ADDITIONS TO THE EFFECTIVENESS BANK 19 July 2018
Patients dependent on prescription opioids are best maintained rather
than withdrawn from substitute medication. Review explores the evidence
for ‘fast and effective’ emergency department alcohol interventions.
Online school-based drug education for new psychoactive substances
reduces intentions to use. Pre-conception counselling helped reduce the
risk of alcohol-exposed pregnancies; associated drinking guidelines
ignite a bigger ethical conversation.
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USE MEDICATION-ASSISTED WITHDRAWAL SPARINGLY FOR PRESCRIPTION OPIOID
DEPENDENCE
As with heroin users, the featured trial showed that people dependent on
prescription opioids had poorer outcomes from tapered withdrawal of a
legal opiate substitute (in this case buprenorphine) than from ongoing
maintenance therapy. Withdrawal risked patients leaving treatment and
the majority rapidly returning to illicit opioid use.
http://findings.org.uk/PHP/dl.php?file=Fiellin_DA_9.txt&s=ml
DELIVERED IN UNDER 10 MINUTES, ARE ULTRA-BRIEF INTERVENTIONS EFFECTIVE?
The hectic and fast-paced environment of the emergency department is not
always considered conducive to even a *brief* alcohol intervention.
While in principle further shortening the time of the intervention would
make delivery more feasible, on important patient outcomes an effective
ultra-brief intervention in this setting has yet to be found.
http://findings.org.uk/PHP/dl.php?file=McGinnes_RA_1.cab&s=ml
2-IN-1 SCHOOL-BASED PREVENTION PROGRAMME FOR ECSTASY AND EMERGING DRUGS
In the UK and elsewhere, a compelling case has been made for
simultaneously targeting use of new psychoactive substances and ‘older’
drugs such as ecstasy. The Australian 'Climate Schools' trial tested
this premise, comparing standard health education with online drug
education and prevention for both types of drugs. Among secondary school
pupils, there were short-term improvements, but not to the same extent
for ecstasy and new psychoactive substances.
http://findings.org.uk/PHP/dl.php?file=Champion_KE_4.txt&s=ml
PREVENTING ALCOHOL- AND TOBACCO-EXPOSED PREGNANCIES
In the USA the CHOICES Plus trial tested a bundle of ‘pre-conception’
services for risky drinking, smoking, and ineffective contraception.
Significant reductions in the risk of pregnancies exposed to alcohol and
tobacco suggest the package may be feasible and effective, but would it
transfer to the UK context?
http://findings.org.uk/PHP/dl.php?file=Velasquez_MM_4.cab&s=ml
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