","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16609",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Camain","Jean Yves","","",,,,,,,,,,,,"HK2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16609",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cornuz","Jacques","","",,,,,,,,,,,,"BD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229","26","archive","5",,,"disk0/00/01/72/29","2012-03-27 08:49:46","2012-12-19 13:44:00","2012-03-27 08:49:46","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","Substance Abuse and Mental Health Services Administration","Addressing viral hepatitis in people with substance use disorders. Treatment Improvement Protocol (TIP) series 53.","pub","NM6-2","","public",,,,,,,,"The main objective of this Treatment Improvement Protocol (TIP) is to improve care for clients with SUDs by increasing knowledge of viral hepatitis among staff in behavioral health programs that provide substance abuse treatment. Some surveys have shown that substance abuse treatment providers are not well informed about viral hepatitis (Strauss et al., 2006). Clients often perceive that counselors do not have the information they need (Munoz-Plaza, Strauss, Astone, Des Jarlais, & Hagan, 2004). With up-to-date information, counselors, health professionals, and administrators in SUD treatment settings can encourage clients to understand the serious nature of hepatitis, risk factors, the importance of liver wellness, screening, treatment options, and ways to avoid spreading— or contracting—hepatitis. Other behavioral health treatment providers (e.g., counselors in mental health treatment settings, nurses, mid-level providers) will also find useful information in this TIP. Information is provided in lay terms so that it can be understood by readers who do not have medical training.","2011-12","published",,"SAMHSA, US",,"","",,,,,,"Substance Abuse and Mental Health Services Administration","Rockville, MD",,"146 p.",,,,,"HHS publication no. (SMA) 11-4656.",,,,,,"protocol","aod_disorder_treatment_method","alcohol_drugs_in_general",,,,,,"SAMHSA, US",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://store.samhsa.gov/product/TIP-53-Addressing-Viral-Hepatitis-in-People-With-Substance-Use-Disorders/SMA11-4656","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"NM6-2 , JM , JS , JU10 , VH4-4 , GA2-2 , JT , GH16-12-6 , AM","N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Health care programme or facility -- G Health and disease > Disorder by cause > Communicable disease > Viral hepatitis -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences","VA Geographic area > Europe > United Kingdom","Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Health care delivery -- Health care administration - Health care quality control -- State of health - Physical health -- Health care programme or facility -- Disorder by cause - Communicable disease - Viral hepatitis -- Drugs and alcohol effects and consequences","Europe - United Kingdom","Substance Abuse and Mental Health Services Administration Substance Abuse and Mental Health Services Administration","0","yes" "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-12-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17229",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717","30","archive","5",,,"disk0/00/01/67/17","2012-01-09 15:58:51","2014-04-09 22:00:34","2012-01-09 15:58:51","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","National Drugs Rehabilitation Implementation Committee","National protocols & common assessment guidelines: to accompany the National Drugs Rehabilitation Framework.","pub","HC","","public",,"other",,,,,,"This document aims to align the National Drugs Rehabilitation Framework document’s model of integrated care pathways with common assessment guidelines and national protocols to enable the implementation of this model. The guidelines detail criteria which should be included in any assessment a service provider undertakes with a service user, across the four tier model of service interventions.","2011-11","published",,"National Drugs Rehabilitation Implementation Committee",,"","",,,,,,"Health Service Executive","Kildare",,"35 p.",,,,,,,,,,,"guideline","screening","alcohol_drugs_in_general",,,,,,"National Drugs Rehabilitation Implementation Committee",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"HC , HH , NM6-2 , VH4-2 , JG26_2_4_2 , JM , JP24-4 , JT8_8_2","HA Screening, identification, and diagnostic method > Medical screening and diagnostic method -- HA Screening, identification, and diagnostic method > Psychosocial screening and diagnostic method -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Rehabilitation -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Medical screening and diagnostic method -- Psychosocial screening and diagnostic method -- Recommendations or guidelines - Practice / clinical guidelines -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Rehabilitation -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","National Drugs Rehabilitation Implementation Committee National Drugs Rehabilitation Implementation Committee","0","no" "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HH",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP24-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16717",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920","28","archive","5",,,"disk0/00/01/29/20","2010-03-02 14:32:19","2014-04-09 21:53:12","2010-03-02 14:32:19","monograph",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","National Immunisation Advisory Committee of the Royal College of Physicians of Ireland","Immunisation guidelines for Ireland, 2008 edition. Online only update September 2011.","pub","GH16","","public",,"other",,,,,,"Chapters of particular relevance to care of drug users: • Chapter 5 Hepatitis A p.49 • Chapter 6 Hepatitis B p.57 • Chapter 15 Tetanus p.149 Alcoholics and smokers: Chapter 12 Pneumococcal Infection","2011-09","published",,"National Immunisation Advisory Committee of the Royal College of Physicians of Ireland",,"","",,,,,,"Royal College of Physicians of Ireland","Dublin",,"269 p.",,,,,"978-0-9559351-0-7",,,,,,"","","",,,,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://www.immunisation.ie/en/HealthcareProfessionals/ImmunisationGuidelines2008/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"GH16 , VH4-2 , NM6-2 , JM , GH16-12 , GH16-12-6-4 , GH16-12-6-2 , JH10-6","G Health and disease > Disorder by cause > Communicable disease -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > Disorder by cause > Communicable disease > Viral disease -- G Health and disease > Disorder by cause > Communicable disease > Hepatitis B -- G Health and disease > Disorder by cause > Communicable disease > Hepatitis A -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control","VA Geographic area > Europe > Ireland","Disorder by cause - Communicable disease -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Disorder by cause - Communicable disease - Viral disease -- Disorder by cause - Communicable disease - Hepatitis B -- Disorder by cause - Communicable disease - Hepatitis A -- Health-related prevention - Health information and education - Communicable disease control","Europe - Ireland","National Immunisation Advisory Committee of the Royal College of Physicians of Ireland National Immunisation Advisory Committee of the Royal College of Physicians of Ireland","0","no" "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-12-6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-12-6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "12920",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653","28","archive","1684",,,"disk0/00/01/66/53","2011-12-20 15:06:06","2012-12-03 14:57:59","2011-12-20 15:06:06","article",,,"show",,,,"","","","","","","","","","","0",,,"Braden","Marina","","","","Braden:Marina::","",,,,,"","","Users, carers and professionals experiences of treatment and care for heroin dependency: implications for practice. A preliminary study.","pub","VH4-4-8","","none",,,,,,,,"Aim: This paper reports on the treatment and care experiences for heroin dependency in a Northern Ireland Healthcare Trust. Background: There is a dearth of multi-dimensional heroin dependency treatment perspectives in background qualitative peer-reviewed literature. This is surprising given the influence of 'consumer evaluation' in service development. Method: Focus groups were undertaken with separate purposive samples of ex//current heroin users ( n == 7), carers of ex//current heroin users ( n == 4) and professionals involved in heroin dependency service provision ( n == 4). Non-directive question schedules elicited collective phenomenological experiences. Focus groups were transcribed verbatim and content analyzed. Findings: Study participants shared mainly dehumanizing experiences of treatment and care provision often characterized by non-communicative and judgemental health professional conduct. Unpredictable prescribing protocol and limited treatment resources have overshadowed any beneficial experiences of substitute prescribing in our pilot study. Findings also showed that participants requested treatment choice and holistic care provision. Conclusions: Incoherent drug treatment policy and communication breakdown between treatment stakeholders has influenced a cyclical blame culture in this study.","2011",,,"Braden Marina",,"","",,"Journal of Substance Use","16","6","6","Informa healthcare",,"452-463",,,,,,,,,,,,"","","",,,,,,,,,"","","","","not_in_collection","","","","","",,"

 

",,,,,,,,,,,"",,"http://web.ebscohost.com/ehost/detail?sid=edc32c59-de09-4e8c-b4c7-3f4607c8bdf3%40sessionmgr114&vid=1&hid=110&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=c8h&AN=2011344542","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","16","Journal of Substance Use","VH4-4-8 , HK2 , JP10_2_2 , BL2 , JP10_6 , TL4-10-4 , JT14-4-12-4 , TL4","HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- B Drugs and alcohol substances > Opioids (opiates) > Heroin -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- T Demographic characteristics > Intravenous / injecting drug user -- J Health care, prevention and rehabilitation > Health care programme or facility > Drugs and alcohol disorder treatment unit -- T Demographic characteristics > Drug user","VA Geographic area > Europe > Northern Ireland","Drugs and alcohol disorder treatment method -- Treatment and maintenance - patient attitude toward treatment -- Opioids (opiates) - Heroin -- Treatment and maintenance - provider attitude toward treatment -- Intravenous / injecting drug user -- Health care programme or facility - Drugs and alcohol disorder treatment unit -- Drug user","Europe - Northern Ireland","Braden Marina , McGowan Iain W , McLaughlin Derek Francis , McKenna Hugh , Keeney Sinead , Quinn Breige","0","no" "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McGowan","Iain W","","",,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McLaughlin","Derek Francis","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McKenna","Hugh","","",,,,,,,,,,,,"BL2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Keeney","Sinead","","",,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Quinn","Breige","","",,,,,,,,,,,,"TL4-10-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT14-4-12-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16653",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240","31","archive","5",,,"disk0/00/01/62/40","2011-11-08 11:30:45","2014-04-09 21:59:43","2011-11-08 11:30:45","guideline",,,"show",,,,"","","","","","","","","","","0",,,"Handford","Curtis","","","",,"",,,,,"","","Buprenorphine/Naloxone for opioid dependence: clinical practice guideline.","pub","BL2-2","","public",,,,,,,,"• The objective of this guideline is to provide clinical recommendations for the initiation, maintenance and discontinuation of buprenorphine/naloxone maintenance treatment in the ambulatory treatment of adults and adolescents with opioid dependence in Ontario. • The guideline intends to contribute to education of practitioners regarding opioid prescribing, improved patient access to treatment for opioid dependence, and safe prescribing and dispensing of buprenorphine/naloxone. • This evidence-based clinical practice guideline was developed by a multidisciplinary committee, and included specialists in the field of addiction medicine, family medicine and pharmacy. • A systematic review of the literature formed the evidence base for this guideline, and recommendations were assigned levels of evidence and grades of recommendations based on those developed by the Canadian Task Force on Preventive Health Care.","2011","published",,"Centre for Addiction and Mental health",,"","",,,,,,"Centre for Addiction and Mental health","Toronto",,"153 p.",,,,,,,,,,,"guideline","aod_disorder_drug_therapy","opioid",,,,,,"Centre for Addiction and Mental health",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://www.camh.net/","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"BL2-2 , JM , JU10 , BL2-3 , HK2-10-2-2 , HK2-10 , VC4 , NM6-2 , BL","B Drugs and alcohol substances > Opioids (opiates) > Naloxone -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- B Drugs and alcohol substances > Opioids (opiates) > Buprenorphine -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol disorder drug therapy -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- B Drugs and alcohol substances > Opioids (opiates)","VA Geographic area > Canada","Opioids (opiates) - Naloxone -- Patient care management -- Health care administration - Health care quality control -- Opioids (opiates) - Buprenorphine -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Drugs and alcohol disorder treatment method - Drugs and alcohol disorder drug therapy -- Recommendations or guidelines - Practice / clinical guidelines -- Opioids (opiates)","Canada","Handford Curtis , Kahan Meldon , Srivastava Anita , Cirone Sharon , Palda Valerie","0","no" "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kahan","Meldon","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Srivastava","Anita","","",,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cirone","Sharon","","",,,,,,,,,,,,"BL2-3",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Palda","Valerie","","",,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VC4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16240",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16724","19","archive","1684",,,"disk0/00/01/67/24","2012-01-10 12:06:58","2016-02-26 13:58:00","2012-01-10 12:06:58","monograph",,,"show",,,,"","","","","","","","","","","0",,,"Gannon","Maria","","","","Gannon:Maria::","",,,,,"","","Protocol for national substance misuse rehabilitation cohort study.","pub","VH4-2","","public",,"other",,,,,,"The National Advisory Committee on Drugs (NACD) commissioned the Centre for Drug Misuse Research at the University of Glasgow to design a protocol for a cohort study examining rehabilitation among Irish substance misusers. This report has two key elements; a review of the literature and the proposed study designs. The literature review focuses on previous cohort studies involving samples of substances misusers from representative treatment modalities. These key longitudinal studies examined treatment effectiveness through the measurement of various outcomes related to recovery. The review also examines duration of treatment; its relationship with positive outcomes and the identification of optimum length of stay for different treatment modalities as well as examining rehabilitation focussed studies. The second section of the report discusses the definition of rehabilitation and how best to evaluate rehabilitation in Ireland. The research team have presented a number of possible cohort study designs: -Enhanced version of ROSIE focussing on rehabilitation outcomes -Sample ex‑clients and assess their progress to rehabilitation -Systemic evaluation of rehabilitation -Combined systemic evaluation and ex‑client assessment -Multiple mini‑cohorts focussing on rehabilitation oriented services -Virtual mapping The advantages and challenges related to each possible design are discussed in turn. Following discussions with the NACD the most promising study design was selected and is discussed in the conclusion of the report.","2011",,,"Gannon Maria",,"","",,,,,,"National Advisory Committee on Drugs","Dublin",,"39 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"VH4-2 , JM , JP24-4 , JT8_8_2","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Rehabilitation -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Patient care management -- Rehabilitation -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","Gannon Maria , McKeganey Neil , Hay Gordon","0","no" "16724",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McKeganey","Neil","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16724",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hay","Gordon","","",,,,,,,,,,,,"JP24-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16724",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033","34","archive","5",,,"disk0/00/01/60/33","2011-10-11 08:10:12","2017-02-13 13:21:02","2011-10-11 08:10:12","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","HIV and AIDS Asia Regional Program","Management of substance use-related disorders and common mental health problems among people who use drugs.","pub","JH10-6-2","","public",,,,,,,,"People who use drugs often present to health workers at drop-in centres (DICs) with health conditions that are consequences of drug use and dependence. People using substances usually have multiple medical problems that need to be assessed comprehensively to plan and implement appropriate treatment. The key objective of these guidelines is to assist health workers in making a comprehensive assessment of drug use–related disorders and to promote the rational use of medication to treat conditions such as withdrawal symptoms, intoxication and common mental health problems within a harm reduction context. The guidelines have two sections. The first section is for use by health workers in HAARP service sites. The second section is for use by trained mental health and advanced practitioners only. They were designed to be used to help service providers in Myanmar and across South-East Asia to deal with drug use– related physical and mental health issues in outpatient settings.","2011","published",,"HIV and AIDS Asia Regional Program",,"","",,,,,,"Commonwealth of Australia","Canberra",,"110 p.",,,,,,,,,,,"guideline","aod_disorder","alcohol_drugs_in_general",,,,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"JH10-6-2 , GA2-4 , JQ6-8 , NM6-2 , HK2 , JG26_2_4_2 , JM , VK2 , GD2 , HZ , GC12 , GH16-12-20-2","J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control > HIV prevention -- G Health and disease > State of health > Mental health -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder -- HJ Treatment method > Psychosocial treatment method -- G Health and disease > Drugs and alcohol related disorder > Dual diagnosis (comorbidity) -- G Health and disease > Disorder by cause > Communicable disease > HIV infection","VA Geographic area > Australia and Oceania > Australia","Health-related prevention - Health information and education - Communicable disease control - HIV prevention -- State of health - Mental health -- Care by type of problem - Mental health care -- Recommendations or guidelines - Practice / clinical guidelines -- Drugs and alcohol disorder treatment method -- Identification and screening - Identification and screening for drugs and alcohol use -- Patient care management -- Drugs and alcohol related disorder - Drugs and alcohol related mental disorder -- Psychosocial treatment method -- Drugs and alcohol related disorder - Dual diagnosis (comorbidity) -- Disorder by cause - Communicable disease - HIV infection","Australia and Oceania - Australia","HIV and AIDS Asia Regional Program HIV and AIDS Asia Regional Program","0","no" "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26_2_4_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GD2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16033",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GH16-12-20-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16166","20","archive","5",,,"disk0/00/01/61/66","2011-10-28 15:08:55","2012-08-01 09:28:19","2011-10-28 15:08:55","article",,,"show",,,,"","","","","","","","","","","0",,,"Keane","Martin","","","mkeane@hrb.ie","Keane:Martin::","",,,,,"","","UK expert group reports on recovery-oriented treatment.","pub","AH18","","public",,,,,,,,,"2011","published",,"Keane Martin",,"","",,"Drugnet Ireland","Issue 39, Autumn 2011",,,"Health Research Board",,"17-18",,,,,,,,,,,,"","","",,,,,,,,,"","","","","available","","","","","",,"

The UK National Treatment Agency (NTA) has published an interim report by Professor John Strang,1 chair of an expert group set up in 2010 ‘to provide guidance to the drug treatment field on the proper use of medications to aid recovery and on how the care for those in need of effective and evidence-based drug treatments is more fully orientated to optimise recovery’ (p. 2).The author makes ‘some early observations’ under three key headings: consensus reached on a number of issues, how services can improve the quality of treatment offered in the short term, and a vision of what recovery-orientated services can become. These observations are summarised below.  

Consensus on a number of issues
The group acknowledged the strong body of evidence that supports the effectiveness of opiod substitution treatment (OST) and seeks to build on this evidence to develop a recovery platform which will achieve even greater outcomes. It recognised the expansion in treatment services in the UK and the benefits to patients through a concerted drive to reduce waiting lists and improve retention in treatment. It also acknowledged, that, in some instances, there has been an over reliance by clinicians on prescribing medication, and ‘patients being allowed to drift into long-term maintenance’ (p.3).The group shared the view that ‘the prescribing of any medication (and perhaps especially of OST) must not be allowed to become detached and delivered in isolation from other crucial components of effective treatment. Other elements of overall care need also to be considered, including individual recovery care planning, psychosocial interventions and integration with mutual help-groups and peer- support’ (p.3).
 
Key elements of effective drug treatment
A comprehensive individual needs assessment that is undertaken early and is ongoing throughout treatment is a key part of the treatment process. The group is agreed that ‘assessment should not be a process that happens to someone but one in which they are actively involved’ (p.4). 
 
A recovery plan tailored to the patient’s needs must be developed collaboratively between the clinician and the patient and should be reviewed regularly and revised when appropriate. This report repeatedly stresses the importance of regular reviews of the recovery plan: ‘if an individual is deriving little or no benefit from an intervention, then it should be modified and tailored in partnership with the patient so that the provision of treatment delivers identified and valued benefit’ (p.4).
 
The group recognised that the eventual package of recovery-orientated treatment services was likely to appear complex to service providers, and that services will need time to adjust and will require training to reorient themselves towards a balance between harm reduction (reduction of negatives) and recovery (accrual of positives). The report lists some immediate steps services can take to begin to strike this balance. These are summarised below.
 
1.     Undertake an audit of your service to assess the current balance between overcoming dependence (recovery) and reducing harm to ensure that both objectives co-exist.
2.     Review all your patients to ensure they have achieved abstinence from their main problem drug(s) or are actively working to achieve abstinence.
3.     Consider changing the current balance between recovery and harm reduction to encourage more patients to pursue recovery.
4.     Let your patients see other patients who have successfully exited from treatment by linking your service to a recovery community, or employing ex-service users or using them as volunteers or as recovery mentors and coaches.
5.     Ensure adequate support is in place for patients who wish to reduce and/or stop using their medication and that rapid response mechanisms are in place in the event of relapse.
6.     Audit the availability of key psycho-social interventions using as a benchmark the interventions recommended by the National Institute of Clinical Excellence (NICE)2 and the audit tool recommended by the NTA and the British Psychological Society.3
7.     Strengthen and develop the social networks around patients including families and access to mutual-help groups.
8.     Establish opportunities for patients to accrue social capital via employment placements, vocational training and volunteering.
9.     Ensure all key workers are trained and supervised to deliver psychosocial interventions to a competent standard. Effective key working should also involve building collaborative interventions to develop the insight of patients and help them build a more integrated lifestyle by attending to their employment and housing needs.
 
A vision of what recovery-orientated services can become
The report outlines an eight-point vision for the future in which services will:
 
·         continue to recognise the role of prescribing medication, but not as an end in itself, rather as one component part in an integrated treatment package that minimises risk and promotes each patient’s recovery;
·         develop and support staff to adopt and promote recovery among patients and train staff to deliver evidence-base psycho-social interventions alongside prescribed medication;
·         make visible to all patients entering treatment the range of treatment and recovery options available and the likely trajectories through options and possible destinations;
·         maximise what individual can achieve with a clear emphasis on movement and progress for patients;
·         recognise the achievement of preventing further deterioration in the most severely damaged patients;
·         involve the families and carers of patients in their recovery planning;
·         develop close links with the community to promote reintegration of all patients; and
·         work with clearly defined guidelines that will allocate clearly defined roles for medication in stabilising, maintaining, detoxing and preventing relapse among patients.
 
The report identifies four key issues which require further intensive consideration: (i) distinguishing between the proportion of patients who might be expected to recover rapidly with no or modest substitute prescribing and the proportion which may need long-term care, including substitute prescribing (this issue is being addressed by a sub-group of the main group), (ii) how can treatment help patients to build ‘recovery capital’, the social, physical, human and cultural resources seen as necessary to initiate and sustain recovery from addiction? (iii) how can recovery capital and its accumulation be measured? and (iv) how can treatment services decide who receives what intervention, when they receive it and how is it best delivered? The last three issues will continue to be addressed by the main body of the expert group.
 
Recovery capital is mentioned as a key conceptual driver of their vision of recovery and further work on assessing how treatment services can help patients to develop recovery capital is underway through a sub-committee of the group. Drawing on the work of the French Sociologist Pierre Bourdieu and the concept of social capital, Cloud and Granfield (2008) 4 conceptualise recovery capital as the sum of resources necessary to initiate and sustain recovery from substance addiction. Recovery capital includes the social, physical, human and cultural resources needed to advance the recovery of drug users. Such resources include networks of non-drug using friends and supports (social capital), tangible assets such as secure accommodation and regular income through employment (physical capital), social and personal skills, education, mental and physical health and career goals and ambitions (human capital) and values, beliefs and attitudes that promotes social reintegration and the ability to live within socially prescribed norms (cultural capital). The full report on the work of the group is expected to be available towards the end of 2011 and will be covered in a later issue of Drugnet Ireland.
 
1. Strang J (2011) Recovery-oriented drug treatment: an interim report. London: National Treatment Agency for Substance Misuse. www.drugsandalcohol.ie/15524
2. NICE (2007) Drug misuse: psychosocial interventions. Nice clinical guidelines 51. London: National Institute for Health and Clinical Excellence. www.nice.org.uk/CG51
3. Pilling S, Hesketh K and Mitcheson L (2010) Psychosocial interventions in drug misuse: a framework and toolkit for implementing NICE-recommended treatment interventions. London: National Treatment Agency for Substance Misuse and British Psychological Society. www.drugsandalcohol.ie/13622
4. Cloud W and Granfield R (2008) Conceptualising recovery capital: expansion of a theoretical construct. Substance Use and Misuse, 43(12–13): 1971–1986.
",,,,,"Issue 39, Autumn 2011",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 39, Autumn 2011","Drugnet Ireland","AH18 , HK2 , VH4-4 , JM , JA8-4 , JP10 , JP10_6","A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Risk and needs assessment > Needs assessment -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment","VA Geographic area > Europe > United Kingdom","Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Drugs and alcohol disorder treatment method -- Patient care management -- Risk and needs assessment - Needs assessment -- Treatment and maintenance - treatment factors -- Treatment and maintenance - provider attitude toward treatment","Europe - United Kingdom","Keane Martin","0","no" "16166",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16166",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16166",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16166",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA8-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16166",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16166",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009","30","archive","5",,,"disk0/00/01/50/09","2011-05-05 08:49:53","2014-10-17 11:35:55","2011-05-05 08:49:53","article",,,"show",,,,"","","","","","","","","","","0",,,"Lyons","Suzi","","","","Lyons:Suzi::","",,,,,"","","External review of methadone treatment protocol makes wide-ranging recommendations.","pub","VH4-2","","public",,,,,,,,,"2011","published",,"Lyons Suzi",,"","",,"Drugnet Ireland","Issue 37, Spring 2011",,,"Health Research Board",,"22-24",,,,,,,,,,,,"","","",,,,,,,,,"","","","","available","","","","","",,"

 The results of the first external review of the Irish methadone treatment protocol were published on 20 December 2010.1 The HSE commissioned Michael Farrell, professor of addiction psychiatry at Kings College London, to conduct the review, assisted by Joe Barry, professor of population health medicine at Trinity College Dublin. This is the second review of the protocol; the Methadone Prescribing Implementation Committee carried out an internal review in 2005.2 

The terms of reference for the external review were to review the methadone treatment protocol with regard to:
·         maximizing provision of treatment, including detoxification, stabilisation, and rehabilitation;
·         clinical governance and audit;
·         effectiveness of referral pathways;
·         the enrolment and training of GPs, the criteria for Level 1 and Level 2 GPs, and the GP co-ordinator role;
·         the appropriateness and efficacy of urinalysis testing;
·         data collection, collation and analysis; and
·         engagement with the Department of Justice on the prescribing of methadone in Garda stations.
 
The review was informed by 69 written submissions and the conclusions of 38 oral hearings with stakeholders on the impact of the protocol. The main points of these inputs are outlined in chapter 5 and appendix 2 of the report. The authors state that the original protocol achieved its aims, especially in relation to improving both poor prescribing and the quality of independent practitioner practice. The current review covers a wide range of new issues, including: developing a model of service for rural Ireland, promoting better integration between and among services, the need to review benzodiazepine prescribing, changing the regime of urine testing and the need to deal urgently with methadone prescribing in Garda stations. 
 
The list of recommendations below, extracted in an abridged form from the published report, give an overview of the scope of the review. The full text of the recommendations is on pp. 33–36 of the report.
 
1. Maximising treatment provision and the efficacy of referral pathways
1.1. Requests for detoxification should have a defined time frame for response and should be reviewed as part of a service audit process.
 
1.2. There should be a mechanism to rapidly access treatment for the six months after detoxification to
ensure support if relapse occurs.
 
1.3. The redrafting of the methadone regulations to incorporate buprenorphine (alone or with naloxone) treatment should be completed to ensure a broader range of treatment options. To this end, the title needs to be changed and could be “The Opioid Treatment Protocol”.
 
1.4. Services with a focus on key workers and multidisciplinary work should be promoted and developed.
 
1.5. An integrated services approach should account for family, community and user groups and it is recommended that these voices get a more prominent place in the future planning and development of drug services.
 
1.6. There is an urgent need for a service model outside of Dublin that has a clear focus on rural aspects of service delivery.
 
1.7. In areas where the service currently relies on doctors travelling from Dublin, it is desirable that more permanent local medical input is organised in the near future for the purposes of continuity of service delivery.
 
1.8. The professional expertise of the adolescent services and the midwifery services should be used for developing an overall national strategy in these specific topics.
 
1.9. Implementation of a once-yearly brief instrument, such as the Treatment Outcome Profile, would provide important information on the performance of individuals and on the overall performance of the service. There is need to create a sense of progression and promote movement within and between services.
 
1.10. Services should use the full range of skills of the multidisciplinary team to ensure that health and social problems of drug users is evenly addressed.
 
1.11. The treatment of Hepatitis C Virus among drug users needs to be expanded further.
 
1.12. There is a need to develop a more structured and explicit care planning process. Everyone should have a clearly documented care plan that is regularly reviewed and updated, drawn up within the first three months of treatment.
 
1.13. The development of an electronic record of care planning is necessary if proper care planning is to be comprehensively implemented.
 
2. Clinical governance and audit
2.1. It is desirable that there be some option for flexibility around the appointment of HSE clinical directors and that the director has a background and training to the level recognised as an Addiction Specialist.
 
2.2. The lines of reporting and accountability for professionals in all of the services to be clarified.
 
2.3. Audit should now be developed across the full range of drug services where standards around practice could be reviewed.
 
2.4. The audit process should also be used to monitor treatment drop-out.
 
2.5. The development of joint guidelines that would enable benchmarks to be set against which future audits could be measured. Such guidelines should be developed by a joint working group of the College of Psychiatry of Ireland and the ICGP with input from relevant other professional groups.
 
2.6. There is a need to link major expansion in delivery of drug treatment to prisoners with the community based services.
 
2.7. The Pharmaceutical Society of Ireland demonstrated an interest in playing a part in improving the standards of prescribing of benzodiazepines. This work needs further development and should be undertaken as soon as possible in order to reduce poor benzodiazepine prescribing practice across all sectors of services in the HSE.
 
2.8. Recommendation 10 from the Report of the Benzodiazepine Prescribing Committee (2002)3 should be implemented.
 
3. Enrolment of GPs, training of GPs, the criteria for level 1 and level 2 GPs, and the GP Co-ordinator role
3.1. It should be an expectation that all trainees completing GP professional training have demonstrable competence to meet criteria for level 1.
 
3.2. There is a need to expand the number of level 2 general practitioners.
 
3.3. There should be a stated time limit for patients to be with level 2 GPs and GP Co-ordinators should ensure that the patient moves on to a level 1 GP within 12 months.
 
3.4. Level 2 GPs are requesting a change of the cap on numbers to be raised from 35 to 50. We recommend that this be done.
 
3.5. The cap on the number of patients with level 1 GPs should be abolished.
 
3.6. The roles of the GP Co-ordinators should be overhauled and the task of moving patients from level 2 to level 1 GPs be prioritised, in conjunction with local management.
 
3.7. The model of GP nurse liaison practitioners who work to both support and move patients on should be further developed.
 
3.8. As new structures evolve the National GP Co-ordinator post should be reviewed.
 
 
4. Urinalysis testing, its appropriateness and efficacy
4.1. Frequent urine testing should be stopped.
 
4.2. The supervision of urine testing should be eliminated except where there is a legal requirement for supervision and that oral fluid or temperature testing be used to indicate whether a fresh sample is being provided.
 
4.3. The technology behind oral fluid testing has improved substantially and it is now possible to undertake on site saliva testing.
 
4.4. The clinical guidelines jointly developed by the ICGP and the College of Psychiatry of Ireland should include an implementation plan for the move to less urine testing and a greater clinical focus on the use of the results of drug testing samples.
 
4.5. Consideration should be given to piloting one or two contingency management treatment programmes to assess their viability.
 
4.6. It would be desirable to introduce a mechanism for periodic monitoring of the levels of supervision of substitution treatment.
 
 
5. Methadone prescribing in Garda stations
5.1. There is a need for a fundamental review of the procedures and systems for medical assessment of people in Garda custody.
 
5.2. There is a need for clear and explicit guidelines for the management of opioid dependence while in Garda custody. A working group with a relevant range of stakeholders should be urgently established.
 
5.3. The overall health care input to Garda stations should be reviewed with consideration that operational responsibility and financial aspects of this service be transferred to become a responsibility of the HSE.
 
5.4. The doctors attending Garda stations should be at a minimum level 2 trained GPs.
 
5.5. Doctors attending users in Garda stations should have access out of hours to the CTL and should also be able to obtain information from Pharmacists on the last time of medication dispensing.
 
5.6. Garda stations should come under the protocol.
 
6. Data collection, collation and analysis
6.1. In developing a care planning approach, consideration should be given to the broader utility of this data monitoring with a view to some brief outcome monitoring process being built into this, where the status of an individual is systematically recorded on a once-yearly basis.
 
6.2. There should ideally be a systematic approach that enables wider data linkage through possible use of the PPS number that would enable ongoing mortality and other service utilisation analysis. Such work would help in tracking the pathways and careers of service users and provide valuable information on the long term outcomes of users.
 
6.3. There is a need for legislative change to allow the linkage of data from different data sources.
 
6.4. We recommend the establishment of a group comprising the main data controllers so that maximum use can be made of the data collected, in a secure and confidential environment with appropriate privacy protection
 
7. Other
7.1. Handwriting exemption procedures should be introduced.
 
7.2. Nurse prescribing of controlled drugs should be explored and if possible developed further in line with international practice.
 
7.3. There is a need for better linkage and for ensuring priority access of prisoners to community based treatment after release from prison from all Irish prisons.
 
 
1.     Farrell M and Barry J (2010) The introduction of the Opioid Treatment Protocol. Dublin: Health Service Executive. Available at www.drugsandalcohol.ie/14458
2.     Methadone Prescribing Implementation Committee (2005) Review of the Methadone Treatment Protocol. Dublin: Department of Health and Children. Available at www.drugsandalcohol.ie/5962
3.     Benzodiazepine Committee (2002) Report of the Benzodiazepine Committee. Dublin: Department of Health and Children. Available at www.drugsandalcohol.ie/5348
",,,,,"Issue 37, Spring 2011",,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"1","Issue 37, Spring 2011","Drugnet Ireland","VH4-2 , JM , HK2-4 , AH18 , MQ8-10 , HK2-10-2-2 , JP10 , HK2-10-2-2-2","J Health care, prevention and rehabilitation > Patient care management -- HJ Treatment method > Drugs and alcohol disorder treatment method > Detoxification method -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- MP-MR Policy, planning, economics, work and social services > Programme planning, implementation, and evaluation > Programme evaluation -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) -- J Health care, prevention and rehabilitation > Treatment and maintenance > treatment factors -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance","VA Geographic area > Europe > Ireland","Patient care management -- Drugs and alcohol disorder treatment method - Detoxification method -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Programme planning, implementation, and evaluation - Programme evaluation -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) -- Treatment and maintenance - treatment factors -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance","Europe - Ireland","Lyons Suzi","0","no" "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MQ8-10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15009",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833","36","archive","5",,,"disk0/00/01/58/33","2011-09-05 14:53:20","2014-04-09 21:58:59","2011-09-05 14:53:20","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","National Institute for Health and Clinical Excellence","Alcohol dependence and harmful alcohol use quality standard.","pub","NM6-2","","public",,,,,,,,"This NICE quality standard defines clinical best practice within this topic area. It provides specific, concise quality statements, measures and audience descriptors to provide the public, health and social care professionals, commissioners and service providers with definitions of high-quality care. Scope of the quality standard This quality standard covers the care of children (aged 10-15 years), young people (aged 16-17 years) and adults (aged 18 years and over) drinking in a harmful way and those with alcohol dependence in all NHS-funded settings. It also includes opportunistic screening and brief interventions for hazardous and harmful drinkers. The quality standard addresses the prevention and management of Wernicke's encephalopathy but does not cover the separate management of other physical and mental health disorders associated with alcohol use.","2011","published",,"NICE",,"","",,,,,,"National Institute for Health and Clinical Excellence","London",,"45 p.",,,,,,,,,,,"other","aod_disorder_treatment_method","alcohol",,,,,,"NICE",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://www.nice.org.uk/guidance/qualitystandards/alcoholdependence/home.jsp","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"NM6-2 , HK2 , JM , BB , AD12-6 , JU10 , GC16-6 , VH4-4 , GC16","N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- HJ Treatment method > Drugs and alcohol disorder treatment method -- J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Alcohol -- A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Drugs and alcohol use behaviour > Alcohol consumption -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence -- G Health and disease > Drugs and alcohol disorder > Alcohol use","VA Geographic area > Europe > United Kingdom","Recommendations or guidelines - Practice / clinical guidelines -- Drugs and alcohol disorder treatment method -- Patient care management -- Alcohol -- Prevalence of drugs and alcohol use - Drugs and alcohol use behaviour - Alcohol consumption -- Health care administration - Health care quality control -- Drugs and alcohol disorder - Alcohol use - Alcohol dependence -- Drugs and alcohol disorder - Alcohol use","Europe - United Kingdom","National Institute for Health and Clinical Excellence National Institute for Health and Clinical Excellence","0","no" "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AD12-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"education_and_training",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15833",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GC16",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16016","24","archive","5",,,"disk0/00/01/60/16","2011-10-03 14:28:40","2015-08-06 13:20:08","2011-10-03 14:28:40","article",,,"show",,,,"","","","","","","","","","","0",,,"O'Reilly","Fiona","","","","O'Reilly:Fiona::","",,,,,"","","Sharing control: user involvement in general practice based methadone maintenance.","pub","VH4-2","","none",,,,,,,,"Objective: This study assessed patients' views of a methadone programme in a Dublin general practice including the degree to which the patients were involved in decisions about their treatment. Conclusions: Most patients receiving methadone in general practice were listed to and had a say in deciding their methadone dose but did not have an opportunity to engage in more structured or contractual forms of involvement in treatment such as written care plans. In line with a patient centred approach, treatment providers should set their sights beyond the safe delivery of methadone, to provide a service which is centred on patient goals, expectations and choice.","2011","published",,"O'Reilly Fiona",,"","",,"Irish Journal of Psychological Medicine","28","3","3","Medmedia Group",,"129-133",,,,,,,,,,,,"","","",,"0790-9667",,,,,,,"","","","","available","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","28","Irish Journal of Psychological Medicine","VH4-2 , JM , JP10_2_2 , MN10-2-2 , HK2-10-2-2-2 , TL4 , JT8_8_2","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- MM-MO Crime and law > Legal rights > Rights of drugs and alcohol users -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- T Demographic characteristics > Drug user -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Patient care management -- Treatment and maintenance - patient attitude toward treatment -- Legal rights - Rights of drugs and alcohol users -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Drug user -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","O'Reilly Fiona , O'Connell David , O'Carroll Austin , Whitford David L , Long Jean","0","no" "16016",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Connell","David","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16016",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Carroll","Austin","","",,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16016",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Whitford","David L","","",,,,,,,,,,,,"MN10-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16016",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Long","Jean","","",,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16016",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TL4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "16016",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15789","20","archive","5",,,"disk0/00/01/57/89","2011-08-23 14:07:40","2016-03-01 16:28:00","2011-08-23 14:07:40","article",,,"show",,,,"","","","","","","","","","","0",,,"Rowley","Dominic","","","","Rowley:Dominic::","",,,,,"","","Review of cancer pain management in patients receiving maintenance methadone therapy.","pub","VH4-2","","none",,,,,,,,"Methadone is commonly used in the treatment of heroin addiction. Patients with a history of opioid misuse or on methadone maintenance therapy (MMT) with cancer often have difficult to manage pain. We studied 12 patients referred to the palliative care service with cancer pain who were on MMT. All had difficult to control pain, and a third required 5 or more analgesic agents. Two patients had documented ''drug-seeking'' behavior. Methadone was used subcutaneously as an analgesic agent in 1 patient. We explore why patients on MMT have difficult to manage pain, the optimal management of their pain, and the increasing role of methadone as an analgesic agent in cancer pain.","2011","published",,"Rowley Dominic",,"","",,"American Journal of Hospice & Palliative Medicine","28","3","3","Sage",,"183-187",,,,,,,,,,,,"","","",,"1049-9091",,,,,,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","28","American Journal of Hospice Palliative Medicine","VH4-2 , JM , BL , HK2-10-2-2-2 , JS , JQ6-4","J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- J Health care, prevention and rehabilitation > Health care delivery -- J Health care, prevention and rehabilitation > Care by type of problem > Medical care","VA Geographic area > Europe > Ireland","Patient care management -- Opioids (opiates) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Health care delivery -- Care by type of problem - Medical care","Europe - Ireland","Rowley Dominic , McLean Sarah , O'Gorman Aisling , Ryan Karen , McQuillan Regina","0","no" "15789",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McLean","Sarah","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15789",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"O'Gorman","Aisling","","",,,,,,,,,,,,"BL",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15789",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Ryan","Karen","","",,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15789",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"McQuillan","Regina","","",,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15789",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15051","18","archive","5",,,"disk0/00/01/50/51","2011-05-10 14:26:11","2013-10-30 13:42:11","2011-05-10 14:26:11","article",,,"show",,,,"","","","","","","","","","","0",,,"Xiao","Liang","","","","Xiao:Liang::","",,,,,"","","Developing an electronic health record (EHR) for methadone treatment recording and decision support.","pub","JU10","","none",,,,,,,,"BACKGROUND: In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR. METHODS: A set of archetypes has been designed in line with the current best practice and clinical guidelines which guide the information-gathering process. A web-based data entry system has been implemented, incorporating elements of the paper-based prescription form, while at the same time facilitating the decision support function. RESULTS: The use of archetypes was found to capture the ever changing requirements in the healthcare domain and externalises them in constrained data structures. The solution is extensible enabling the EHR to cover medicine management in general as per the programme of the HRB Centre for Primary Care Research. CONCLUSIONS: The data collected via this Irish system can be aggregated into a larger dataset, if necessary, for analysis and evidence-gathering, since we adopted the openEHR standard. It will be later extended to include the functionalities of prescribing drugs other than methadone along with the research agenda at the HRB Centre for Primary Care Research in Ireland.","2011","published",,"Xiao Liang",,"","",,"BMC Medical Informatics and Decision Making","11","5","5","BioMed Central",,,,,,,,"doi: 10.1186/1472-6947-11-5.",,,,,,"","","",,,,,,,,,"","","","","electronic_only","","","","","",,"

 

",,,,,,,,,,,"","http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039554/?tool=pubmed","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","do_not_display",,"1","11","BMC Medical Informatics and Decision Making","JU10 , NJ , VH4-2 , JM , HK2-10-2-2-2","J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- N Communication, information and education > Information technology -- J Health care, prevention and rehabilitation > Patient care management -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance","VA Geographic area > Europe > Ireland","Health care administration - Health care quality control -- Information technology -- Patient care management -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance","Europe - Ireland","Xiao Liang , Cousins Grainne , Courtney Brenda , Hederman Lucy , Fahey Tom , Dimitrov Borislav D.","0","no" "15051",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Cousins","Grainne","","",,,,,,,,,,,,"NJ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15051",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Courtney","Brenda","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15051",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Hederman","Lucy","","",,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15051",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Fahey","Tom","","",,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15051",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Dimitrov","Borislav D.","","",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17927","15","archive","5",,,"disk0/00/01/79/27","2012-07-03 14:46:19","2015-12-23 10:41:54","2012-07-03 14:46:19","article",,,"show",,,,"","","","","","","","","","","0",,,"Duggan","Michelle","","","","Duggan:Michelle::","",,,,,"","","Perioperative modifications of respiratory function.","pub","VH4-2","","none",,,,,,,,"Postoperative pulmonary complications contribute considerably to morbidity and mortality, especially after major thoracic or abdominal surgery. Clinically relevant pulmonary complications include the exacerbation of underlying chronic lung disease, bronchospasm, atelectasis, pneumonia and respiratory failure with prolonged mechanical ventilation. Risk factors for postoperative pulmonary complications include patient-related risk factors (e.g., chronic obstructive pulmonary disease (COPD), tobacco smoking and increasing age) as well as procedure-related risk factors (e.g., site of surgery, duration of surgery and general vs. regional anaesthesia). Careful history taking and a thorough physical examination may be the most sensitive ways to identify at-risk patients. Pulmonary function tests are not suitable as a general screen to assess risk of postoperative pulmonary complications. Strategies to reduce the risk of postoperative pulmonary complications include smoking cessation, inspiratory muscle training, optimising nutritional status and intra-operative strategies. Postoperative care should include lung expansion manoeuvres and adequate pain control.","2010","published",,"Duggan Michelle",,"","",,"Best Practice & Research: Clinical Anaesthesiology","24","2","2","Elsevier",,"145-155",,,,,,,,,,,,"","","",,,,,,,,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","24","Best Practice Research Clinical Anaesthesiology","VH4-2 , GA2-2 , JA8-2 , JM , BD","G Health and disease > State of health > Physical health -- J Health care, prevention and rehabilitation > Risk and needs assessment > Risk assessment -- J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Tobacco (cigarette smoking)","VA Geographic area > Europe > Ireland","State of health - Physical health -- Risk and needs assessment - Risk assessment -- Patient care management -- Tobacco (cigarette smoking)","Europe - Ireland","Duggan Michelle , Kavanagh Brian P","0","yes" "17927",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Kavanagh","Brian P","","",,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17927",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA8-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17927",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "17927",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BD",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458","48","archive","1684",,,"disk0/00/01/44/58","2010-12-20 14:44:54","2014-04-09 21:56:09","2010-12-20 14:44:54","monograph",,,"show",,,,"","","","","","","","","","","0",,,"Farrell","Michael","","","","Farrell:Michael::","",,,,,"","Health Service Executive. Social Inclusion Unit","The introduction of the opioid treatment protocol.","pub","BL2-2","","public",,"other",,,,,,"This is the first external review of the Methadone Treatment Protocol in Ireland. It seeks to examine the regulatory process and oversight of methadone and opiate dependence treatment, focusing on both the 1998 protocol and the processes by which treatment is implemented and delivered.","2010",,,"Farrell Michael",,"","",,,,,,"Health Service Executive","Dublin",,"89 p.",,,,,,,,,,,"","","",,,,,,,,,"","","4928","","available","","","","","",,,"HK2.10.2.2 VH4.2",,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"BL2-2 , VH4-2 , NM6-2 , JM , BL2-1 , TT2-12 , JS , HK2-4 , AH18 , BL2-3 , BL , HK2-10-2-2-2 , JT8_8_2","B Drugs and alcohol substances > Opioids (opiates) > Naloxone -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- B Drugs and alcohol substances > Opioids (opiates) > Methadone -- T Demographic characteristics > Doctor -- J Health care, prevention and rehabilitation > Health care delivery -- HJ Treatment method > Drugs and alcohol disorder treatment method > Detoxification method -- A Drugs and alcohol use, abuse, and dependence > Natural history of drugs and alcohol use > Drugs and alcohol recovery -- B Drugs and alcohol substances > Opioids (opiates) > Buprenorphine -- B Drugs and alcohol substances > Opioids (opiates) -- HJ Treatment method > Drugs and alcohol disorder treatment method > Drugs and alcohol replacement method (substitution) > Methadone maintenance -- J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)","VA Geographic area > Europe > Ireland","Opioids (opiates) - Naloxone -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Opioids (opiates) - Methadone -- Doctor -- Health care delivery -- Drugs and alcohol disorder treatment method - Detoxification method -- Natural history of drugs and alcohol use - Drugs and alcohol recovery -- Opioids (opiates) - Buprenorphine -- Opioids (opiates) -- Drugs and alcohol disorder treatment method - Drugs and alcohol replacement method (substitution) - Methadone maintenance -- Health care programme or facility - Community-based treatment (primary care)","Europe - Ireland","Farrell Michael , Barry Joseph , Health Service Executive. Social Inclusion Unit Health Service Executive. Social Inclusion Unit","0","no" "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Barry","Joseph","","",,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL2-1",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-12",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JS",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AH18",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL2-3",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BL",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2-10-2-2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "14458",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JT8_8_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26599","14","archive","5",,,"disk0/00/02/65/99","2016-12-31 17:23:35","2016-12-31 17:27:59","2016-12-31 17:23:35","guideline",,,"show",,,,"","","","","","","","","","",,,,,,,,"",,"",,,,,"","International Research for Research on Cancer","Alcohol consumption and ethyl carbamate.","pub","AD12-6","","public",,,,,,,,"Consumption of Alcoholic Beverages 1. Exposure Data 2. Studies of Cancer in Humans 2.1 Description of cohort studies 2.2 Cancer of the oral cavity and pharynx 2.3 Cancer of the larynx 2.4 Cancer of the oesophagus 2.5 Cancer of the liver 2.6 Breast cancer 2.7 Cancer of the stomach 2.8 Cancers of the colon and/or rectum 2.9 Cancer of the pancreas 2.10 Cancer of the lung 2.11 Cancer of the urinary bladder 2.12 Cancer of the endometrium 2.13 Cancer of the ovary 2.14 Cancer of the uterine cervix 2.15 Cancer of the prostate 2.16 Cancer of the kidney 2.17 Cancer of the lymphatic and haematopoietic system 2.18 Cancer at other sites 3. Studies of Cancer in Experimental Animals 4. Mechanistic and Other Relevant Data 5. Summary of Data Reported 6. Evaluation and Rationale Ethyl Carbamate 1. Exposure Data 2. Studies of Cancer in Humans 3. Studies of Cancer in Experimental Animals 4. Mechanistic and Other Relevant Data 5. Summary of Data Reported 6. Evaluation and Rationale","2010",,,"International Research for Research on Cancer",,"","",,"IARC monographs on the evaluation of carcinogenic risks to humans","96",,,"World Health Organization","Geneva",,,,,,,,,,,,,"report","aod_disorder","alcohol",,,,,,,,,"","","","","","","","","","",,,,,,,,,,,,,"","http://monographs.iarc.fr/ENG/Monographs/vol96/index.php","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3","96","IARC monographs on the evaluation of carcinogenic risks to humans","AD12-6 , AM , BB , GA2-2 , GA4 , JM","A Drugs and alcohol use, abuse, and dependence > Prevalence of drugs and alcohol use > Drugs and alcohol use behaviour > Alcohol consumption -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences -- B Drugs and alcohol substances > Alcohol -- G Health and disease > State of health > Physical health -- G Health and disease > Public health -- J Health care, prevention and rehabilitation > Patient care management",,"Prevalence of drugs and alcohol use - Drugs and alcohol use behaviour - Alcohol consumption -- Drugs and alcohol effects and consequences -- Alcohol -- State of health - Physical health -- Public health -- Patient care management",,"International Research for Research on Cancer International Research for Research on Cancer","0","yes" "26599",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_use_harm_reduction",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26599",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BB",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26599",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26599",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "26599",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095","23","archive","5",,,"disk0/00/01/80/95","2012-07-18 08:54:08","2012-07-18 08:55:32","2012-07-18 08:54:08","article",,,"show",,,,"","","","","","","","","","","0",,,"McCreaddie","May","","","","McCreaddie:May::","",,,,,"","","Routines and rituals: a grounded theory of the pain management of drug users in acute care settings.","pub","VH4-2","","none",,,,,,,,"Aim. This study reviewed the perceptions and strategies of drug users and nurses with regard to pain management in acute care settings. Background. Drug users present unique challenges in acute care settings with pain management noted to be at best suboptimal, at worst non-existent. Little is known about why and specifically how therapeutic effectiveness is compromised. Design. Qualitative: constructivist grounded theory Method. A constructivist grounded theory approach incorporating a constant comparative method of data collection and analysis was applied. The data corpus comprised interviews with drug users (n = 11) and five focus groups (n = 22) of nurses and recovering drug users. Results. Moral relativism as the core category both represents the phenomenon and explains the basic social process. Nurses and drug users struggle with moral relativism when addressing the issue of pain management in the acute care setting. Drug users lay claim to expectations of compassionate care and moralise via narration. Paradoxically, nurses report that the caring ideal and mutuality of caring are diminished. Drug users’ individual sensitivities, anxieties and felt stigma in conjunction with opioid-induced hyperalgesia complicate the processes. Nurses’ and hospitals’ organisational routines challenge drug user rituals and vice versa leading both protagonists to become disaffected. Consequently, key clinical issues such as preventing withdrawal and managing pain are left unaddressed and therapeutic effectiveness is compromised. Conclusion. This study provides a robust account of nurses’ and drug users’ struggle with pain management in the acute care setting. Quick technological fixes such as urine screens, checklists or the transient effects of (cognitive-based) education (or training) are not the answer. This study highlights the need for nurses to engage meaningfully with this perceptibly ‘difficult’group of patients. Relevance to clinical practice. The key aspects likely to contribute to problematic interactions with this patient cohort are outlined so that they can be prevented and, or addressed.","2010","published",,"McCreaddie May",,"","",,"Journal of Clinical Nursing","19",,,"Blackwell",,"2730-2740",,,,,,"doi: 10.1111/j.1365-2702.2010.03284.x",,,,,,"","","",,,,,,,,,"","","","","not_in_collection","","","","","",,"

 

",,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","19","Journal of Clinical Nursing","VH4-2 , JM , JP10_2_2 , JP10_6 , VH4-4 , GA2-2 , HJ2 , AM","J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Treatment and maintenance > patient attitude toward treatment -- J Health care, prevention and rehabilitation > Treatment and maintenance > provider attitude toward treatment -- G Health and disease > State of health > Physical health -- HJ Treatment method > General treatment method concepts -- A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences","VA Geographic area > Europe > Ireland -- VA Geographic area > Europe > United Kingdom","Patient care management -- Treatment and maintenance - patient attitude toward treatment -- Treatment and maintenance - provider attitude toward treatment -- State of health - Physical health -- General treatment method concepts -- Drugs and alcohol effects and consequences","Europe - Ireland -- Europe - United Kingdom","McCreaddie May","0","yes" "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_2_2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JP10_6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GA2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HJ2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "18095",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"AM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918","29","archive","5",,,"disk0/00/01/39/18","2010-09-23 08:16:57","2012-12-19 10:03:31","2010-09-23 08:16:57","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","National Institute for Health and Clinical Excellence","Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors.","pub","ED4-12","","public",,,,,,,,"The care that women should be offered during pregnancy is outlined in NICE clinical guideline 62 ('Antenatal care'). However, pregnant women with complex social factors may need additional support to use antenatal care services. This guideline describes how access to care can be improved, how contact with antenatal carers can be maintained, the additional support and consultations that are required and the additional information that should be offered to pregnant women with complex social factors. Examples of complex social factors include: • substance misuse; • recent arrival as a migrant; • asylum seeker or refugee status; • difficulty speaking or understanding English; • age under 20; • domestic abuse; • poverty; • homelessness","2010","published",,"NICE",,"","",,,,,,"National Institute for Health and Clinical Excellence","London",,"34 p.",,,,,"NICE clinical guideline 110",,,,,,"guideline","aod_use_harm_reduction","alcohol_drugs_in_general",,,,,,"NICE",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"","http://guidance.nice.org.uk/CG110","","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"ED4-12 , NM6-2 , JM , T10-4-2 , JA6-6 , JB2-4 , JU10 , MF4 , BA , VH4-4","E Concepts in biomedical areas > Pregnancy -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Pregnant woman -- J Health care, prevention and rehabilitation > Risk and protective factors > risk factors -- J Health care, prevention and rehabilitation > Drugs and alcohol prevention > Drugs and alcohol use harm reduction -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- MA-ML Social science, culture and community > Social position > Social equality and inequality -- B Drugs and alcohol substances > Drugs and alcohol in general","VA Geographic area > Europe > United Kingdom","Pregnancy -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Pregnant woman -- Risk and protective factors - risk factors -- Drugs and alcohol prevention - Drugs and alcohol use harm reduction -- Health care administration - Health care quality control -- Social position - Social equality and inequality -- Drugs and alcohol in general","Europe - United Kingdom","National Institute for Health and Clinical Excellence National Institute for Health and Clinical Excellence","0","no" "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"T10-4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JA6-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JB2-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MF4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BA",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13918",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-4",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24336","11","archive","1684",,,"disk0/00/02/43/36","2015-07-27 11:41:56","2015-08-05 14:30:03","2015-07-27 11:41:56","article",,,"show",,,,"","","","","","","","","","",,,,"Nash","M J","","","","Nash:M J::","",,,,,"","","An exploration of mental health nursing students' experiences and attitudes towards using cigarettes to change client's behaviour.","pub","BD","","none",,,,,,,,"There are ethical and moral dilemmas around using lifestyle risk factors as rewards or using client's nicotine addiction as a means of controlling behaviour. The question of whether this intervention should ever be used, given its associated health risk, requires more critical debate in clinical practice.","2010","published",,"Nash M J",,"","",,"Journal of Psychiatric and Mental Health Nursing","17","8","8","Wiley-Blackwell",,"683-691",,,,,,,,,,,"TRUE","","","",,"1351-0126",,,,,,,"","","","","not_in_collection","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","","display_if_logged_in",,"1","17","Journal of Psychiatric and Mental Health Nursing","BD , FR , JM , TN2-6 , TT2-14 , VH4-2","B Drugs and alcohol substances > Tobacco (cigarette smoking) -- F Concepts in psychology > Attitude and behaviour -- J Health care, prevention and rehabilitation > Patient care management -- T Demographic characteristics > Undergraduate or graduate student -- T Demographic characteristics > Nurse","VA Geographic area > Europe > Ireland","Tobacco (cigarette smoking) -- Attitude and behaviour -- Patient care management -- Undergraduate or graduate student -- Nurse","Europe - Ireland","Nash M J , Romanos M T","0","yes" "24336",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"Romanos","M T","","",,,,,,,,,,,,"FR",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24336",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24336",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TN2-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24336",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"TT2-14",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "24336",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15550","36","archive","5",,,"disk0/00/01/55/50","2011-07-20 14:11:55","2014-04-09 21:58:17","2011-07-20 14:11:55","monograph",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","National SATU Guidelines Development Group","Recent rape/sexual assault: National guidelines on referral and forensic clinical examination in Ireland.","pub","MM26","","public",,"other",,,,,,"The purpose of this document is to facilitate all aspects of a responsive and coordinated service for men and women over the age of 14 years who have been raped or sexually assaulted. This is the second edition of the ‘Recent Rape/Sexual Assault: National Guidelines on Referral and Forensic Clinical Examination in Ireland’ and the updates to the various sections emphasise the many positive developments in the service over the past 4 years. The interagency nature of these guidelines will enable consistent provision of high quality care at all stages of the journey, regardless of the circumstances of the assault or the person’s involvement with criminal justice agencies. This document also ensures that clearly defined referral pathways exist, so that men and women can access appropriate individualised care that is responsive to their needs. It is important to highlight that people respond to instances of sexual violence in different ways, and while this document provides guidance for compassionate and effective care it does not represent the only medically or legally acceptable response. There may be circumstances where personal or clinical factors may mandate appropriate deviation from these guidelines. Quick reference pages have been devised in order to enable practitioners to access information quickly. The quick reference pages are: • Pathway options: Recent history Of rape/sexual assault (p. 13) • Referral pathway: To a sexual assault treatment unit (p. 14) • Contact details for SATUs (p. 14) • Guide to help preserve forensic evidence which may be available. (p. 15)","2010","published",,"National SATU Guidelines Development Group",,"","",,,,,,"National SATU Guidelines Development Group","Dublin",,"170 p.",,,,,,,,,,,"","","",,,,,,,,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"","",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"2",,,"MM26 , VH4-2 , NM6-2 , JM , MM2-2 , JH10-6 , JG26","MM-MO Crime and law > Crime and violence > Crime against persons (assault / abuse / intimidation) -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- MM-MO Crime and law > Crime > Drugs and alcohol related crime -- J Health care, prevention and rehabilitation > Health-related prevention > Health information and education > Communicable disease control -- J Health care, prevention and rehabilitation > Identification and screening","VA Geographic area > Europe > Ireland","Crime and violence - Crime against persons (assault / abuse / intimidation) -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Crime - Drugs and alcohol related crime -- Health-related prevention - Health information and education - Communicable disease control -- Identification and screening","Europe - Ireland","National SATU Guidelines Development Group National SATU Guidelines Development Group","0","no" "15550",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VH4-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15550",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15550",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15550",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"MM2-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15550",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JH10-6",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "15550",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JG26",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984","33","archive","5",,,"disk0/00/01/39/84","2010-10-08 08:01:50","2012-12-19 10:06:46","2010-10-08 08:01:50","guideline",,,"show",,,,"","","","","","","","","","","0",,,,,,,"",,"",,,,,"","World Health Organization","mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings.","pub","TT2","","public",,,,,,,,"The mhGAP Intervention Guide (mhGAP-IG) for mental, neurological and substance use disorders for non-specialist health settings, is a technical tool developed by WHO to assist in implementation of mhGAP. The Intervention Guide has been developed through a systematic review of evidence followed by an international consultative and participatory process. The mhGAP-IG presents integrated management of priority conditions using protocols for clinical decision-making. The priority conditions included are: depression, psychosis, bipolar disorders, epilepsy, developmental and behavioural disorders in children and adolescents, dementia, alcohol use disorders, drug use disorders, self-harm/suicide and other significant emotional or medically unexplained complaints. The mhGAP-IG is a model guide and has been developed for use by health-care providers working in non-specialized health-care settings after adaptation for national and local needs. For access to the mhGAP Evidence Centre please click the related URL link below.","2010","published",,"WHO",,"","",,,,,,"WHO","Geneva",,"107 p.",,,,,,,,,,,"guideline","aod_disorder_treatment_method","alcohol_drugs_in_general",,"978 92 4 154806 9",,,,"WHO",,,"","","","","electronic_only","","","","","",,,,,,,,,,,,,"",,"http://www.who.int/mental_health/evidence/mhGAP_intervention_guide/en/index.html","pub",,"","",,,,,,"",,,,,,,"",,,,,"",,,,,"","",,,,,"","",,"","","",,,"3",,,"TT2 , JQ6-8 , HK2 , NM6-2 , JM , GD2 , JU10 , HZ , BA , VA2 , HJ2","T Demographic characteristics > Drug or health care worker -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care -- HJ Treatment method > Drugs and alcohol disorder treatment method -- N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines -- J Health care, prevention and rehabilitation > Patient care management -- G Health and disease > Drugs and alcohol related disorder > Drugs and alcohol related mental disorder -- J Health care, prevention and rehabilitation > Health care administration > Health care quality control -- HJ Treatment method > Psychosocial treatment method -- B Drugs and alcohol substances > Drugs and alcohol in general -- HJ Treatment method > General treatment method concepts","VA Geographic area > International aspects","Drug or health care worker -- Care by type of problem - Mental health care -- Drugs and alcohol disorder treatment method -- Recommendations or guidelines - Practice / clinical guidelines -- Patient care management -- Drugs and alcohol related disorder - Drugs and alcohol related mental disorder -- Health care administration - Health care quality control -- Psychosocial treatment method -- Drugs and alcohol in general -- General treatment method concepts","International aspects","World Health Organization World Health Organization","0","no" "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JQ6-8",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"aod_disorder_drug_therapy",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"http://www.who.int/mental_health/mhgap/evidence/en/index.html",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HK2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"screening",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"NM6-2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"psychosocial_treatment_method",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JM",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"GD2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"JU10",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HZ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"BA",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"VA2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "13984",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"HJ2",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,