info:oai:generic.eprints.org:28007info:ofi/fmt:xml:xsd:journalYoderRuthYoder, Ruth <http://www.drugsandalcohol.ie/view/people/Yoder=3ARuth=3A=3A.html>MacNeelaPadraigMacNeela, Padraig <http://www.drugsandalcohol.ie/view/people/MacNeela=3APadraig=3A=3A.html>ConwayRonanConway, Ronan <http://www.drugsandalcohol.ie/view/people/Conway=3ARonan=3A=3A.html>HearyCarolineHeary, Caroline <http://www.drugsandalcohol.ie/view/people/Heary=3ACaroline=3A=3A.html>Early online14 October 20171708-0428How do individuals develop alcohol use disorder after bariatric surgery? A grounded theory exploration.Obesity Surgeryarticleinfo:oai:generic.eprints.org:28035info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/28035/ Substance use treatment as part of a ‘wrap-around’ package of care. Drugs and alcohol recovery Patient care management Treatment factors Health care delivery Drug or health care worker 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? Drug and Alcohol Findings 2017-10-03 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/28035/1/Hot-Topic_Substance_Use_tr_wrap_findings.pdf Drug and Alcohol Findings. (2017) Substance use treatment as part of a ‘wrap-around’ package of care. London: Drug and Alcohol Findings. Drug and Alcohol Findings Hot Topic (October-December 2017) 3 p. http://findings.org.uk/hot_topics.php?s=ebinfo:oai:generic.eprints.org:22467info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22467/ Drug Matrix cell C1: management/supervision - reducing harm. Drugs and alcohol use harm reduction Communicable disease control Needle distribution and exchange Patient care management Health care delivery Health care administration Harm reduction policy Workforce / staff skills and training Drug and Alcohol Findings 2017-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22467/1/Drug-%26_Alcohol_Findings_C1_findings.pdf Drug and Alcohol Findings. (2017) Drug Matrix cell C1: management/supervision - reducing harm. London: Drug and Alcohol Findings. 4 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/C1.htm&format=open&s=dyinfo:oai:generic.eprints.org:27973info:ofi/fmt:xml:xsd:journalO'DriscollColinO'Driscoll, Colin <http://www.drugsandalcohol.ie/view/people/O=27Driscoll=3AColin=3A=3A.html>FoySeanFoy, Sean <http://www.drugsandalcohol.ie/view/people/Foy=3ASean=3A=3A.html>1243October 2017Working with clients with addiction: what psychologists need to know.The Irish Psychologist16-20articleinfo:oai:generic.eprints.org:27951info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27951/ Health Matters: preventing ill health from alcohol and tobacco use. Alcohol Alcohol use Patient care management Health care delivery Drug or health care worker Nurse Prevention worker United Kingdom Public Health England 2017-10 Evidence resource NonPeerReviewed Public Health England. (2017) Health Matters: preventing ill health from alcohol and tobacco use. London: Public Health England. https://www.gov.uk/government/publications/health-matters-preventing-ill-health-from-alcohol-and-tobacco/health-matters-preventing-ill-health-from-alcohol-and-tobacco-useinfo:oai:generic.eprints.org:27903info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27903/ Do we all agree what "good health care" looks like? Views from those who are "seldom heard" in health research, policy and service improvement. Ryan, Sara Hislop, Jenny Ziebland, Sue Patient care management Patient attitude toward treatment Mental health care Health care delivery Health care quality control Drug user Drug or health care worker Doctor Nurse United Kingdom 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. Wiley 2017-10 Evidence resource PeerReviewed Ryan, Sara <http://www.drugsandalcohol.ie/view/people/Ryan=3ASara=3A=3A.html> and Hislop, Jenny <http://www.drugsandalcohol.ie/view/people/Hislop=3AJenny=3A=3A.html> and Ziebland, Sue <http://www.drugsandalcohol.ie/view/people/Ziebland=3ASue=3A=3A.html> . (2017) Do we all agree what "good health care" looks like? Views from those who are "seldom heard" in health research, policy and service improvement. Wiley. Health Expectations, 20 (5) 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.info:oai:generic.eprints.org:28029info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/28029/ WHO alcohol brief intervention training manual for primary care. Alcohol Alcohol dependence Psychosocial treatment method Brief intervention Identification and screening for drugs and alcohol use Patient care management Community-based treatment (primary care) Drug or health care worker Doctor Nurse Prevention worker Social worker 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 WHO Regional Office for Europe 2017-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/28029/1/WHO_Alcohol-training-manual-final-edit-LSJB-290917.pdf WHO Regional Office for Europe. [WHO] (2017) WHO alcohol brief intervention training manual for primary care. Copenhagan: WHO Regional Office for Europe. 117 p. http://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/publications/2017/who-alcohol-brief-intervention-training-manual-for-primary-care-2017info:oai:generic.eprints.org:27911info:ofi/fmt:xml:xsd:journalIversJo-HannaIvers, Jo-Hanna <http://www.drugsandalcohol.ie/view/people/Ivers=3AJo-Hanna=3A=3A.html>ZgagaLinaZgaga, Lina <http://www.drugsandalcohol.ie/view/people/Zgaga=3ALina=3A=3A.html>SweeneyBrionSweeney, Brion <http://www.drugsandalcohol.ie/view/people/Sweeney=3ABrion=3A=3A.html>KeenanEamonKeenan, Eamon <http://www.drugsandalcohol.ie/view/people/Keenan=3AEamon=3A=3A.html>DarkerCatherineDarker, Catherine <http://www.drugsandalcohol.ie/view/people/Darker=3ACatherine=3A=3A.html>SmythBobby PSmyth, Bobby P <http://www.drugsandalcohol.ie/view/people/Smyth=3ABobby_P=3A=3A.html>BarryJoeBarry, Joe <http://www.drugsandalcohol.ie/view/people/Barry=3AJoe=3A=3A.html>Early online20 September 20171465-3362A naturalistic longitudinal analysis of post-detoxification outcomes in opioid-dependent patients.Drug and Alcohol Reviewarticleinfo:oai:generic.eprints.org:27823info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27823/ The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. 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 Cannabis / Marijuana Prescription drug (medicine / medication) State of health Patient care management Adolescent / youth (teenager / young person) United States American College of Physicians 2017-09-05 Evidence resource NonPeerReviewed Nugent, Shannon M <http://www.drugsandalcohol.ie/view/people/Nugent=3AShannon_M=3A=3A.html> and Morasco, Benjamin J <http://www.drugsandalcohol.ie/view/people/Morasco=3ABenjamin_J=3A=3A.html> and O'Neil, Maya E <http://www.drugsandalcohol.ie/view/people/O=27Neil=3AMaya_E=3A=3A.html> and Freeman, Michele <http://www.drugsandalcohol.ie/view/people/Freeman=3AMichele=3A=3A.html> and Low, Allison <http://www.drugsandalcohol.ie/view/people/Low=3AAllison=3A=3A.html> and Kondo, Karli <http://www.drugsandalcohol.ie/view/people/Kondo=3AKarli=3A=3A.html> and Elven, Camille <http://www.drugsandalcohol.ie/view/people/Elven=3ACamille=3A=3A.html> and Zakher, Bernadette <http://www.drugsandalcohol.ie/view/people/Zakher=3ABernadette=3A=3A.html> and Motu'apuaka, Makalapua <http://www.drugsandalcohol.ie/view/people/Motu=27apuaka=3AMakalapua=3A=3A.html> and Paynter, Robin <http://www.drugsandalcohol.ie/view/people/Paynter=3ARobin=3A=3A.html> and Kansagara, Devan <http://www.drugsandalcohol.ie/view/people/Kansagara=3ADevan=3A=3A.html> . (2017) The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. American College of Physicians. Annals of Internal Medicine, 167 (5) http://annals.org/aim/article/2648595/effects-cannabis-among-adults-chronic-pain-overview-general-harms-systematicinfo:oai:generic.eprints.org:22466info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22466/ Drug Matrix cell B1: practitioners - reducing harm. Drugs and alcohol use harm reduction Patient care management Patient attitude toward treatment Provider attitude toward treatment Health care delivery Harm reduction policy Drug or health care worker Doctor Nurse Counsellor / Therapist Social worker Drug and Alcohol Findings 2017-09 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22466/1/Drug_Matrix_B1_findings.pdf Drug and Alcohol Findings. (2017) Drug Matrix cell B1: practitioners - reducing harm. London: Drug and Alcohol Findings. http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/B1.htm&s=ebinfo:oai:generic.eprints.org:27729info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27729/ Hepatitis C screening. National clinical guideline no. 15. Summary. Hepatitis C Communicable disease control Patient care management Health care delivery Intravenous / injecting drug user Drug or health care worker Doctor Nurse 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) Department of Health 2017-08 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/27729/1/HepC-NCG-15_Summary_v8.pdf Department of Health. (2017) Hepatitis C screening. National clinical guideline no. 15. Summary. Dublin: Department of Health. http://health.gov.ie/national-patient-safety-office/ncec/national-clinical-guidelines/prevention/info:oai:generic.eprints.org:27752info:ofi/fmt:xml:xsd:journalLyonsSuziLyons, Suzi <http://www.drugsandalcohol.ie/view/people/Lyons=3ASuzi=3A=3A.html>Issue 62, Summer 2017August 2017New clinical guidelines for opioid substitution treatment.Drugnet Ireland27-30articleinfo:oai:generic.eprints.org:27754info:ofi/fmt:xml:xsd:journalLyonsSuziLyons, Suzi <http://www.drugsandalcohol.ie/view/people/Lyons=3ASuzi=3A=3A.html>Issue 62, Summer 2017August 2017Updated community detoxification protocols for methadone and benzodiazepines.Drugnet Ireland31articleinfo:oai:generic.eprints.org:27758info:ofi/fmt:xml:xsd:journalMillarSeanMillar, Sean <http://www.drugsandalcohol.ie/view/people/Millar=3ASean=3A=3A.html>Issue 62, Summer 2017August 2017Healthcare in Irish prisons.Drugnet Ireland36-37articleinfo:oai:generic.eprints.org:27667info:ofi/fmt:xml:xsd:journalAyuAstri ParawitaAyu, Astri Parawita <http://www.drugsandalcohol.ie/view/people/Ayu=3AAstri_Parawita=3A=3A.html>El-GuebalyNadyEl-Guebaly, Nady <http://www.drugsandalcohol.ie/view/people/El-Guebaly=3ANady=3A=3A.html>SchellekensArntSchellekens, Arnt <http://www.drugsandalcohol.ie/view/people/Schellekens=3AArnt=3A=3A.html>De JongCorDe Jong, Cor <http://www.drugsandalcohol.ie/view/people/De_Jong=3ACor=3A=3A.html>Welle-StrandGabrielleWelle-Strand, Gabrielle <http://www.drugsandalcohol.ie/view/people/Welle-Strand=3AGabrielle=3A=3A.html>SmallWilliamSmall, William <http://www.drugsandalcohol.ie/view/people/Small=3AWilliam=3A=3A.html>WoodEvanWood, Evan <http://www.drugsandalcohol.ie/view/people/Wood=3AEvan=3A=3A.html>CullenWalterCullen, Walter <http://www.drugsandalcohol.ie/view/people/Cullen=3AWalter=3A=3A.html>KlimasJanKlimas, Jan <http://www.drugsandalcohol.ie/view/people/Klimas=3AJan=3A=3A.html>Early online18 July 20171747-597XCore addiction medicine competencies for doctors, an international consultation on training..Substance Abuse0articleinfo:oai:generic.eprints.org:27601info:ofi/fmt:xml:xsd:journalPeckhamEmilyPeckham, Emily <http://www.drugsandalcohol.ie/view/people/Peckham=3AEmily=3A=3A.html>BrabynSallyBrabyn, Sally <http://www.drugsandalcohol.ie/view/people/Brabyn=3ASally=3A=3A.html>CookLizCook, Liz <http://www.drugsandalcohol.ie/view/people/Cook=3ALiz=3A=3A.html>TewGarryTew, Garry <http://www.drugsandalcohol.ie/view/people/Tew=3AGarry=3A=3A.html>GilbodySimonGilbody, Simon <http://www.drugsandalcohol.ie/view/people/Gilbody=3ASimon=3A=3A.html>11714 July 20171471-244XSmoking cessation in severe mental ill health: what works? an updated systematic review and meta-analysis.BMC psychiatry252articleinfo:oai:generic.eprints.org:27253info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27253/ The effectiveness of interventions related to the use of illicit drugs: prevention, harm reduction, treatment and recovery. A ‘review of reviews’. Bates, Geoff Jones, Lisa Cochrane, Madeleine Pendlebury, Marissa Sumnall, Harry Problem drugs and alcohol use Drugs and alcohol recovery Drugs and alcohol disorder treatment method Alternative medical treatment Psychosocial treatment method Treatment outcome Drugs and alcohol prevention Drugs and alcohol use harm reduction Prevention outcome Universal prevention Targeted prevention School-based prevention Community-based prevention Prevention approach Patient care management Treatment factors Community-based treatment (primary care) Adolescent / youth (teenager / young person) Doctor Prevention worker International aspects Health Research Board 2017-07 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/27253/1/fHB2656_Review%20of%20reviews_web.pdf Bates, Geoff <http://www.drugsandalcohol.ie/view/people/Bates=3AGeoff=3A=3A.html> and Jones, Lisa <http://www.drugsandalcohol.ie/view/people/Jones=3ALisa=3A=3A.html> and Cochrane, Madeleine <http://www.drugsandalcohol.ie/view/people/Cochrane=3AMadeleine=3A=3A.html> and Pendlebury, Marissa <http://www.drugsandalcohol.ie/view/people/Pendlebury=3AMarissa=3A=3A.html> and Sumnall, Harry <http://www.drugsandalcohol.ie/view/people/Sumnall=3AHarry=3A=3A.html> (2017) The effectiveness of interventions related to the use of illicit drugs: prevention, harm reduction, treatment and recovery. A ‘review of reviews’. Dublin: Health Research Board. HRB Drug and Alcohol Evidence Review 5info:oai:generic.eprints.org:27587info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27587/ Pain management and the opioid epidemic: balancing societal and individual benefits and risks of prescription opioid use. Bonnie, Richard J Ford, Morgan A Phillips, Jonathan K Problem drugs and alcohol use Opioids (opiates) Prescription drug (medicine / medication) State of health risk factors Patient care management Social costs and benefits of drugs and alcohol United States 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.] National Academies Press 2017-07 Evidence resource NonPeerReviewed Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse. Bonnie, Richard J <http://www.drugsandalcohol.ie/view/people/Bonnie=3ARichard_J=3A=3A.html> and Ford, Morgan A <http://www.drugsandalcohol.ie/view/people/Ford=3AMorgan_A=3A=3A.html> and Phillips, Jonathan K <http://www.drugsandalcohol.ie/view/people/Phillips=3AJonathan_K=3A=3A.html> . (2017) Pain management and the opioid epidemic: balancing societal and individual benefits and risks of prescription opioid use. Washington: National Academies Press. 380 p. http://www.nap.edu/24781info:oai:generic.eprints.org:27709info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27709/ Frequently asked questions on opioid agonist treatment for pharmaceutical opioid dependence: An evidence summary. Nielsen, Suzanne Opioids (opiates) Drugs and alcohol disorder treatment method Drugs and alcohol disorder drug therapy Drugs and alcohol replacement method (substitution) Patient care management Australia 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. National Drug and Alcohol Research Centre 2017-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/27709/1/NDARC_FAQ_Pharmacetuical_Opioid_Dependence_Treatment.pdf Nielsen, Suzanne <http://www.drugsandalcohol.ie/view/people/Nielsen=3ASuzanne=3A=3A.html> [NDARC] . (2017) Frequently asked questions on opioid agonist treatment for pharmaceutical opioid dependence: An evidence summary. Sydney: National Drug and Alcohol Research Centre. 16 p. info:oai:generic.eprints.org:27595info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27595/ Drug misuse and dependence. UK guidelines on clinical management. State of health Drugs and alcohol disorder treatment method Drugs and alcohol replacement method (substitution) Methadone maintenance Psychosocial treatment method Treatment outcome Drugs and alcohol use harm reduction Communicable disease control Health promotion Patient care management Treatment factors Health care delivery Community-based treatment (primary care) Health care quality control Drug user Drug or health care worker Doctor Nurse United Kingdom 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 Department of Health 2017-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/27595/1/Drug_Misuse_clinical_guidelines_2017.pdf Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group. [Public Health England] (2017) Drug misuse and dependence. UK guidelines on clinical management. London: Department of Health. 317 p. info:oai:generic.eprints.org:24912info:ofi/fmt:xml:xsd:journalVan HoutMarie ClaireVan Hout, Marie Claire <http://www.drugsandalcohol.ie/view/people/Van_Hout=3AMarie_Claire=3A=3A.html>HoranAHoran, A <http://www.drugsandalcohol.ie/view/people/Horan=3AA=3A=3A.html>SantlalKSantlal, K <http://www.drugsandalcohol.ie/view/people/Santlal=3AK=3A=3A.html>RichERich, E <http://www.drugsandalcohol.ie/view/people/Rich=3AE=3A=3A.html>BerginMBergin, M <http://www.drugsandalcohol.ie/view/people/Bergin=3AM=3A=3A.html>327July 20171049-7323‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland.Qualitative Health Research341-350articleinfo:oai:generic.eprints.org:27658info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27658/ Elevated alcohol consumption following alcohol cue exposure is partially mediated by reduced inhibitory control and increased craving. Ward, Matt Jones, Andrew Alcohol consumption Alcohol risk factors Patient care management Treatment factors 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. Springer 2017-07 Evidence resource NonPeerReviewed Ward, Matt <http://www.drugsandalcohol.ie/view/people/Ward=3AMatt=3A=3A.html> and Jones, Andrew <http://www.drugsandalcohol.ie/view/people/Jones=3AAndrew=3A=3A.html> . (2017) Elevated alcohol consumption following alcohol cue exposure is partially mediated by reduced inhibitory control and increased craving. Springer. Psychopharmacology, Early online https://link.springer.com/article/10.1007/s00213-017-4694-6info:oai:generic.eprints.org:27666info:ofi/fmt:xml:xsd:journalCrowleyDesCrowley, Des <http://www.drugsandalcohol.ie/view/people/Crowley=3ADes=3A=3A.html>CullenWalterCullen, Walter <http://www.drugsandalcohol.ie/view/people/Cullen=3AWalter=3A=3A.html>LairdEamonLaird, Eamon <http://www.drugsandalcohol.ie/view/people/Laird=3AEamon=3A=3A.html>LambertJohn SLambert, John S <http://www.drugsandalcohol.ie/view/people/Lambert=3AJohn_S=3A=3A.html>Mc HughTinaMc Hugh, Tina <http://www.drugsandalcohol.ie/view/people/Mc_Hugh=3ATina=3A=3A.html>MurphyCarolMurphy, Carol <http://www.drugsandalcohol.ie/view/people/Murphy=3ACarol=3A=3A.html>Van HoutMarie ClaireVan Hout, Marie Claire <http://www.drugsandalcohol.ie/view/people/Van_Hout=3AMarie_Claire=3A=3A.html>25June 20172450-131XExploring patient characteristics and barriers to hepatitis C treatment in patients on opioid substitution treatment attending a community based fibro-scanning clinic.Journal of Translational Internal Medicine112-119articleinfo:oai:generic.eprints.org:23732info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/23732/ Alcohol matrix cell C5: Management/supervision - safeguarding the community. Alcohol Patient attitude toward treatment Provider attitude toward treatment Health care programme or facility Community-based treatment (primary care) Crime prevention Organisational development Workforce / staff skills and training Drug or health care worker Counsellor / Therapist Social worker Drug and Alcohol Findings 2017-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/23732/1/C5_findings_Alcohol_Matrix.pdf Drug and Alcohol Findings. (2017) Alcohol matrix cell C5: Management/supervision - safeguarding the community. London: Drug and Alcohol Findings. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/C5.htm&s=ebinfo:oai:generic.eprints.org:27483info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27483/ Liver disease. Quality standard. Drugs and alcohol effects and consequences Physical health Patient care management Health care delivery Drug or health care worker Doctor United Kingdom National Institute for Health and Care Excellence 2017-06 Evidence resource NonPeerReviewed National Institute for Health and Care Excellence. [NICE] (2017) Liver disease. Quality standard. London: National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/QS152info:oai:generic.eprints.org:27705info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27705/ Multimorbidity: quality standard. Physical health Patient care management Health care delivery United Kingdom 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. NICE 2017-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/27705/1/NICE_multimorbidity.pdf National Institute for Health and Care Excellence. [NICE] (2017) Multimorbidity: quality standard. London: NICE. 21 p. QS153 https://www.nice.org.uk/guidance/qs153 QS153info:oai:generic.eprints.org:27317info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27317/ What do prisoners think of drug treatment? Webster, Russell Patient attitude toward treatment Prison-based health service Correctional system and facility Prison Prison Inmate (prisoner) 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........... Russell Webster 2017-05-18 Evidence resource NonPeerReviewed Webster, Russell <http://www.drugsandalcohol.ie/view/people/Webster=3ARussell=3A=3A.html> . (2017) What do prisoners think of drug treatment? Russell Webster. http://www.russellwebster.com/what-do-prisoners-think-of-drug-treatment-2/info:oai:generic.eprints.org:23731info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/23731/ Alcohol matrix cell B5: Practitioners - safeguarding the community. Alcohol Attitude toward drugs and alcohol addict or user Patient attitude toward treatment Provider attitude toward treatment Drug or health care worker Doctor Nurse Counsellor / Therapist Social worker Drug and Alcohol Findings 2017-05 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/23731/1/B5_findings_Alcohol_Matrix.pdf Drug and Alcohol Findings. (2017) Alcohol matrix cell B5: Practitioners - safeguarding the community. London: Drug and Alcohol Findings. 4 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B5.htm&s=ebinfo:oai:generic.eprints.org:27226info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27226/ Sláinte agus Tiomáint. Medical fitness to drive guidelines (Group 1 and Group 2 Drivers). Drug use and driving Drinking and driving Patient care management Transportation safety laws (driving) Doctor Ireland 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 Road Safety Authority 2017-04 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/27226/1/Sla%CC%81inte%20Agus%20Tioma%CC%81int%202017%20i.pdf National Office for Traffic Medicine. (2017) Sláinte agus Tiomáint. Medical fitness to drive guidelines (Group 1 and Group 2 Drivers). Dublin: Road Safety Authority. info:oai:generic.eprints.org:25451info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25451/ Supervised dosing with a long acting opioid medication in the management of opioid dependence. Saulle, Rosella Vecchi, Simona Gowing, Linda Opioids (opiates) Drugs and alcohol replacement method (substitution) Treatment outcome Patient care management Treatment factors 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. John Wiley & Sons, Ltd 2017-04 Evidence resource NonPeerReviewed Saulle, Rosella <http://www.drugsandalcohol.ie/view/people/Saulle=3ARosella=3A=3A.html> and Vecchi, Simona <http://www.drugsandalcohol.ie/view/people/Vecchi=3ASimona=3A=3A.html> and Gowing, Linda <http://www.drugsandalcohol.ie/view/people/Gowing=3ALinda=3A=3A.html> [The Cochrane Library] . (2017) Supervised dosing with a long acting opioid medication in the management of opioid dependence. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews (4) DOI: 10.1002/14651858.CD011983.pub2 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011983.pub2/full DOI: 10.1002/14651858.CD011983.pub2info:oai:generic.eprints.org:22525info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22525/ Alcohol Matrix cell B4: Practitioners - psychosocial therapies. Alcohol Psychosocial treatment method Treatment outcome Patient care management Treatment factors Patient attitude toward treatment Provider attitude toward treatment Workforce / staff skills and training Drug or health care worker Nurse Counsellor / Therapist Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2017-03 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22525/1/Alcohol_Matrix_B4_findings.pdf Drug and Alcohol Findings. (2017) Alcohol Matrix cell B4: Practitioners - psychosocial therapies. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. 7 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B4.htm&s=ebinfo:oai:generic.eprints.org:27052info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/27052/ Cannabis and young users- a brief intervention to reduce their consumption (CANABIC): a cluster randomized controlled trial in primary care. Laporte, Catherine Vaillant-Roussel, Hélène Pereira, Bruno Blanc, Olivier Eschalier, Bénédicte Kinouani, Shérazade Brousse, Georges Llorca, Pierre-Michel Vorilhon, Philippe Prevalence of drugs and alcohol use Cannabis / Marijuana Brief intervention Patient care management Community-based treatment (primary care) Adolescent / youth (teenager / young person) Doctor Nurse France 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 Evidence resource NonPeerReviewed Laporte, Catherine <http://www.drugsandalcohol.ie/view/people/Laporte=3ACatherine=3A=3A.html> and Vaillant-Roussel, Hélène <http://www.drugsandalcohol.ie/view/people/Vaillant-Roussel=3AH=E9l=E8ne=3A=3A.html> and Pereira, Bruno <http://www.drugsandalcohol.ie/view/people/Pereira=3ABruno=3A=3A.html> and Blanc, Olivier <http://www.drugsandalcohol.ie/view/people/Blanc=3AOlivier=3A=3A.html> and Eschalier, Bénédicte <http://www.drugsandalcohol.ie/view/people/Eschalier=3AB=E9n=E9dicte=3A=3A.html> and Kinouani, Shérazade <http://www.drugsandalcohol.ie/view/people/Kinouani=3ASh=E9razade=3A=3A.html> and Brousse, Georges <http://www.drugsandalcohol.ie/view/people/Brousse=3AGeorges=3A=3A.html> and Llorca, Pierre-Michel <http://www.drugsandalcohol.ie/view/people/Llorca=3APierre-Michel=3A=3A.html> and Vorilhon, Philippe <http://www.drugsandalcohol.ie/view/people/Vorilhon=3APhilippe=3A=3A.html> . (2017) Cannabis and young users- a brief intervention to reduce their consumption (CANABIC): a cluster randomized controlled trial in primary care. Annals of Family Medicine, 15 (2) http://www.annfammed.org/content/15/2/131.fullinfo:oai:generic.eprints.org:26869info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26869/ Qualitative exploration of why people repeatedly attend emergency departments for alcohol-related reasons. Parkman, Tom Neale, Joanne Day, Ed Drummond, Colin Alcohol Alcohol intoxication Alcohol dependence Patient attitude toward treatment emergency care Hospital Community-based treatment (primary care) Doctor Nurse 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. BioMed Central 2017-02 Evidence resource NonPeerReviewed Parkman, Tom <http://www.drugsandalcohol.ie/view/people/Parkman=3ATom=3A=3A.html> and Neale, Joanne <http://www.drugsandalcohol.ie/view/people/Neale=3AJoanne=3A=3A.html> and Day, Ed <http://www.drugsandalcohol.ie/view/people/Day=3AEd=3A=3A.html> and Drummond, Colin <http://www.drugsandalcohol.ie/view/people/Drummond=3AColin=3A=3A.html> [Biomed Central] . (2017) Qualitative exploration of why people repeatedly attend emergency departments for alcohol-related reasons. BioMed Central. BMC Health Services Research, 17 (140) DOI: 10.1186/s12913-017-2091-9 https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2091-9 DOI: 10.1186/s12913-017-2091-9info:oai:generic.eprints.org:26707info:ofi/fmt:xml:xsd:journalGalvinBrianGalvin, Brian <http://www.drugsandalcohol.ie/view/people/Galvin=3ABrian=3A=3A.html>Issue 60, Winter 2017January 2017HRB drug and alcohol evidence review on case management.Drugnet Ireland15-17articleinfo:oai:generic.eprints.org:26624info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26624/ How does older people’s drinking appear in the daily work of home care professionals? Koivula, Riitta Tigerstedt, Christoffer Vilkko, Anni Kuussaari, Kristiina Pajala, Satu Alcohol consumption Drugs and alcohol effects and consequences Alcohol Alcohol intoxication Patient care management Social support Elderly / Older person Drug or health care worker Nurse Finland 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. De Gruyter 2016-12 Evidence resource NonPeerReviewed Koivula, Riitta <http://www.drugsandalcohol.ie/view/people/Koivula=3ARiitta=3A=3A.html> and Tigerstedt, Christoffer <http://www.drugsandalcohol.ie/view/people/Tigerstedt=3AChristoffer=3A=3A.html> and Vilkko, Anni <http://www.drugsandalcohol.ie/view/people/Vilkko=3AAnni=3A=3A.html> and Kuussaari, Kristiina <http://www.drugsandalcohol.ie/view/people/Kuussaari=3AKristiina=3A=3A.html> and Pajala, Satu <http://www.drugsandalcohol.ie/view/people/Pajala=3ASatu=3A=3A.html> . (2016) How does older people’s drinking appear in the daily work of home care professionals? De Gruyter. Nordic Studies on Alcohol and Drugs, 33 (5-6) 537-50. https://www.degruyter.com/view/j/nsad.2016.33.issue-5-6/nsad-2016-0044/nsad-2016-0044.xml?format=INTinfo:oai:generic.eprints.org:22519info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22519/ Alcohol Matrix cell A3: Interventions - medical treatment. Alcohol General treatment method concepts Drugs and alcohol disorder treatment method Drugs and alcohol disorder drug therapy Drugs and alcohol replacement method (substitution) Patient care management Treatment factors Health care delivery Hospital Doctor Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2016-11 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22519/1/Alcohol_Matrix_A3_findings.pdf Drug and Alcohol Findings. (2016) Alcohol Matrix cell A3: Interventions - medical treatment. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. 5 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/A3.htm&s=ebinfo:oai:generic.eprints.org:22520info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22520/ Alcohol Matrix cell B3: Practitioners - medical treatment. Alcohol Treatment factors Patient attitude toward treatment Provider attitude toward treatment Health care delivery Drug or health care worker Doctor Nurse Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2016-11 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22520/1/Alcohol_Matrix_B3_findings.pdf Drug and Alcohol Findings. (2016) Alcohol Matrix cell B3: Practitioners - medical treatment. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. 3 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B3.htm&s=ebinfo:oai:generic.eprints.org:26313info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26313/ Global report on access to hepatitis C treatment - Focus on overcoming barriers. Hepatitis C Patient care management Harm reduction policy Intravenous / injecting drug user International aspects 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. World Health Organization 2016-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/26313/1/WHO-HIV-2016.20-eng.pdf World Health Organization. [WHO] (2016) Global report on access to hepatitis C treatment - Focus on overcoming barriers. Geneva: World Health Organization. 68 p. info:oai:generic.eprints.org:26057info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26057/ Alcohol Matrix cell B2: Practitioners; generic and cross-cutting issues. Alcohol consumption Alcohol Attitude toward drugs and alcohol addict or user Treatment outcome Treatment factors Patient attitude toward treatment Provider attitude toward treatment Drug or health care worker Doctor Nurse Prevention worker Social worker Drug and Alcohol Findings 2016-09 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/26057/1/Alcohol-matrix-B2_findings.pdf Drug and Alcohol Findings. (2016) Alcohol Matrix cell B2: Practitioners; generic and cross-cutting issues. London: Drug and Alcohol Findings. 4 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/B2.htm&format=open&s=ebinfo:oai:generic.eprints.org:26614info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26614/ Alcohol Matrix cell D2: Organisational functioning; Generic and cross-cutting issues. Alcohol Patient care management Health care delivery Health care quality control Organisational development Workforce / staff skills and training Drug or health care worker Drug and Alcohol Findings 2016-09 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/26614/1/Alcohol-matrix_D2_findings.pdf Drug and Alcohol Findings. (2016) Alcohol Matrix cell D2: Organisational functioning; Generic and cross-cutting issues. London: Drug and Alcohol Findings. 4 p. http://findings.org.uk/PHP/dl.php?file=Matrix/Alcohol/D2.htm&s=ebinfo:oai:generic.eprints.org:15185info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/15185/ Alcohol-use disorders overview. Treatment outcome Drugs and alcohol disorder treatment method Patient care management Brief intervention Alcohol Health care delivery Health care quality control State of health United Kingdom Alcohol use Community-based treatment (primary care) Practice / clinical guidelines Identification and screening for drugs and alcohol use Doctor Alcohol dependence Psychosocial treatment method Treatment factors 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. National Institute for Health and Clinical Excellence 2016-09 Evidence resource NonPeerReviewed [NICE] (2016) Alcohol-use disorders overview. London: National Institute for Health and Clinical Excellence. NICE Pathways http://pathways.nice.org.uk/pathways/alcohol-use-disorders#content=view-info%3Aintroduction-source NICE Pathwaysinfo:oai:generic.eprints.org:25734info:ofi/fmt:xml:xsd:journalCousinsGráinneCousins, Gráinne <http://www.drugsandalcohol.ie/view/people/Cousins=3AGr=E1inne=3A=3A.html>MonganDeirdreMongan, Deirdre <http://www.drugsandalcohol.ie/view/people/Mongan=3ADeirdre=3A=3A.html>BarryJoeBarry, Joe <http://www.drugsandalcohol.ie/view/people/Barry=3AJoe=3A=3A.html>SmythBobbySmyth, Bobby <http://www.drugsandalcohol.ie/view/people/Smyth=3ABobby=3A=3A.html>RackardMarionRackard, Marion <http://www.drugsandalcohol.ie/view/people/Rackard=3AMarion=3A=3A.html>LongJeanLong, Jean <http://www.drugsandalcohol.ie/view/people/Long=3AJean=3A=3A.html>840August 20161530-0277Estimating 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.Alcoholism Clinical and Experimental Research1700-1706articleinfo:oai:generic.eprints.org:25822info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25822/ Citalopram: suspected drug interaction with cocaine; prescribers should consider enquiring about illicit drug use. Prescription drug (medicine / medication) Mental health Patient care management Mental health care Doctor United Kingdom 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 Evidence resource NonPeerReviewed Medicines and Healthcare products Regulatory Agency. [gov.uk] (2016) Citalopram: suspected drug interaction with cocaine; prescribers should consider enquiring about illicit drug use. Drug Safety Update, 9 (12) https://www.gov.uk/drug-safety-update/citalopram-suspected-drug-interaction-with-cocaine-prescribers-should-consider-enquiring-about-illicit-drug-useinfo:oai:generic.eprints.org:25806info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25806/ Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults. 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 Mental health Treatment outcome Patient care management Mental health care 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. John Wiley & Sons, Ltd 2016-07 Evidence resource NonPeerReviewed Kendrick, Tony <http://www.drugsandalcohol.ie/view/people/Kendrick=3ATony=3A=3A.html> and El-Gohary, Magdy <http://www.drugsandalcohol.ie/view/people/El-Gohary=3AMagdy=3A=3A.html> and Stuart, Beth <http://www.drugsandalcohol.ie/view/people/Stuart=3ABeth=3A=3A.html> and Gilbody, Simon <http://www.drugsandalcohol.ie/view/people/Gilbody=3ASimon=3A=3A.html> and Churchill, Rachel <http://www.drugsandalcohol.ie/view/people/Churchill=3ARachel=3A=3A.html> and Aiken, Laura <http://www.drugsandalcohol.ie/view/people/Aiken=3ALaura=3A=3A.html> and Bhattacharya, Abhishek <http://www.drugsandalcohol.ie/view/people/Bhattacharya=3AAbhishek=3A=3A.html> and Gimson, Amy <http://www.drugsandalcohol.ie/view/people/Gimson=3AAmy=3A=3A.html> and Brutt, Anna L <http://www.drugsandalcohol.ie/view/people/Brutt=3AAnna_L=3A=3A.html> and de Jong, Kim <http://www.drugsandalcohol.ie/view/people/de_Jong=3AKim=3A=3A.html> and Moore, Michael <http://www.drugsandalcohol.ie/view/people/Moore=3AMichael=3A=3A.html> [The Cochrane Library] . (2016) Routine use of patient reported outcome measures (PROMs) for improving treatment of common mental health disorders in adults. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews, 7 DOI: 10.1002/14651858.CD011119.pub2 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011119.pub2/full DOI: 10.1002/14651858.CD011119.pub2info:oai:generic.eprints.org:22483info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22483/ Alcohol Matrix cell B1: Practitioners - screening and brief intervention. Alcohol Alcohol dependence Medical screening and diagnostic method Psychosocial screening and diagnostic method Brief intervention Identification and screening for drugs and alcohol use Patient care management emergency care Community-based treatment (primary care) Drug or health care worker Doctor Nurse Social worker Drug and Alcohol Findings 2016-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22483/1/Alcohol_matrix_B1.pdf Drug and Alcohol Findings. (2016) Alcohol Matrix cell B1: Practitioners - screening and brief intervention. London: Drug and Alcohol Findings. http://findings.org.uk/count/downloads/download.php?file=Matrix/Alcohol/B1.htminfo:oai:generic.eprints.org:20066info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/20066/ Alcohol Matrix: Evidence for effective treatment. Alcohol Drugs and alcohol disorder treatment method Psychosocial treatment method Treatment outcome Identification and screening for drugs and alcohol use Patient care management Treatment factors Organisational development Workforce / staff skills and training United Kingdom 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. Drug and Alcohol Findings and the Consortium 2016-06 Evidence resource NonPeerReviewed Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2016) Alcohol Matrix: Evidence for effective treatment. London: Drug and Alcohol Findings and the Consortium. http://findings.org.uk/docs/amatrix.htminfo:oai:generic.eprints.org:25702info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25702/ Partnership for change. Report of the Mental Health Reference Group. Mental health Patient care management Mental health care Ireland 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. Health Service Executive 2016-06 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/25702/1/HSE_Partnership_for_change.pdf HSE Mental Health Division. (2016) Partnership for change. Report of the Mental Health Reference Group. Dublin: Health Service Executive. info:oai:generic.eprints.org:25715info:ofi/fmt:xml:xsd:journalRowntreeRRowntree, R <http://www.drugsandalcohol.ie/view/people/Rowntree=3AR=3A=3A.html>SweeneyJSweeney, J <http://www.drugsandalcohol.ie/view/people/Sweeney=3AJ=3A=3A.html>CrumlishNCrumlish, N <http://www.drugsandalcohol.ie/view/people/Crumlish=3AN=3A=3A.html>FlynnGFlynn, G <http://www.drugsandalcohol.ie/view/people/Flynn=3AG=3A=3A.html>Early onlineJune 20160790-9667How do we compare with best practice? A completed audit of benzodiazepine and z-hypnotic prescribing.Irish Journal of Psychological Medicinearticleinfo:oai:generic.eprints.org:25471info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25471/ Frequent attenders to accident and emergency departments: a qualitative study of individuals who repeatedly present with alcohol-related health conditions. Neale, Joanne Parkman, Tom Day, Ed Drummond, Colin Drugs and alcohol effects and consequences Alcohol Attitude toward drugs and alcohol addict or user State of health Alcohol dependence Patient care management emergency care Drug or health care worker Doctor Nurse Social worker United Kingdom 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. Alcohol research UK 2016-05 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/25471/1/AlcoholInsight_0134_emergency_departments.pdf Neale, Joanne <http://www.drugsandalcohol.ie/view/people/Neale=3AJoanne=3A=3A.html> and Parkman, Tom <http://www.drugsandalcohol.ie/view/people/Parkman=3ATom=3A=3A.html> and Day, Ed <http://www.drugsandalcohol.ie/view/people/Day=3AEd=3A=3A.html> and Drummond, Colin <http://www.drugsandalcohol.ie/view/people/Drummond=3AColin=3A=3A.html> [Alcohol Research UK] . (2016) Frequent attenders to accident and emergency departments: a qualitative study of individuals who repeatedly present with alcohol-related health conditions. London: Alcohol research UK. 5 p. Alcohol Insight Number 0134 Alcohol Insight Number 0134info:oai:generic.eprints.org:22482info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22482/ Alcohol Matrix cell A1: Interventions - screening and brief intervention. Alcohol Medical screening and diagnostic method Psychosocial screening and diagnostic method Brief intervention Identification and screening for drugs and alcohol use Patient care management emergency care Community-based treatment (primary care) Drug or health care worker Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2016-05 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22482/7/Alcohol_matrix_A1.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2016) Alcohol Matrix cell A1: Interventions - screening and brief intervention. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/count/downloads/download.php?file=Matrix/Alcohol/A1.htminfo:oai:generic.eprints.org:25552info:ofi/fmt:xml:xsd:journalSimpsonAlanSimpson, Alan <http://www.drugsandalcohol.ie/view/people/Simpson=3AAlan=3A=3A.html>HanniganBenHannigan, Ben <http://www.drugsandalcohol.ie/view/people/Hannigan=3ABen=3A=3A.html>CoffeyMichaelCoffey, Michael <http://www.drugsandalcohol.ie/view/people/Coffey=3AMichael=3A=3A.html>BarlowSallyBarlow, Sally <http://www.drugsandalcohol.ie/view/people/Barlow=3ASally=3A=3A.html>CohenRachelCohen, Rachel <http://www.drugsandalcohol.ie/view/people/Cohen=3ARachel=3A=3A.html>JonesAledJones, Aled <http://www.drugsandalcohol.ie/view/people/Jones=3AAled=3A=3A.html>VšetečkováJitkaVšetečková, Jitka <http://www.drugsandalcohol.ie/view/people/V==0161ete==010Dkov=E1=3AJitka=3A=3A.html>FaulknerAlisonFaulkner, Alison <http://www.drugsandalcohol.ie/view/people/Faulkner=3AAlison=3A=3A.html>ThorntonAlexandraThornton, Alexandra <http://www.drugsandalcohol.ie/view/people/Thornton=3AAlexandra=3A=3A.html>CartwrightMartinCartwright, Martin <http://www.drugsandalcohol.ie/view/people/Cartwright=3AMartin=3A=3A.html>116March 20161471-244XRecovery-focused care planning and coordination in England and Wales: a cross-national mixed methods comparative case study.BMC Psychiatry147articleinfo:oai:generic.eprints.org:26338info:ofi/fmt:xml:xsd:journalVan HoutMarie ClaireVan Hout, Marie Claire <http://www.drugsandalcohol.ie/view/people/Van_Hout=3AMarie_Claire=3A=3A.html>NormanIanNorman, Ian <http://www.drugsandalcohol.ie/view/people/Norman=3AIan=3A=3A.html>27January 20160955-3959Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies.International Journal of Drug Policy17-22articleinfo:oai:generic.eprints.org:25864info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25864/ Smuggling compassion into care: is the NHS destined for system D? Bhui, Kamaldeep S Attitude toward drugs and alcohol addict or user Patient care management Provider attitude toward treatment Mental health care Health care delivery Workforce / staff skills and training United Kingdom 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. Sage 2016 Evidence resource NonPeerReviewed Bhui, Kamaldeep S <http://www.drugsandalcohol.ie/view/people/Bhui=3AKamaldeep_S=3A=3A.html> . (2016) Smuggling compassion into care: is the NHS destined for system D? Sage. Australian & New Zealand Journal of Psychiatry, 50 (7) 611-12. DOI: 10.1177/0004867416654577 http://anp.sagepub.com/content/50/7/611.long DOI: 10.1177/0004867416654577info:oai:generic.eprints.org:25875info:ofi/fmt:xml:xsd:journalCarrollRCarroll, R <http://www.drugsandalcohol.ie/view/people/Carroll=3AR=3A=3A.html>CorcoranPaulCorcoran, Paul <http://www.drugsandalcohol.ie/view/people/Corcoran=3APaul=3A=3A.html>GriffinEGriffin, E <http://www.drugsandalcohol.ie/view/people/Griffin=3AE=3A=3A.html>PerryIPerry, I <http://www.drugsandalcohol.ie/view/people/Perry=3AI=3A=3A.html>ArensmanEllaArensman, Ella <http://www.drugsandalcohol.ie/view/people/Arensman=3AElla=3A=3A.html>GunnellDGunnell, D <http://www.drugsandalcohol.ie/view/people/Gunnell=3AD=3A=3A.html>MetcalfeCMetcalfe, C <http://www.drugsandalcohol.ie/view/people/Metcalfe=3AC=3A=3A.html>115120161433-9285Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentation.Social Psychiatry and Psychiatric Epidemiology1485-1493articleinfo:oai:generic.eprints.org:25507info:ofi/fmt:xml:xsd:journalDarkerCatherine DDarker, Catherine D <http://www.drugsandalcohol.ie/view/people/Darker=3ACatherine_D=3A=3A.html>SweeneyBrionSweeney, Brion <http://www.drugsandalcohol.ie/view/people/Sweeney=3ABrion=3A=3A.html>KeenanEamonKeenan, Eamon <http://www.drugsandalcohol.ie/view/people/Keenan=3AEamon=3A=3A.html>WhistonLucyWhiston, Lucy <http://www.drugsandalcohol.ie/view/people/Whiston=3ALucy=3A=3A.html>AndersonRolandeAnderson, Rolande <http://www.drugsandalcohol.ie/view/people/Anderson=3ARolande=3A=3A.html>BarryJosephBarry, Joseph <http://www.drugsandalcohol.ie/view/people/Barry=3AJoseph=3A=3A.html>95120161532-2491Screening 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.Substance Use & Misuse1104-1115articleinfo:oai:generic.eprints.org:26681info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26681/ Scoping review of case management in the treatment of drug and alcohol misuse, 2003–2013. Nic Gabhainn, Saoirse D'Eath, M Keane, Martin Sixsmith, Jane Drugs and alcohol disorder treatment method Patient care management Health care delivery AOD task forces Programme planning, implementation, and evaluation Programme planning (strategy) Drug or health care worker Prevention worker Social worker International aspects 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. Health Research Board 2016 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/26681/1/Scoping_review_of_case_management_in_the_management_of_treatment_final_draft.pdf Nic Gabhainn, Saoirse <http://www.drugsandalcohol.ie/view/people/Nic_Gabhainn=3ASaoirse=3A=3A.html> and D'Eath, M <http://www.drugsandalcohol.ie/view/people/D=27Eath=3AM=3A=3A.html> and Keane, Martin <http://www.drugsandalcohol.ie/view/people/Keane=3AMartin=3A=3A.html> and Sixsmith, Jane <http://www.drugsandalcohol.ie/view/people/Sixsmith=3AJane=3A=3A.html> (2016) Scoping review of case management in the treatment of drug and alcohol misuse, 2003–2013. Dublin: Health Research Board. HRB drug and alcohol evidence review 3info:oai:generic.eprints.org:26334info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26334/ Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature. Friedrichs, Anke Spies, Maren Härter, Martin Buchholz, Angela Treatment outcome Patient care management Treatment factors Patient attitude toward treatment Provider attitude toward treatment 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. National Library for Public Health 2016 Evidence resource NonPeerReviewed Friedrichs, Anke <http://www.drugsandalcohol.ie/view/people/Friedrichs=3AAnke=3A=3A.html> and Spies, Maren <http://www.drugsandalcohol.ie/view/people/Spies=3AMaren=3A=3A.html> and Härter, Martin <http://www.drugsandalcohol.ie/view/people/H=E4rter=3AMartin=3A=3A.html> and Buchholz, Angela <http://www.drugsandalcohol.ie/view/people/Buchholz=3AAngela=3A=3A.html> [PLOS One] . (2016) Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature. National Library for Public Health. PloS one, 11 (1) /10.1371/journal.pone.0145817 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145817 http://dx.doi.org/10.1371/journal.pone.0145817info:oai:generic.eprints.org:24881info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24881/ Late diagnosis of HIV in the United Kingdom: An evidence review. Harris, Jane Khatri, Rose HIV infection Drugs and alcohol use harm reduction HIV prevention Patient care management Intravenous / injecting drug user United Kingdom •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 Liverpool John Moores University 2015-12-02 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24881/1/Late-HIV-diagnosis-rapid-evidence-review.pdf Harris, Jane <http://www.drugsandalcohol.ie/view/people/Harris=3AJane=3A=3A.html> and Khatri, Rose <http://www.drugsandalcohol.ie/view/people/Khatri=3ARose=3A=3A.html> . (2015) Late diagnosis of HIV in the United Kingdom: An evidence review. Liverpool John Moores University. 20 p. info:oai:generic.eprints.org:24915info:ofi/fmt:xml:xsd:journalCalamiAlviseCalami, Alvise <http://www.drugsandalcohol.ie/view/people/Calami=3AAlvise=3A=3A.html>DowdallDeirdreDowdall, Deirdre <http://www.drugsandalcohol.ie/view/people/Dowdall=3ADeirdre=3A=3A.html>1132December 2015The challenge of opioid-induced hyperalgeisa.Forum39-42articleinfo:oai:generic.eprints.org:26067info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26067/ Fetal Alcohol Spectrum Disorders. Clinical report: Guidance for the clinician in rendering pediatric care. Williams, Janet F Smith, Vincent C Alcohol Pregnancy State of health Foetal (fetal) alcohol syndrome Patient care management Health care delivery Pregnant woman Doctor Child of drugs and alcohol user United States 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. American Academy of Pediatrics 2015-11 Evidence resource NonPeerReviewed Williams, Janet F <http://www.drugsandalcohol.ie/view/people/Williams=3AJanet_F=3A=3A.html> and Smith, Vincent C <http://www.drugsandalcohol.ie/view/people/Smith=3AVincent_C=3A=3A.html> . (2015) Fetal Alcohol Spectrum Disorders. Clinical report: Guidance for the clinician in rendering pediatric care. American Academy of Pediatrics. Pediatrics, 136 (5) 14 p. DOI: 10.1542/peds.2015-3113 http://pediatrics.aappublications.org/content/early/2015/10/13/peds.2015-3113 DOI: 10.1542/peds.2015-3113info:oai:generic.eprints.org:24620info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24620/ Prescribed drugs associated with dependence and withdrawal – building a consensus for action. Analysis report. Sedatives or tranquillisers (CNS depressants) Benzodiazepine Prescription drug (medicine / medication) Patient care management Doctor United Kingdom 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. British Medical Association 2015-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24620/1/BMA_Prescribed_drugs_associated_with_dependence.pdf BMA Board of Science. [BMA] (2015) Prescribed drugs associated with dependence and withdrawal – building a consensus for action. Analysis report. London: British Medical Association. 44 p. info:oai:generic.eprints.org:24580info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24580/ Medication-assisted treatment of opioid dependence information toolkit. Dolan, Kate Mehrjerdi, Zahra Alam Opioids (opiates) Methadone Buprenorphine Drugs and alcohol disorder drug therapy Drugs and alcohol replacement method (substitution) Patient care management Research outcome International aspects 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. Australian National Council on Drugs 2015-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24580/1/NDARC_MATOD_Your_questions_answered.pdf application/pdf en http://www.drugsandalcohol.ie/24580/2/NCARC_MATOD_A_Review_of_the_Evidence.pdf Dolan, Kate <http://www.drugsandalcohol.ie/view/people/Dolan=3AKate=3A=3A.html> and Mehrjerdi, Zahra Alam <http://www.drugsandalcohol.ie/view/people/Mehrjerdi=3AZahra_Alam=3A=3A.html> [NDARC] . (2015) Medication-assisted treatment of opioid dependence information toolkit. Sydney: Australian National Council on Drugs. https://ndarc.med.unsw.edu.au/news/new-ndarc-resource-provides-heroin-dependence-treatment-informationinfo:oai:generic.eprints.org:24381info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24381/ Prescribing drugs of dependence in general practice, Part A – Clinical governance framework. Prescription drug (medicine / medication) Patient care management Health care delivery Community-based treatment (primary care) Health care quality control Doctor Australia 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. The Royal Australian College of General Practitioners 2015-08 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24381/1/Prescribing%20drugs%20of%20dependence%20in%20general%20practice%2C%20%20Clinical%20governance%20framework.pdf The Royal Australian College of General Practitioners. [RACGP] (2015) Prescribing drugs of dependence in general practice, Part A – Clinical governance framework. Melbourne: The Royal Australian College of General Practitioners. 88 p. info:oai:generic.eprints.org:24311info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24311/ Public health plan for the pharmaceutical treatment of Hepatitis C. Physical health Hepatitis C Drugs and alcohol use harm reduction Communicable disease control Patient care management Health care delivery Intravenous / injecting drug user Ireland Department of Health 2015-07 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24311/1/Public-Health-Plan-for-the-Pharmaceutical-Treatment-of-Hep-C-Final-Copy-Circulated-July-2015.pdf Ireland. Department of Health. (2015) Public health plan for the pharmaceutical treatment of Hepatitis C. Dublin: Department of Health. info:oai:generic.eprints.org:24291info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24291/ Improving access to, and completion of, hepatitis C treatment. Hepatitis C Communicable disease control Patient care management Treatment factors Health care delivery Harm reduction policy Intravenous / injecting drug user England 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. Public Health England 2015-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24291/1/PHE_turning-evidence-into-practice-improving-access-to-hepatitis-c-treatment.pdf Public Health England. (2015) Improving access to, and completion of, hepatitis C treatment. London: Public Health England. 6 p. Turning evidence into practice series Turning evidence into practice seriesinfo:oai:generic.eprints.org:24341info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24341/ Naloxone – preliminary advice from the working group updating Drug misuse and dependence: UK guidelines on clinical management. Strang, John Naloxone Drugs and alcohol poisoning (overdose) Patient care management emergency care United Kingdom 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...... Public Health England 2015-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24341/1/PHEchairsletter-naloxone-22july2015.pdf Strang, John <http://www.drugsandalcohol.ie/view/people/Strang=3AJohn=3A=3A.html> [Public Health England] . (2015) Naloxone – preliminary advice from the working group updating Drug misuse and dependence: UK guidelines on clinical management. London: Public Health England. 3 p. info:oai:generic.eprints.org:16602info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16602/ Psychosocial interventions for smoking cessation in patients with coronary heart disease. Barth, Jürgen Jacob, Tiffany Daha, Ioana Critchley, Julia A. Physical health Patient care management Psychosocial treatment method Tobacco (cigarette smoking) Cessation of drugs and alcohol use 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. John Wiley & Sons, Ltd 2015-07 Evidence resource NonPeerReviewed Barth, Jürgen <http://www.drugsandalcohol.ie/view/people/Barth=3AJ=FCrgen=3A=3A.html> and Jacob, Tiffany <http://www.drugsandalcohol.ie/view/people/Jacob=3ATiffany=3A=3A.html> and Daha, Ioana <http://www.drugsandalcohol.ie/view/people/Daha=3AIoana=3A=3A.html> and Critchley, Julia A. <http://www.drugsandalcohol.ie/view/people/Critchley=3AJulia_A=2E=3A=3A.html> [The Cochrane Library] . (2015) Psychosocial interventions for smoking cessation in patients with coronary heart disease. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews (7) DOI: 10.1002/14651858.CD006886.pub2 http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD006886.pub2 DOI: 10.1002/14651858.CD006886.pub2info:oai:generic.eprints.org:24178info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24178/ Systems change: a guide to what it is and how to do it. Abercrombie, Rob Harries, Ellen Wharton, Rachel Patient care management Health care delivery Community development Advocacy Organisational development Drug or health care worker United Kingdom 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. New Philanthropy Capital 2015-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24178/1/NPC_Systems-Change.pdf Abercrombie, Rob <http://www.drugsandalcohol.ie/view/people/Abercrombie=3ARob=3A=3A.html> and Harries, Ellen <http://www.drugsandalcohol.ie/view/people/Harries=3AEllen=3A=3A.html> and Wharton, Rachel <http://www.drugsandalcohol.ie/view/people/Wharton=3ARachel=3A=3A.html> . (2015) Systems change: a guide to what it is and how to do it. London: New Philanthropy Capital. 45 p. info:oai:generic.eprints.org:24380info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24380/ Prescribing drugs of dependence in general practice, Part B - benzodiazepines. Sedatives or tranquillisers (CNS depressants) Benzodiazepine Prescription drug (medicine / medication) Drugs and alcohol disorder drug therapy Patient care management Community-based treatment (primary care) Doctor Australia 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. The Royal Australian College of General Practitioners 2015-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24380/1/Prescribing_drugs_of_dependence_in_general_practice_Benzodiazepines.pdf The Royal Australian College of General Practitioners. [RACGP] (2015) Prescribing drugs of dependence in general practice, Part B - benzodiazepines. Victoria: The Royal Australian College of General Practitioners. 101 p. info:oai:generic.eprints.org:24281info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24281/ Alcohol: a toolkit for improving care. Alcohol Alcohol intoxication Identification and screening for drugs and alcohol use Patient care management emergency care Hospital Doctor Nurse United Kingdom 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. The Royal College of Emergency Medicine 2015-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24281/1/royal-college-of-emergency-medicine_alcohol---a-toolkit-for-improving-care.pdf The Royal College of Emergency Medicine. (2015) Alcohol: a toolkit for improving care. London: The Royal College of Emergency Medicine. 47 p. info:oai:generic.eprints.org:24292info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24292/ Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances. Abdulrahim, D Bowden-Jones, O Drugs and alcohol effects and consequences Cannabis product (synthetic cannabinoids) Sedatives or tranquillisers (CNS depressants) CNS stimulants Ecstasy Mephedrone Cocaine New (novel) psychoactive substances Physical health Patient care management emergency care Health care delivery Community-based treatment (primary care) Social context Context encouraging drugs and alcohol use Doctor Nurse United Kingdom 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. NEPTUNE 2015-03 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24292/1/NEPTUNE-Guidance_on_clinical_managemen_of_club_drugs_and_nove_%20psychoactive_substances.pdf Novel Psychoactive Treatment UK Network. Abdulrahim, D <http://www.drugsandalcohol.ie/view/people/Abdulrahim=3AD=3A=3A.html> and Bowden-Jones, O <http://www.drugsandalcohol.ie/view/people/Bowden-Jones=3AO=3A=3A.html> [Public Health England] . (2015) Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances. London: NEPTUNE. 335 p. info:oai:generic.eprints.org:25683info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/25683/ Best practice principles for risk assessment and safety planning for nurses working in mental health services. Higgins, A Morrissey, J Doyle, L Bailey, J Gill, A Risk assessment Patient care management Mental health care Health care quality control Nurse Ireland 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. Health Service Executive 2015 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/25683/1/Best_Practice_Principles_for_Risk_Assessment.pdf application/pdf en http://www.drugsandalcohol.ie/25683/2/Risk_assessment_and_safety_planning_in-mental_health_nursing.pdf Higgins, A <http://www.drugsandalcohol.ie/view/people/Higgins=3AA=3A=3A.html> and Morrissey, J <http://www.drugsandalcohol.ie/view/people/Morrissey=3AJ=3A=3A.html> and Doyle, L <http://www.drugsandalcohol.ie/view/people/Doyle=3AL=3A=3A.html> and Bailey, J <http://www.drugsandalcohol.ie/view/people/Bailey=3AJ=3A=3A.html> and Gill, A <http://www.drugsandalcohol.ie/view/people/Gill=3AA=3A=3A.html> (2015) Best practice principles for risk assessment and safety planning for nurses working in mental health services. Dublin: Health Service Executive. info:oai:generic.eprints.org:24144info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24144/ Psychosis with coexisting substance misuse overview (Dual diagnosis). Mental health Dual diagnosis (comorbidity) Drugs and alcohol related mental disorder Identification and screening for drugs and alcohol use Patient care management Mental health care Community-based treatment (primary care) Adolescent / youth (teenager / young person) United Kingdom National Institute for Health and Care Excellence 2015 Evidence resource NonPeerReviewed National Institute for Health and Care Excellence. [NICE] (2015) Psychosis with coexisting substance misuse overview (Dual diagnosis). London: National Institute for Health and Care Excellence. NICE Pathways http://pathways.nice.org.uk/pathways/psychosis-with-coexisting-substance-misuse NICE Pathwaysinfo:oai:generic.eprints.org:24967info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24967/ Evaluating the implementation of the RCI in Irish mental health services. O'Brien, Tom Webb, Margaret Stynes, Greg Cosgrave, Gavin Ardis, Jennifer Drugs and alcohol recovery Mental health Patient care management Mental health care Ireland 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 Health Service Executive 2015 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24967/1/Evaluating_the_Implementation_of_the_RCI_Full_Report.pdf application/pdf en http://www.drugsandalcohol.ie/24967/2/RCI_implentation_executive_summary.pdf O'Brien, Tom <http://www.drugsandalcohol.ie/view/people/O=27Brien=3ATom=3A=3A.html> and Webb, Margaret <http://www.drugsandalcohol.ie/view/people/Webb=3AMargaret=3A=3A.html> and Stynes, Greg <http://www.drugsandalcohol.ie/view/people/Stynes=3AGreg=3A=3A.html> and Cosgrave, Gavin <http://www.drugsandalcohol.ie/view/people/Cosgrave=3AGavin=3A=3A.html> and Ardis, Jennifer <http://www.drugsandalcohol.ie/view/people/Ardis=3AJennifer=3A=3A.html> (2015) Evaluating the implementation of the RCI in Irish mental health services. Dublin: Health Service Executive. info:oai:generic.eprints.org:24023info:ofi/fmt:xml:xsd:journalOhakimAdannaOhakim, Adanna <http://www.drugsandalcohol.ie/view/people/Ohakim=3AAdanna=3A=3A.html>MellonLisaMellon, Lisa <http://www.drugsandalcohol.ie/view/people/Mellon=3ALisa=3A=3A.html>JafarBedourJafar, Bedour <http://www.drugsandalcohol.ie/view/people/Jafar=3ABedour=3A=3A.html>O'ByrneCarolineO'Byrne, Caroline <http://www.drugsandalcohol.ie/view/people/O=27Byrne=3ACaroline=3A=3A.html>McElvaneyNGMcElvaney, NG <http://www.drugsandalcohol.ie/view/people/McElvaney=3ANG=3A=3A.html>CormicanLiamCormican, Liam <http://www.drugsandalcohol.ie/view/people/Cormican=3ALiam=3A=3A.html>McDonnellRonanMcDonnell, Ronan <http://www.drugsandalcohol.ie/view/people/McDonnell=3ARonan=3A=3A.html>DoyleFrankDoyle, Frank <http://www.drugsandalcohol.ie/view/people/Doyle=3AFrank=3A=3A.html>132015Smoking, attitudes to smoking and provision of smoking cessation advice in two teaching hospitals in Ireland: do smoke-free policies matter?Health Psychology and Behavioral Medicine142-153articleinfo:oai:generic.eprints.org:24348info:ofi/fmt:xml:xsd:journalTuiteHelenTuite, Helen <http://www.drugsandalcohol.ie/view/people/Tuite=3AHelen=3A=3A.html>HorganMHorgan, M <http://www.drugsandalcohol.ie/view/people/Horgan=3AM=3A=3A.html>MallomPWGMallom, PWG <http://www.drugsandalcohol.ie/view/people/Mallom=3APWG=3A=3A.html>McConkeySJMcConkey, SJ <http://www.drugsandalcohol.ie/view/people/McConkey=3ASJ=3A=3A.html>MookaBMooka, B <http://www.drugsandalcohol.ie/view/people/Mooka=3AB=3A=3A.html>MulcahyFMulcahy, F <http://www.drugsandalcohol.ie/view/people/Mulcahy=3AF=3A=3A.html>WalshCWalsh, C <http://www.drugsandalcohol.ie/view/people/Walsh=3AC=3A=3A.html>O'HoraAidanO'Hora, Aidan <http://www.drugsandalcohol.ie/view/people/O=27Hora=3AAidan=3A=3A.html>O'FlanaganDO'Flanagan, D <http://www.drugsandalcohol.ie/view/people/O=27Flanagan=3AD=3A=3A.html>BerginCBergin, C <http://www.drugsandalcohol.ie/view/people/Bergin=3AC=3A=3A.html>FlemingCFleming, C <http://www.drugsandalcohol.ie/view/people/Fleming=3AC=3A=3A.html>710820150332-3102Patients accessing ambulatory care for HIV-infection: epidemiology and prevalence assessment.Irish Medical Journalarticleinfo:oai:generic.eprints.org:23131info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/23131/ Young people’s hospital alcohol pathways. Support pack for A&E departments. Alcohol Identification and screening for drugs and alcohol use Patient care management emergency care Health care delivery Hospital Adolescent / youth (teenager / young person) Underage drinker Doctor Nurse 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. Public Health England 2014-12 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/23131/1/young-peoples-hospital-alcohol-pathways-support-pack-for-ae-departments.pdf Public Health England. (2014) Young people’s hospital alcohol pathways. Support pack for A&E departments. London: Public Health England. 13 p. info:oai:generic.eprints.org:16619info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16619/ Use of electronic health records to support smoking cessation. Boyle, Raymond Solberg, Leif Fiore, Michael Information technology Patient care management Tobacco (cigarette smoking) Cessation of drugs and alcohol use 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. John Wiley & Sons, Ltd 2014-12 Evidence resource NonPeerReviewed Boyle, Raymond <http://www.drugsandalcohol.ie/view/people/Boyle=3ARaymond=3A=3A.html> and Solberg, Leif <http://www.drugsandalcohol.ie/view/people/Solberg=3ALeif=3A=3A.html> and Fiore, Michael <http://www.drugsandalcohol.ie/view/people/Fiore=3AMichael=3A=3A.html> [The Cochrane Library] . (2014) Use of electronic health records to support smoking cessation. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews (12) Art. No.: CD008743. DOI: 10.1002/14651858.CD008743.pub3 http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD008743.pub3 Art. No.: CD008743. DOI: 10.1002/14651858.CD008743.pub3info:oai:generic.eprints.org:23725info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/23725/ Drug matrix cell B5: Practitioners - safeguarding the community. Drugs and alcohol related societal (social) problems Attitude toward drugs and alcohol addict or user Patient attitude toward treatment Provider attitude toward treatment Community environment Social costs and benefits of drugs and alcohol Workforce / staff skills and training Drug or health care worker Doctor Nurse Counsellor / Therapist Social worker Drug and Alcohol Findings 2014-11 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/23725/1/B5_findings.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug matrix cell B5: Practitioners - safeguarding the community. London: Drug and Alcohol Findings. http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/B5.htminfo:oai:generic.eprints.org:23726info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/23726/ Drug matrix cell C5: Management/supervision - safeguarding the community. Attitude toward drugs and alcohol addict or user Patient attitude toward treatment Provider attitude toward treatment Community environment Organisational development Workforce / staff skills and training Drug or health care worker Nurse Counsellor / Therapist Social worker Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2014-11 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/23726/1/C5_findings.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug matrix cell C5: Management/supervision - safeguarding the community. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/PHP/dl.php?file=Matrix/Drugs/C5.htminfo:oai:generic.eprints.org:22718info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22718/ Drug Matrix cell B4: Practitioners - psychosocial therapies. Psychosocial treatment method Behaviour therapy Group therapy Treatment outcome Psychoanalytic therapy Treatment factors Patient attitude toward treatment Provider attitude toward treatment Drug or health care worker Counsellor / Therapist Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2014-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22718/1/Drug%20Matrix%20cell%20B4.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug Matrix cell B4: Practitioners - psychosocial therapies. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/B4.htminfo:oai:generic.eprints.org:20696info:ofi/fmt:xml:xsd:journalMcMahonAMcMahon, A <http://www.drugsandalcohol.ie/view/people/McMahon=3AA=3A=3A.html>BrohanJBrohan, J <http://www.drugsandalcohol.ie/view/people/Brohan=3AJ=3A=3A.html>DonnellyMDonnelly, M <http://www.drugsandalcohol.ie/view/people/Donnelly=3AM=3A=3A.html>FitzpatrickGJFitzpatrick, GJ <http://www.drugsandalcohol.ie/view/people/Fitzpatrick=3AGJ=3A=3A.html>3183October 20141863-4362Characteristics of patients admitted to the intensive care unit following self-poisoning and their impact on resource utilisation.Irish Journal of Medical Science391-395articleinfo:oai:generic.eprints.org:21807info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/21807/ Alcohol and cancer risks: a guide for health professionals. Drugs and alcohol effects and consequences Alcohol Physical health Patient care management Practice / clinical guidelines Scotland 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. Scottish Health Action on Alcohol Problems 2014-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/21807/7/shaap_cancer_risks_booklet.pdf0.pdf application/pdf en http://www.drugsandalcohol.ie/21807/1/Alcoholcancerriskfinal_shaapfinal2013.pdf Scottish Health Action on Alcohol Problems. [SHAAP] (2014) Alcohol and cancer risks: a guide for health professionals. Edinburgh: Scottish Health Action on Alcohol Problems. 16 p. info:oai:generic.eprints.org:22480info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22480/ Drug Matrix cell A3: Interventions - medical treatment. Buprenorphine General treatment method concepts Drugs and alcohol disorder treatment method Drugs and alcohol replacement method (substitution) Methadone maintenance Treatment outcome Patient care management Treatment factors Drug or health care worker Doctor Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2014-08 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22480/1/Drug%20matrix%20A3.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug Matrix cell A3: Interventions - medical treatment. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/A3.htminfo:oai:generic.eprints.org:22470info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22470/ Drug Matrix cell A2: interventions - generic and cross-cutting issues. Drugs and alcohol recovery General treatment method concepts Treatment outcome Patient care management Treatment factors Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2014-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22470/1/Drug%20matrix%20A2.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug Matrix cell A2: interventions - generic and cross-cutting issues. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/A2.htminfo:oai:generic.eprints.org:22476info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22476/ Drug Matrix cell B2: practitioners: generic and cross-cutting issues. Treatment factors Patient attitude toward treatment Provider attitude toward treatment Workforce / staff skills and training Drug or health care worker Counsellor / Therapist Social worker Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2014-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22476/1/Drug%20matrix%20B2.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug Matrix cell B2: practitioners: generic and cross-cutting issues. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/count/downloads/download.php?file=Matrix/Drugs/B2.htminfo:oai:generic.eprints.org:22366info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22366/ Non-medical prescribing in the management of substance misuse. Drugs and alcohol disorder treatment method Drugs and alcohol disorder drug therapy Patient care management Health care delivery Drug or health care worker United Kingdom 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. Public Health England 2014-07 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22366/1/PHE%20nmp-in-the-management-of-substance-misuse.pdf National Substance Misuse Non-Medical Prescribing Forum. [Public Health England] (2014) Non-medical prescribing in the management of substance misuse. London: Public Health England. 25 p. PHE publications gateway number: 2014205 PHE publications gateway number: 2014205info:oai:generic.eprints.org:20065info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/20065/ Drug Matrix: Evidence for effective treatment. Drugs and alcohol disorder treatment method Psychosocial treatment method Treatment outcome Identification and screening for drugs and alcohol use Patient care management Treatment factors Organisational development Workforce / staff skills and training United Kingdom 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. Drug and Alcohol Findings and the Consortium 2014-06 Evidence resource NonPeerReviewed Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Drug Matrix: Evidence for effective treatment. London: Drug and Alcohol Findings and the Consortium. http://findings.org.uk/docs/dmatrix.htminfo:oai:generic.eprints.org:22502info:ofi/fmt:xml:xsd:journalGalvinRoseGalvin, Rose <http://www.drugsandalcohol.ie/view/people/Galvin=3ARose=3A=3A.html>MoriartyFrankMoriarty, Frank <http://www.drugsandalcohol.ie/view/people/Moriarty=3AFrank=3A=3A.html>CousinsGráinneCousins, Gráinne <http://www.drugsandalcohol.ie/view/people/Cousins=3AGr=E1inne=3A=3A.html>CahirCaitrionaCahir, Caitriona <http://www.drugsandalcohol.ie/view/people/Cahir=3ACaitriona=3A=3A.html>MotterliniNicolaMotterlini, Nicola <http://www.drugsandalcohol.ie/view/people/Motterlini=3ANicola=3A=3A.html>BradleyMarieBradley, Marie <http://www.drugsandalcohol.ie/view/people/Bradley=3AMarie=3A=3A.html>HughesCarmel MHughes, Carmel M <http://www.drugsandalcohol.ie/view/people/Hughes=3ACarmel_M=3A=3A.html>BennettKathleenBennett, Kathleen <http://www.drugsandalcohol.ie/view/people/Bennett=3AKathleen=3A=3A.html>SmithSusan MSmith, Susan M <http://www.drugsandalcohol.ie/view/people/Smith=3ASusan_M=3A=3A.html>FaheyTomFahey, Tom <http://www.drugsandalcohol.ie/view/people/Fahey=3ATom=3A=3A.html>KennyRose-AnneKenny, Rose-Anne <http://www.drugsandalcohol.ie/view/people/Kenny=3ARose-Anne=3A=3A.html>570May 20141432-1041Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish longitudinal study on ageing study (TILDA).European Journal of Clinical Pharmacology599-606articleinfo:oai:generic.eprints.org:21862info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/21862/ Guidance for health and social care providers. Principles of good practice in medication reconciliation. Prescription drug (medicine / medication) Patient care management Ireland 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. Health Information and Quality Authority 2014-05 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/21862/1/Guidance-Medication-Reconciliation.pdf Health Information and Quality Authority. (2014) Guidance for health and social care providers. Principles of good practice in medication reconciliation. Cork: Health Information and Quality Authority. info:oai:generic.eprints.org:22963info:ofi/fmt:xml:xsd:journalMcVeighTMcVeigh, T <http://www.drugsandalcohol.ie/view/people/McVeigh=3AT=3A=3A.html>HynesNHynes, N <http://www.drugsandalcohol.ie/view/people/Hynes=3AN=3A=3A.html>TawfickWTawfick, W <http://www.drugsandalcohol.ie/view/people/Tawfick=3AW=3A=3A.html>SultanSSultan, S <http://www.drugsandalcohol.ie/view/people/Sultan=3AS=3A=3A.html>348April 20141938-9116Endovascular aneurysm repair for multiple aneurysms as a sequel of hypereosinophilic syndrome.Vascular and endovascular surgery277-280articleinfo:oai:generic.eprints.org:21600info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/21600/ Evaluation report of the National Drugs Rehabilitation Framework pilot. Barry, Joseph Ivers, Jo-Hanna H Ireland Patient attitude toward treatment Patient care management Health care delivery Provider attitude toward treatment Programme evaluation Organisational development Collaboration (co-operation) Rehabilitation Health care programme or facility Family support Health Service Executive 2014-03 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/21600/1/Evaluation_Report_of_the_National_Drugs_Rehabilitation_Framework_Pilot.pdf Barry, Joseph <http://www.drugsandalcohol.ie/view/people/Barry=3AJoseph=3A=3A.html> and Ivers, Jo-Hanna H <http://www.drugsandalcohol.ie/view/people/Ivers=3AJo-Hanna_H=3A=3A.html> (2014) Evaluation report of the National Drugs Rehabilitation Framework pilot. Dublin: Health Service Executive. info:oai:generic.eprints.org:21508info:ofi/fmt:xml:xsd:journalMeaganGeraldineMeagan, Geraldine <http://www.drugsandalcohol.ie/view/people/Meagan=3AGeraldine=3A=3A.html>331March 2014Novel approach to tackle alcohol problems.Forum23articleinfo:oai:generic.eprints.org:21419info:ofi/fmt:xml:xsd:journalTwomeyCTwomey, C <http://www.drugsandalcohol.ie/view/people/Twomey=3AC=3A=3A.html>ByrneMByrne, M <http://www.drugsandalcohol.ie/view/people/Byrne=3AM=3A=3A.html>LeahyTLeahy, T <http://www.drugsandalcohol.ie/view/people/Leahy=3AT=3A=3A.html>131March 20140790-9667Steps towards effective teamworking in community mental health teams.Irish Journal of Psychological Medicine51-59articleinfo:oai:generic.eprints.org:22524info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22524/ Alcohol Matrix cell A4: Interventions - psychosocial therapies. Alcohol Psychosocial treatment method Twelve-step model Group therapy Treatment outcome Cognitive behavioural therapy (CBT) Motivational interviewing Patient care management Counsellor / Therapist Drug and Alcohol Findings and the Substance Misuse Skills Consortium 2014-02 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22524/1/Alcohol%20Matrix%20%20cell%20A4.pdf Drug and Alcohol Findings, Substance Misuse Skills Consortium. (2014) Alcohol Matrix cell A4: Interventions - psychosocial therapies. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. http://findings.org.uk/count/downloads/download.php?file=Matrix/Alcohol/A4.htminfo:oai:generic.eprints.org:21455info:ofi/fmt:xml:xsd:journalNfilaGNfila, G <http://www.drugsandalcohol.ie/view/people/Nfila=3AG=3A=3A.html>LeeSLee, S <http://www.drugsandalcohol.ie/view/people/Lee=3AS=3A=3A.html>BinchyJBinchy, J <http://www.drugsandalcohol.ie/view/people/Binchy=3AJ=3A=3A.html>2107February 2014Impact of new UK paracetamol overdose guidelines on patients presenting to the emergency department.Irish Medical Journal47articleinfo:oai:generic.eprints.org:24476info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24476/ Guide to the European Union (Prevention of Sharps Injuries in the Healthcare Sector) Regulations 2014. Communicable disease control Needle distribution and exchange Patient care management Doctor Nurse Ireland European Union 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. Health and Safety Authority 2014 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24476/1/HSA_Sharps_Regulations_Guidelines_2014.pdf Health and Safety Authority. [HSA] (2014) Guide to the European Union (Prevention of Sharps Injuries in the Healthcare Sector) Regulations 2014. Dublin: Health and Safety Authority. 16 p. info:oai:generic.eprints.org:24143info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24143/ Drug misuse overview. Cannabis / Marijuana CNS stimulants Opioids (opiates) Drugs and alcohol disorder treatment method Drugs and alcohol disorder drug therapy Methadone maintenance Detoxification method Psychosocial treatment method Identification and screening for drugs and alcohol use Patient care management Family support Drug or health care worker Nurse Prevention worker Social worker National Institute for Health and Care Excellence 2014 Evidence resource NonPeerReviewed National Institute for Health and Care Excellence. [NICE] (2014) Drug misuse overview. London: National Institute for Health and Care Excellence. NICE Pathways http://pathways.nice.org.uk/pathways/drug-misuse NICE Pathwaysinfo:oai:generic.eprints.org:22793info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22793/ A framework for personalised care and population health for nurses, midwives, health visitors and allied health professionals. Alcohol Pregnancy Public health Health promotion Patient care management Health care delivery Drug or health care worker Nurse Social worker United Kingdom 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] Department of Health 2014 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22793/1/PHP_Framework_Version_1.pdf Public Health England. (2014) A framework for personalised care and population health for nurses, midwives, health visitors and allied health professionals. London: Department of Health. 82 p. info:oai:generic.eprints.org:21100info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/21100/ Medications in recovery: best practice in reviewing treatment. Drugs and alcohol recovery Treatment outcome Drugs and alcohol disorder treatment method United Kingdom Patient care management Treatment factors Drugs and alcohol disorder drug therapy 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. Public Health England 2013-12 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/21100/1/medications_in_recovery-reviewing_treatment.pdf Recovery Orientated Drug Treatment Expert Group. [Public Health England] (2013) Medications in recovery: best practice in reviewing treatment. London: Public Health England. 20 p. info:oai:generic.eprints.org:20671info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/20671/ Infection with Bacillus anthracis - Injecting drug users potential presentations and case definitions. Intravenous / injecting drug user Ireland Patient care management Bacterial disease Communicable disease control Drugs and alcohol use harm reduction 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. Health Protection Surveillance Centre 2013-09 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/20671/1/Infection_with_Bacillus_anthracis.pdf Health Protection Surveillance Centre, Health Service Executive. [HSE Website] (2013) Infection with Bacillus anthracis - Injecting drug users potential presentations and case definitions. Dublin: Health Protection Surveillance Centre. 6 p. info:oai:generic.eprints.org:20447info:ofi/fmt:xml:xsd:journalFieldCatherine-AnneField, Catherine-Anne <http://www.drugsandalcohol.ie/view/people/Field=3ACatherine-Anne=3A=3A.html>KlimasJanKlimas, Jan <http://www.drugsandalcohol.ie/view/people/Klimas=3AJan=3A=3A.html>BarryJosephBarry, Joseph <http://www.drugsandalcohol.ie/view/people/Barry=3AJoseph=3A=3A.html>BuryGerardBury, Gerard <http://www.drugsandalcohol.ie/view/people/Bury=3AGerard=3A=3A.html>KeenanEamonKeenan, Eamon <http://www.drugsandalcohol.ie/view/people/Keenan=3AEamon=3A=3A.html>SmythBobby PSmyth, Bobby P <http://www.drugsandalcohol.ie/view/people/Smyth=3ABobby_P=3A=3A.html>CullenWalterCullen, Walter <http://www.drugsandalcohol.ie/view/people/Cullen=3AWalter=3A=3A.html>14July 20131471-2296Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment.BMC Family Practice98articleinfo:oai:generic.eprints.org:20862info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/20862/ Licit and illicit drug use during pregnancy: maternal, neonatal and early childhood consequences. Finnegan, Loretta Foetal (fetal) alcohol syndrome Pregnancy Drugs and alcohol disorder treatment method Patient care management Pregnant woman Developmental disorder Attitude toward drugs and alcohol addict or user Provider attitude toward treatment Canada 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 Canadian Centre on Substance Abuse 2013 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/20862/1/CCSA-Drug-Use-during-Pregnancy-Report-2013.pdf Finnegan, Loretta <http://www.drugsandalcohol.ie/view/people/Finnegan=3ALoretta=3A=3A.html> [CCSA] . (2013) Licit and illicit drug use during pregnancy: maternal, neonatal and early childhood consequences. Ottawa: Canadian Centre on Substance Abuse. 116 p. info:oai:generic.eprints.org:19944info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/19944/ Leading for outcomes integrated working. Scotland Treatment outcome Organisational development Patient care management Rehabilitation 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. Institute for Research and Innovation in Social Services 2013 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/19944/1/01173_leading_for_outcomes_-_integration_44.pdf (2013) Leading for outcomes integrated working. Glasgow: Institute for Research and Innovation in Social Services. 64 p. info:oai:generic.eprints.org:19335info:ofi/fmt:xml:xsd:journalMaguireAideenMaguire, Aideen <http://www.drugsandalcohol.ie/view/people/Maguire=3AAideen=3A=3A.html>HughesCarmel MHughes, Carmel M <http://www.drugsandalcohol.ie/view/people/Hughes=3ACarmel_M=3A=3A.html>CardwellChrisCardwell, Chris <http://www.drugsandalcohol.ie/view/people/Cardwell=3AChris=3A=3A.html>O'ReillyDermotO'Reilly, Dermot <http://www.drugsandalcohol.ie/view/people/O=27Reilly=3ADermot=3A=3A.html>612013Psychotropic medications and the transition into care: a national data linkage study.Journal of the American Geriatrics Society215-221articleinfo:oai:generic.eprints.org:22061info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/22061/ Urine Analysis, an exploratory case study from the perspective of participants in a rehabilitation day programme. O'Heaire, Gary Drugs and alcohol recovery Identification and screening for drugs and alcohol use Treatment factors Patient attitude toward treatment Drugs and alcohol disorder treatment unit Dublin 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. Bawnogue Youth and Family Support Group 2013 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/22061/1/Urine%20Analysis%20Research.pdf O'Heaire, Gary <http://www.drugsandalcohol.ie/view/people/O=27Heaire=3AGary=3A=3A.html> (2013) Urine Analysis, an exploratory case study from the perspective of participants in a rehabilitation day programme. Dublin: Bawnogue Youth and Family Support Group. info:oai:generic.eprints.org:20726info:ofi/fmt:xml:xsd:journalPikeBrigidPike, Brigid <http://www.drugsandalcohol.ie/view/people/Pike=3ABrigid=3A=3A.html>Issue 47, Autumn 20132013BYAP values individuality and people’s potential for change.Drugnet Ireland3-4articleinfo:oai:generic.eprints.org:16942info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16942/ Standards and guidelines for practices. Web resource. Drugs and alcohol disorder treatment method Practice / clinical guidelines Patient care management Health services, drugs and alcohol research Drugs and alcohol use harm reduction Health care delivery Health care quality control Drugs and alcohol prevention Europe 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. European Monitoring Centre for Drugs and Drug Addiction 2012-12 Evidence resource NonPeerReviewed European Monitoring Centre for Drugs and Drug Addiction. [EMCDDA] (2012) Standards and guidelines for practices. Web resource. Lisbon: European Monitoring Centre for Drugs and Drug Addiction. http://www.emcdda.europa.eu/themes/best-practice/standardsinfo:oai:generic.eprints.org:18809info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/18809/ Quality standard for drug use disorders. Drugs and alcohol disorder treatment method Practice / clinical guidelines Patient care management Communicable disease control Health care delivery Health care quality control Needle distribution and exchange Drugs and alcohol recovery Psychosocial treatment method United Kingdom Health care programme or facility Rights of drugs and alcohol users Drug user 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. National Institute for Health and Clinical Excellence 2012-11 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/18809/1/NICE_quality-standard-for-drug-use-disorders.pdf application/pdf en http://www.drugsandalcohol.ie/18809/2/NICE_Information_for_people_who_use_NHS_services_for_drug_use_disorders.pdf National Institute for Health and Clinical Excellence. [EMCDDA] (2012) Quality standard for drug use disorders. London: National Institute for Health and Clinical Excellence. 48 p. info:oai:generic.eprints.org:18557info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/18557/ Effectiveness Bank Bulletin [Strategies for improving outcomes of services] Treatment outcome Drugs and alcohol disorder treatment method Patient attitude toward treatment Health care delivery Health care quality control Drugs and alcohol recovery Information technology Health care programme or facility Treatment factors Counsellor / Therapist Policy on drugs and alcohol Information use and impact 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. Drug and Alcohol Findings 2012-10-08 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/18557/1/Humphreys_K_27_findings.pdf Drug and Alcohol Findings. (2012) Effectiveness Bank Bulletin [Strategies for improving outcomes of services]. Drug and Alcohol Findings. Effectiveness Bank Bulletin, 8 Octo http://findings.org.uk/docs/bulletins/Bull_08_10_12.phpinfo:oai:generic.eprints.org:18232info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/18232/ Effectiveness Bank Bulletin [Community drug team prescribing and client views] Wales Drugs and alcohol disorder treatment method England Patient attitude toward treatment Prescription drug (medicine / medication) Drugs and alcohol disorder drug therapy Drug user Community-based treatment (primary care) 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. Drug and Alcohol Findings 2012-08-09 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/18232/1/Luty_J_7_findings_August_2012.pdf [Drug and Alcohol Findings] (2012) Effectiveness Bank Bulletin [Community drug team prescribing and client views]. Drug and Alcohol Findings. Drug and Alcohol Findings, 09 Aug info:oai:generic.eprints.org:18124info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/18124/ Effectiveness Bank Bulletin (Heart screening in methadone maintenance treatment). Patient care management Risk assessment Methadone Physical health Methadone maintenance 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. Drug and Alcohol Findings 2012-07-18 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/18124/1/EBB_QT_interval_screening_in_methadone_maintenance_Martin_JA_1_findings.pdf application/pdf en http://www.drugsandalcohol.ie/18124/2/EBB_QT_Merthadone_maintenance_Mayet_S_4_findings.pdf application/pdf en http://www.drugsandalcohol.ie/18124/3/EBB_QT_interval_screening_Fareed_A_3_findings.pdf [Drug and Alcohol Findings] (2012) Effectiveness Bank Bulletin (Heart screening in methadone maintenance treatment). Drug and Alcohol Findings. 6 p. http://findings.org.uk/docs/bulletins/Bull_18_07_12.phpinfo:oai:generic.eprints.org:17885info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/17885/ Practice standards for young people with substance misuse problems. Adolescent / youth (teenager / young person) Mental health care Practice / clinical guidelines Drugs and alcohol disorder treatment method Patient care management Drugs and alcohol related family problems Drugs and alcohol related mental disorder United Kingdom Psychosocial treatment method Family support Young drug user Treatment and maintenance Community-based treatment (primary care) 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." Royal College of Psychiatrists Gilvarry, Eilish McArdle, Paul O’Herlihy, Anne Mirza, Kah Bevington, Dickon Malcolm, Norman 2012-06 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/17885/2/Practice_standards_for_young_people_with_substance_misuse_problems.pdf Gilvarry, Eilish <http://www.drugsandalcohol.ie/view/people/Gilvarry=3AEilish=3A=3A.html> and McArdle, Paul <http://www.drugsandalcohol.ie/view/people/McArdle=3APaul=3A=3A.html> and O’Herlihy, Anne <http://www.drugsandalcohol.ie/view/people/O==2019Herlihy=3AAnne=3A=3A.html> and Mirza, Kah <http://www.drugsandalcohol.ie/view/people/Mirza=3AKah=3A=3A.html> and Bevington, Dickon <http://www.drugsandalcohol.ie/view/people/Bevington=3ADickon=3A=3A.html> and Malcolm, Norman <http://www.drugsandalcohol.ie/view/people/Malcolm=3ANorman=3A=3A.html>, eds. [Royal College of Psychiatrists] (2012) Practice standards for young people with substance misuse problems. London: Royal College of Psychiatrists. 53 p. info:oai:generic.eprints.org:16600info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16600/ Interventions for smoking cessation in hospitalised patients. Rigotti, Nancy A. Clair, Carole Munafo, Marcus R Stead, Lindsay F Patient care management Tobacco (cigarette smoking) Cessation of drugs and alcohol use Hospital 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. John Wiley & Sons, Ltd 2012-03 Evidence resource NonPeerReviewed Rigotti, Nancy A. <http://www.drugsandalcohol.ie/view/people/Rigotti=3ANancy_A=2E=3A=3A.html> and Clair, Carole <http://www.drugsandalcohol.ie/view/people/Clair=3ACarole=3A=3A.html> and Munafo, Marcus R <http://www.drugsandalcohol.ie/view/people/Munafo=3AMarcus_R=3A=3A.html> and Stead, Lindsay F <http://www.drugsandalcohol.ie/view/people/Stead=3ALindsay_F=3A=3A.html> [The Cochrane Library] . (2012) Interventions for smoking cessation in hospitalised patients. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews (5) DOI: 10.1002/14651858.CD001837.pub3 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001837.pub3/abstract DOI: 10.1002/14651858.CD001837.pub3info:oai:generic.eprints.org:17805info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/17805/ Effectiveness Bank Bulletin. [Care management & employment] United States Drugs and alcohol recovery Social services Social support Patient care management Vocational rehabilitation (employment / occupation) Employment and unemployment 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. Drug and Alcohol Findings 2012-01-10 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/17805/1/Drug_and_Alcohol_Findings_review_Care_management_%26_employment.pdf [Drug and Alcohol Findings] (2012) Effectiveness Bank Bulletin. [Care management & employment]. Drug and Alcohol Findings. Drug and Alcohol Findings, 10 Jan http://findings.org.uk/docs/bulletins/Bull_10_01_12.phpinfo:oai:generic.eprints.org:24404info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/24404/ National standards for safer better healthcare. Patient care management Health care delivery Health care quality control Organisational development Workforce / staff skills and training Drug or health care worker Doctor Nurse 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 Health Information and Quality Authority 2012 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/24404/1/HIQA%20Safer-Better-Healthcare-Standards.pdf Health Information and Quality Authority. [HIQA] (2012) National standards for safer better healthcare. Dublin: Health Information and Quality Authority. 168 p. info:oai:generic.eprints.org:15788info:ofi/fmt:xml:xsd:journalKennyKevinKenny, Kevin <http://www.drugsandalcohol.ie/view/people/Kenny=3AKevin=3A=3A.html>O'CarrollAustinO'Carroll, Austin <http://www.drugsandalcohol.ie/view/people/O=27Carroll=3AAustin=3A=3A.html>118120121863-4362The use of psychotherapeutic interventions by primary care GPs in Ireland in the treatment of their methadone patients: a grounded theory study.Irish Journal of Medical Science43-48articleinfo:oai:generic.eprints.org:17679info:ofi/fmt:xml:xsd:journalKiernanClaireKiernan, Claire <http://www.drugsandalcohol.ie/view/people/Kiernan=3AClaire=3A=3A.html>Ni FhearailAislinnNi Fhearail, Aislinn <http://www.drugsandalcohol.ie/view/people/Ni_Fhearail=3AAislinn=3A=3A.html>CoyneImeldaCoyne, Imelda <http://www.drugsandalcohol.ie/view/people/Coyne=3AImelda=3A=3A.html>8212012Nurses' role in managing alcohol misuse among adolescents.British Journal of Nursing474-478articleinfo:oai:generic.eprints.org:18991info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/18991/ Mental health, drug and alcohol - emergency department and ambulance monitoring. Mental health care Practice / clinical guidelines Identification and screening for drugs and alcohol use Patient care management emergency care Australia Drugs and alcohol related mental disorder 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. NSW Department of Health 2012 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/18991/1/Mental_health%2C_drug_and_alcohol_-_Emergency_Department_and_Ambulance_monitoring.pdf Epidemiology and Research Branch. [NSW Department of Health] (2012) Mental health, drug and alcohol - emergency department and ambulance monitoring. Sydney: NSW Department of Health. 6 p. info:oai:generic.eprints.org:17444info:ofi/fmt:xml:xsd:journalNí ChróinínDNí Chróinín, D <http://www.drugsandalcohol.ie/view/people/N=ED_Chr=F3in=EDn=3AD=3A=3A.html>GaineSGaine, S <http://www.drugsandalcohol.ie/view/people/Gaine=3AS=3A=3A.html>410520120332-3102Crack-ing the case: a patient with persistent delirium due to body packing with cocaine.Irish Medical Journal118-119articleinfo:oai:generic.eprints.org:19882info:ofi/fmt:xml:xsd:journalO'RiordanMargaretO'Riordan, Margaret <http://www.drugsandalcohol.ie/view/people/O=27Riordan=3AMargaret=3A=3A.html>FineganPearseFinegan, Pearse <http://www.drugsandalcohol.ie/view/people/Finegan=3APearse=3A=3A.html>12302012College ready to tackle alcohol-related problems.Forum21-22articleinfo:oai:generic.eprints.org:18001info:ofi/fmt:xml:xsd:journalPerkJoepPerk, Joep <http://www.drugsandalcohol.ie/view/people/Perk=3AJoep=3A=3A.html>De BackerGuyDe Backer, Guy <http://www.drugsandalcohol.ie/view/people/De_Backer=3AGuy=3A=3A.html>GohlkeHelmutGohlke, Helmut <http://www.drugsandalcohol.ie/view/people/Gohlke=3AHelmut=3A=3A.html>GrahamIanGraham, Ian <http://www.drugsandalcohol.ie/view/people/Graham=3AIan=3A=3A.html>ReinerAeljkoReiner, Aeljko <http://www.drugsandalcohol.ie/view/people/Reiner=3AAeljko=3A=3A.html>VerschurenWM MoniqueVerschuren, WM Monique <http://www.drugsandalcohol.ie/view/people/Verschuren=3AWM_Monique=3A=3A.html>AlbusChristianAlbus, Christian <http://www.drugsandalcohol.ie/view/people/Albus=3AChristian=3A=3A.html>BenlianPascaleBenlian, Pascale <http://www.drugsandalcohol.ie/view/people/Benlian=3APascale=3A=3A.html>BoysenGudrunBoysen, Gudrun <http://www.drugsandalcohol.ie/view/people/Boysen=3AGudrun=3A=3A.html>CifkovaRenataCifkova, Renata <http://www.drugsandalcohol.ie/view/people/Cifkova=3ARenata=3A=3A.html>DeatonChristiDeaton, Christi <http://www.drugsandalcohol.ie/view/people/Deaton=3AChristi=3A=3A.html>EbrahimShahEbrahim, Shah <http://www.drugsandalcohol.ie/view/people/Ebrahim=3AShah=3A=3A.html>FisherMilesFisher, Miles <http://www.drugsandalcohol.ie/view/people/Fisher=3AMiles=3A=3A.html>GermanoGuiseppeGermano, Guiseppe <http://www.drugsandalcohol.ie/view/people/Germano=3AGuiseppe=3A=3A.html>HobbsRichardHobbs, Richard <http://www.drugsandalcohol.ie/view/people/Hobbs=3ARichard=3A=3A.html>HoesArnoHoes, Arno <http://www.drugsandalcohol.ie/view/people/Hoes=3AArno=3A=3A.html>KaradenizSehnazKaradeniz, Sehnaz <http://www.drugsandalcohol.ie/view/people/Karadeniz=3ASehnaz=3A=3A.html>MezzaniAlessandroMezzani, Alessandro <http://www.drugsandalcohol.ie/view/people/Mezzani=3AAlessandro=3A=3A.html>PrescottEvaPrescott, Eva <http://www.drugsandalcohol.ie/view/people/Prescott=3AEva=3A=3A.html>RydenLarsRyden, Lars <http://www.drugsandalcohol.ie/view/people/Ryden=3ALars=3A=3A.html>SchererMartinScherer, Martin <http://www.drugsandalcohol.ie/view/people/Scherer=3AMartin=3A=3A.html>SyvanneMikkoSyvanne, Mikko <http://www.drugsandalcohol.ie/view/people/Syvanne=3AMikko=3A=3A.html>Scholte Op ReimerWilma JMScholte Op Reimer, Wilma JM <http://www.drugsandalcohol.ie/view/people/Scholte_Op_Reimer=3AWilma_JM=3A=3A.html>VrintsChristianVrints, Christian <http://www.drugsandalcohol.ie/view/people/Vrints=3AChristian=3A=3A.html>WoodDavidWood, David <http://www.drugsandalcohol.ie/view/people/Wood=3ADavid=3A=3A.html>ZamoranoJose LuisZamorano, Jose Luis <http://www.drugsandalcohol.ie/view/people/Zamorano=3AJose_Luis=3A=3A.html>ZannadFaiezZannad, Faiez <http://www.drugsandalcohol.ie/view/people/Zannad=3AFaiez=3A=3A.html>332012European guidelines on cardiovascular disease prevention in clinical practice (version 2012).European Heart Journal1635-1701articleinfo:oai:generic.eprints.org:17228info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/17228/ Managing chronic pain in adults with or in recovery from substance use disorders. Treatment Improvement Protocol (TIP) Series 54. Drugs and alcohol disorder treatment method Practice / clinical guidelines Patient care management Medical care Health care delivery Health care quality control State of health Drugs and alcohol recovery Alternative medical treatment Psychosocial treatment method Physical health Drugs and alcohol effects and consequences 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. Substance Abuse and Mental Health Services Administration 2012 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/17228/1/SAMHSA_SMA12-4671_pain.pdf Substance Abuse and Mental Health Services Administration. [SAMHSA, US] (2012) Managing chronic pain in adults with or in recovery from substance use disorders. Treatment Improvement Protocol (TIP) Series 54. Rockville, MD: Substance Abuse and Mental Health Services Administration. 129 p. HHS publication no. (SMA) 12-4671 HHS publication no. (SMA) 12-4671info:oai:generic.eprints.org:16609info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16609/ Biomedical risk assessment as an aid for smoking cessation. Bize, Raphaël Burnand, Bernard Mueller, Yolanda Rège Walther, Miriam Camain, Jean Yves Cornuz, Jacques Drugs and alcohol disorder treatment method Physical health Psychosocial treatment method Patient care management Cessation of drugs and alcohol use Tobacco (cigarette smoking) 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. John Wiley & Sons, Ltd 2012 Evidence resource NonPeerReviewed Bize, Raphaël <http://www.drugsandalcohol.ie/view/people/Bize=3ARapha=EBl=3A=3A.html> and Burnand, Bernard <http://www.drugsandalcohol.ie/view/people/Burnand=3ABernard=3A=3A.html> and Mueller, Yolanda <http://www.drugsandalcohol.ie/view/people/Mueller=3AYolanda=3A=3A.html> and Rège Walther, Miriam <http://www.drugsandalcohol.ie/view/people/R=E8ge_Walther=3AMiriam=3A=3A.html> and Camain, Jean Yves <http://www.drugsandalcohol.ie/view/people/Camain=3AJean_Yves=3A=3A.html> and Cornuz, Jacques <http://www.drugsandalcohol.ie/view/people/Cornuz=3AJacques=3A=3A.html> [The Cochrane Library] . (2012) Biomedical risk assessment as an aid for smoking cessation. London: John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews (12) DOI: 10.1002/14651858.CD004705.pub4. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004705.pub4/full DOI: 10.1002/14651858.CD004705.pub4.info:oai:generic.eprints.org:17229info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/17229/ Addressing viral hepatitis in people with substance use disorders. Treatment Improvement Protocol (TIP) series 53. Practice / clinical guidelines Patient care management Health care delivery Health care quality control United Kingdom Physical health Health care programme or facility Viral hepatitis Drugs and alcohol effects and consequences 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. Substance Abuse and Mental Health Services Administration 2011-12 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/17229/1/SAMHSA_Addressing_Viral_Hepatiti_TIP_53.pdf Substance Abuse and Mental Health Services Administration. [SAMHSA, US] (2011) Addressing viral hepatitis in people with substance use disorders. Treatment Improvement Protocol (TIP) series 53. Rockville, MD: Substance Abuse and Mental Health Services Administration. 146 p. HHS publication no. (SMA) 11-4656. HHS publication no. (SMA) 11-4656.info:oai:generic.eprints.org:16717info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16717/ National protocols & common assessment guidelines: to accompany the National Drugs Rehabilitation Framework. Medical screening and diagnostic method Psychosocial screening and diagnostic method Practice / clinical guidelines Ireland Identification and screening for drugs and alcohol use Patient care management Rehabilitation Community-based treatment (primary care) 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. Health Service Executive 2011-11 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/16717/1/National_Protocols_%26_Assessment_Guidelines_November_2011.pdf National Drugs Rehabilitation Implementation Committee. (2011) National protocols & common assessment guidelines: to accompany the National Drugs Rehabilitation Framework. Kildare: Health Service Executive. 35 p. info:oai:generic.eprints.org:12920info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/12920/ Immunisation guidelines for Ireland, 2008 edition. Online only update September 2011. Communicable disease Ireland Practice / clinical guidelines Patient care management Viral disease Hepatitis B Hepatitis A Communicable disease control 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 Royal College of Physicians of Ireland 2011-09 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/12920/1/RCPI_Immunisation_guidelines.pdf application/pdf en http://www.drugsandalcohol.ie/12920/2/Immunisation_guidelines_update_September_2011.pdf National Immunisation Advisory Committee of the Royal College of Physicians of Ireland. (2011) Immunisation guidelines for Ireland, 2008 edition. Online only update September 2011. Dublin: Royal College of Physicians of Ireland. 978-0-9559351-0-7info:oai:generic.eprints.org:16653info:ofi/fmt:xml:xsd:journalBradenMarinaBraden, Marina <http://www.drugsandalcohol.ie/view/people/Braden=3AMarina=3A=3A.html>McGowanIain WMcGowan, Iain W <http://www.drugsandalcohol.ie/view/people/McGowan=3AIain_W=3A=3A.html>McLaughlinDerek FrancisMcLaughlin, Derek Francis <http://www.drugsandalcohol.ie/view/people/McLaughlin=3ADerek_Francis=3A=3A.html>McKennaHughMcKenna, Hugh <http://www.drugsandalcohol.ie/view/people/McKenna=3AHugh=3A=3A.html>KeeneySineadKeeney, Sinead <http://www.drugsandalcohol.ie/view/people/Keeney=3ASinead=3A=3A.html>QuinnBreigeQuinn, Breige <http://www.drugsandalcohol.ie/view/people/Quinn=3ABreige=3A=3A.html>6162011Users, carers and professionals experiences of treatment and care for heroin dependency: implications for practice. A preliminary study.Journal of Substance Use452-463articleinfo:oai:generic.eprints.org:16240info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16240/ Buprenorphine/Naloxone for opioid dependence: clinical practice guideline. Handford, Curtis Kahan, Meldon Srivastava, Anita Cirone, Sharon Palda, Valerie Naloxone Patient care management Health care quality control Buprenorphine Drugs and alcohol replacement method (substitution) Drugs and alcohol disorder drug therapy Canada Practice / clinical guidelines Opioids (opiates) • 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. Centre for Addiction and Mental health 2011 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/16240/1/CAMH_Buprenorphine_Naloxone.pdf application/pdf en http://www.drugsandalcohol.ie/16240/2/Handford_C_1_findings.pdf Handford, Curtis <http://www.drugsandalcohol.ie/view/people/Handford=3ACurtis=3A=3A.html> and Kahan, Meldon <http://www.drugsandalcohol.ie/view/people/Kahan=3AMeldon=3A=3A.html> and Srivastava, Anita <http://www.drugsandalcohol.ie/view/people/Srivastava=3AAnita=3A=3A.html> and Cirone, Sharon <http://www.drugsandalcohol.ie/view/people/Cirone=3ASharon=3A=3A.html> and Palda, Valerie <http://www.drugsandalcohol.ie/view/people/Palda=3AValerie=3A=3A.html> [Centre for Addiction and Mental health] . (2011) Buprenorphine/Naloxone for opioid dependence: clinical practice guideline. Toronto: Centre for Addiction and Mental health. 153 p. info:oai:generic.eprints.org:16724info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16724/ Protocol for national substance misuse rehabilitation cohort study. Gannon, Maria McKeganey, Neil Hay, Gordon Ireland Patient care management Rehabilitation Community-based treatment (primary care) 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. National Advisory Committee on Drugs 2011 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/16724/1/protocol_nsmrcs.pdf Gannon, Maria <http://www.drugsandalcohol.ie/view/people/Gannon=3AMaria=3A=3A.html> and McKeganey, Neil <http://www.drugsandalcohol.ie/view/people/McKeganey=3ANeil=3A=3A.html> and Hay, Gordon <http://www.drugsandalcohol.ie/view/people/Hay=3AGordon=3A=3A.html> (2011) Protocol for national substance misuse rehabilitation cohort study. Dublin: National Advisory Committee on Drugs. info:oai:generic.eprints.org:16033info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/16033/ Management of substance use-related disorders and common mental health problems among people who use drugs. HIV prevention Mental health Mental health care Practice / clinical guidelines Drugs and alcohol disorder treatment method Identification and screening for drugs and alcohol use Patient care management Australia Drugs and alcohol related mental disorder Psychosocial treatment method Dual diagnosis (comorbidity) HIV infection 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. Commonwealth of Australia 2011 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/16033/1/HAARP_Prescription%2BGuidelines.pdf HIV and AIDS Asia Regional Program. (2011) Management of substance use-related disorders and common mental health problems among people who use drugs. Canberra: Commonwealth of Australia. 110 p. info:oai:generic.eprints.org:16166info:ofi/fmt:xml:xsd:journalKeaneMartinKeane, Martin <http://www.drugsandalcohol.ie/view/people/Keane=3AMartin=3A=3A.html>Issue 39, Autumn 20112011UK expert group reports on recovery-oriented treatment.Drugnet Ireland17-18articleinfo:oai:generic.eprints.org:15009info:ofi/fmt:xml:xsd:journalLyonsSuziLyons, Suzi <http://www.drugsandalcohol.ie/view/people/Lyons=3ASuzi=3A=3A.html>Issue 37, Spring 20112011External review of methadone treatment protocol makes wide-ranging recommendations.Drugnet Ireland22-24articleinfo:oai:generic.eprints.org:15833info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/15833/ Alcohol dependence and harmful alcohol use quality standard. Practice / clinical guidelines Drugs and alcohol disorder treatment method Patient care management Alcohol Alcohol consumption Health care quality control Alcohol dependence United Kingdom Alcohol use 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. National Institute for Health and Clinical Excellence 2011 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/15833/1/NICE_AlcoholQualityStandard.pdf National Institute for Health and Clinical Excellence. [NICE] (2011) Alcohol dependence and harmful alcohol use quality standard. London: National Institute for Health and Clinical Excellence. 45 p. http://www.nice.org.uk/guidance/qualitystandards/alcoholdependence/home.jspinfo:oai:generic.eprints.org:16016info:ofi/fmt:xml:xsd:journalO'ReillyFionaO'Reilly, Fiona <http://www.drugsandalcohol.ie/view/people/O=27Reilly=3AFiona=3A=3A.html>O'ConnellDavidO'Connell, David <http://www.drugsandalcohol.ie/view/people/O=27Connell=3ADavid=3A=3A.html>O'CarrollAustinO'Carroll, Austin <http://www.drugsandalcohol.ie/view/people/O=27Carroll=3AAustin=3A=3A.html>WhitfordDavid LWhitford, David L <http://www.drugsandalcohol.ie/view/people/Whitford=3ADavid_L=3A=3A.html>LongJeanLong, Jean <http://www.drugsandalcohol.ie/view/people/Long=3AJean=3A=3A.html>32820110790-9667Sharing control: user involvement in general practice based methadone maintenance.Irish Journal of Psychological Medicine129-133articleinfo:oai:generic.eprints.org:15789info:ofi/fmt:xml:xsd:journalRowleyDominicRowley, Dominic <http://www.drugsandalcohol.ie/view/people/Rowley=3ADominic=3A=3A.html>McLeanSarahMcLean, Sarah <http://www.drugsandalcohol.ie/view/people/McLean=3ASarah=3A=3A.html>O'GormanAislingO'Gorman, Aisling <http://www.drugsandalcohol.ie/view/people/O=27Gorman=3AAisling=3A=3A.html>RyanKarenRyan, Karen <http://www.drugsandalcohol.ie/view/people/Ryan=3AKaren=3A=3A.html>McQuillanReginaMcQuillan, Regina <http://www.drugsandalcohol.ie/view/people/McQuillan=3ARegina=3A=3A.html>32820111049-9091Review of cancer pain management in patients receiving maintenance methadone therapy.American Journal of Hospice & Palliative Medicine183-187articleinfo:oai:generic.eprints.org:15051info:ofi/fmt:xml:xsd:journalXiaoLiangXiao, Liang <http://www.drugsandalcohol.ie/view/people/Xiao=3ALiang=3A=3A.html>CousinsGrainneCousins, Grainne <http://www.drugsandalcohol.ie/view/people/Cousins=3AGrainne=3A=3A.html>CourtneyBrendaCourtney, Brenda <http://www.drugsandalcohol.ie/view/people/Courtney=3ABrenda=3A=3A.html>HedermanLucyHederman, Lucy <http://www.drugsandalcohol.ie/view/people/Hederman=3ALucy=3A=3A.html>FaheyTomFahey, Tom <http://www.drugsandalcohol.ie/view/people/Fahey=3ATom=3A=3A.html>DimitrovBorislav D.Dimitrov, Borislav D. <http://www.drugsandalcohol.ie/view/people/Dimitrov=3ABorislav_D=2E=3A=3A.html>5112011Developing an electronic health record (EHR) for methadone treatment recording and decision support.BMC Medical Informatics and Decision Makingarticleinfo:oai:generic.eprints.org:17927info:ofi/fmt:xml:xsd:journalDugganMichelleDuggan, Michelle <http://www.drugsandalcohol.ie/view/people/Duggan=3AMichelle=3A=3A.html>KavanaghBrian PKavanagh, Brian P <http://www.drugsandalcohol.ie/view/people/Kavanagh=3ABrian_P=3A=3A.html>2242010Perioperative modifications of respiratory function.Best Practice & Research: Clinical Anaesthesiology145-155articleinfo:oai:generic.eprints.org:14458info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/14458/ The introduction of the opioid treatment protocol. Farrell, Michael Barry, Joseph Naloxone Ireland Practice / clinical guidelines Patient care management Methadone Doctor Health care delivery Detoxification method Drugs and alcohol recovery Buprenorphine Opioids (opiates) Methadone maintenance Community-based treatment (primary care) 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. Health Service Executive 2010 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/14458/1/Opioid_Treatment_Protocol%5B1%5D.pdf Health Service Executive. Social Inclusion Unit. Farrell, Michael <http://www.drugsandalcohol.ie/view/people/Farrell=3AMichael=3A=3A.html> and Barry, Joseph <http://www.drugsandalcohol.ie/view/people/Barry=3AJoseph=3A=3A.html> (2010) The introduction of the opioid treatment protocol. Dublin: Health Service Executive. info:oai:generic.eprints.org:26599info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/26599/ Alcohol consumption and ethyl carbamate. Alcohol consumption Drugs and alcohol effects and consequences Alcohol Physical health Public health Patient care management 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 World Health Organization 2010 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/26599/1/IARC_mono96.pdf International Research for Research on Cancer. (2010) Alcohol consumption and ethyl carbamate. Geneva: World Health Organization. IARC monographs on the evaluation of carcinogenic risks to humans, 96 http://monographs.iarc.fr/ENG/Monographs/vol96/index.phpinfo:oai:generic.eprints.org:18095info:ofi/fmt:xml:xsd:journalMcCreaddieMayMcCreaddie, May <http://www.drugsandalcohol.ie/view/people/McCreaddie=3AMay=3A=3A.html>192010Routines and rituals: a grounded theory of the pain management of drug users in acute care settings.Journal of Clinical Nursing2730-2740articleinfo:oai:generic.eprints.org:13918info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/13918/ Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors. Pregnancy Practice / clinical guidelines Patient care management Pregnant woman risk factors Drugs and alcohol use harm reduction Health care quality control Social equality and inequality Drugs and alcohol in general United Kingdom 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 National Institute for Health and Clinical Excellence 2010 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/13918/1/NICE_pregnancy_social_issues.pdf National Institute for Health and Clinical Excellence. [NICE] (2010) Pregnancy and complex social factors: A model for service provision for pregnant women with complex social factors. London: National Institute for Health and Clinical Excellence. 34 p. NICE clinical guideline 110 http://guidance.nice.org.uk/CG110 NICE clinical guideline 110info:oai:generic.eprints.org:24336info:ofi/fmt:xml:xsd:journalNashM JNash, M J <http://www.drugsandalcohol.ie/view/people/Nash=3AM_J=3A=3A.html>RomanosM TRomanos, M T <http://www.drugsandalcohol.ie/view/people/Romanos=3AM_T=3A=3A.html>81720101351-0126An exploration of mental health nursing students' experiences and attitudes towards using cigarettes to change client's behaviour.Journal of Psychiatric and Mental Health Nursing683-691articleinfo:oai:generic.eprints.org:15550info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/15550/ Recent rape/sexual assault: National guidelines on referral and forensic clinical examination in Ireland. Crime against persons (assault / abuse / intimidation) Ireland Practice / clinical guidelines Patient care management Drugs and alcohol related crime Communicable disease control Identification and screening 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) National SATU Guidelines Development Group 2010 Report NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/15550/1/NationalSATUGuidelines_2010.pdf National SATU Guidelines Development Group. (2010) Recent rape/sexual assault: National guidelines on referral and forensic clinical examination in Ireland. Dublin: National SATU Guidelines Development Group. info:oai:generic.eprints.org:13984info:ofi/fmt:xml:xsd:oai_dc http://www.drugsandalcohol.ie/13984/ mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings. Drug or health care worker Mental health care Drugs and alcohol disorder treatment method Practice / clinical guidelines Patient care management Drugs and alcohol related mental disorder Health care quality control Psychosocial treatment method Drugs and alcohol in general International aspects General treatment method concepts 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. WHO 2010 Evidence resource NonPeerReviewed application/pdf en http://www.drugsandalcohol.ie/13984/1/WHO_mhGAP_intervention_guide.pdf World Health Organization. [WHO] (2010) mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings. Geneva: WHO. 107 p.