Home > The effectiveness of treatment for opiate dependent drug users: an international systematic review of the evidence.

Simoens, Steven and Matheson, Catriona and Inkster, Karen and Ludbrook, Anne and Bond, Christine (2002) The effectiveness of treatment for opiate dependent drug users: an international systematic review of the evidence. [Edinburgh]: Substance Misuse Division, Scottish Executive.

The aim of this study was to identify, review, and critically appraise the quality of reviews and trials in the international research literature on drug misuse concerning the (cost-)effectiveness of inte rventions, and the demographic and programme factors that influence treatment outcomes.

A systematic search of databases, journals, and the grey literature was carried out from 1990 to 2002. Studies were included if they had enrolled clients who were aged 18 years or over, were dependent on opiates, and were involved in a community maintenance, community detoxification or residential rehabilitation treatment programme. The methodological quality of effectiveness studies was assessed using Cochrane Collaboration and CASP guidelines. The methodological quality of reviews of effectiveness studies was examined in terms of search strategy, in/exclusion criteria, design and quality assessment of primary studies, number and dates of primary studies, method of combining effectiveness estimates, and scope for bias. The primary outcome measures studied were abstinence from opiate use, reduction in illicit opiate use, withdrawal severity, length of stay, and retention in treatment.

The cost-effectiveness literature was expected to be small and, hence, a very general search was conducted to avoid the possibility of missing relevant articles. A systematic search of electronic databases was undertaken from 1990 to 2002 to identify any study that included some form of economic evaluation even if this was not complete. Studies where a passing reference to costs or costeffectiveness was given without any supporting data were excluded. Economic evaluations were assessed against a checklist. This considered, inter alia, the choice of comparator, the scope of the costs and benefits included, the sources of data on costs and outcomes, the detail with which cost data were reported, the use of discounting and sensitivity analysis, where appropriate, and the relevance of results to the U.K.

Item Type
Publication Type
International, Report
Drug Type
Intervention Type
Treatment method
Call No
JP14, VH4
189 p.
Substance Misuse Division, Scottish Executive
Place of Publication
Accession Number
HRB 823 (Available), HRB 1804 (Available)

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