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Home > Drug Treatment Matrix cell E2: Treatment systems - Generic and cross-cutting issues.

Drug and Alcohol Findings. (2018) Drug Treatment Matrix cell E2: Treatment systems - Generic and cross-cutting issues. London: Drug and Alcohol Findings. 6 p.

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

What is cell E2 about?

How across an administrative area to engineer an effective and cost-effective mix of services which offers patients/clients appropriate options for entering and moving between services or using them in parallel. Involves commissioning, contracting and purchasing decisions to meet local needs in the context of resource constraints and national policy. Activities include: needs assessment; restructuring or re-tendering services; contractual requirements on services to demonstrate evidence-based practice, meet standards, and implement performance monitoring; and financial or other rewards/sanctions linked to activity, quality or outcomes.

At this distance from the preoccupation with intervention effectiveness, research is scarce and rarely of the ‘gold standard’ randomised controlled trial format (there is just one example in this cell). Instead researchers often have to interpret how things happen in the messy real world, attempting to isolate what may have been the active ingredients among a complex set of variables not under their control. The key limitation of such methodologies is the difficulty of being sure what (if anything) was cause, and what effect.

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