HOT TOPICS for September and October 2012

The more important an issue, the more likely it is to be contested. These are the hot topics, some
new, some perennial, plus some which ought to be hot but have been neglected. For each we give a
context-setting introduction plus one-click access to all relevant Findings analyses. New entries
are drafted or previous ones updated every two months.

This latest set reflect important new policy or science developments in brief alcohol interventions
and the pricing of drink, both potentially major public health levers, and in the prescribing of
opiates to opiate addicts, under threat from recovery-oriented policies. An upturn in
methadone-related deaths in Scotland has fuelled that debate, one aspect of the stalled drive to
reduce overdose deaths. See all four at:
http://findings.org.uk/hot_topics.php
or click on the individual links below.

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BRIEF ALCOHOL INTERVENTIONS: CAN THEY DELIVER POPULATION-WIDE HEALTH GAINS?
Not long ago virtually universal screening of adult primary care patients was seen as a major
gateway to reducing the burden of alcohol-related harm. Now ambition in Britain has been scaled back
to targeted screening of new patients and/or those thought possibly at risk, with well structured
advice to follow. Then came preliminary findings from the SIPS project funded by the Department of
Health, which called both targeted screening and the need for sophisticated advice in to question.
http://findings.org.uk/count/downloads/download.php?file=hot_alc_BI.hot

ALCOHOL LICENSING, PRICE AND TAXATION
Market levers not available for illicit drugs promise to make the greatest difference to
alcohol-related harm across the population; most of all, setting a high price per unit of alcohol.
After reverses, in 2012 Scotland passed enabling legislation and the UK national alcohol strategy
grasped this potentially vote-losing nettle. The prize is great, but so too are the obstacles, and
objections cannot simply be dismissed.
http://findings.org.uk/count/downloads/download.php?file=alc_license_price.hot

EVER CONTROVERSIAL: PRESCRIBING OPIATES TO OPIATE ADDICTS
Divisions of opinion over methadone maintenance and allied treatments were reflected by parties
contesting the 2010 election, from the Conservatives who denigrated it as state-induced dependence,
to the Greens who wanted more heroin prescribing. Post-election recovery-focused policy was the
vehicle for translating the outcome of the arguments in to change on the ground. It all came to a
head when in 2012 an expert group convened for the UK Department of Health sought to reconcile
competing perspectives. Their report might be looked back on as rescuing and the same time
revitalising methadone maintenance in Britain.
http://findings.org.uk/count/downloads/download.php?file=hot_subst_UK.hot

OVERDOSE PREVENTION
Satisfaction at meeting addiction treatment targets in Britain has been tempered by the recent
growth in drug-related deaths. Among the studies thrown up by this hot topic search is the first
large-scale UK follow-up study of overdose prevention training featuring naloxone, a drug which
rapidly reverses the respiratory depression which causes overdose. Across the UK there is concern
that methadone, prescribed partly to save lives, has contributed to the loss of too many, concern
revived by an upturn in Scotland in 2011. Also listed is the two-part Findings series from 2001
which remains the most thorough analysis of the literature.
http://findings.org.uk/count/downloads/download.php?file=overdose_prevent.hot

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Effectiveness Bank alerts are provided by Drug and Alcohol Findings (http://findings.org.uk) to
alert you to site updates and recent UK-relevant evaluation studies and reviews of drug/alcohol
interventions. Findings is managed by DrugScope, Alcohol Concern and the National Addiction Centre.
The Effectiveness Bank is supported by Alcohol Research UK and the J Paul Getty Jr Charitable Trust.
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