Recent bulletins from the drug and alcohol bank:
In 1973 researchers showed that even physically dependent drinkers could learn to drink in moderation. But controversy was fierce, with abstinence returning to prominence as an essential component of contemporary visions of ‘recovery’.
Though close to the heart of the UK government’s abstinence-based ambitions for recovery, their own research has cast doubt on whether residential rehabilitation is a good deal for the public purse. We look at the evidence for residential rehabilitation, and whether despite the rhetoric, these services are under threat.
Time to consolidate the lessons of the five cells of row 3 in the Alcohol Treatment Matrix, all on the treatment of alcohol dependence in a medical context or involving medical care. The centrality of medications most clearly marks an intervention as medical. But for this ‘disease’, medications do not have reliable, mechanical effects. The evidence challenges us to place drugs in the context of the practitioners delivering them, managements and organisations which shape the therapeutic environment, and the local treatment system which provides preparatory, supportive and follow-on care.
Every treatment involves human interaction, but this cell is about therapies in which interaction is intended to be the active ingredient – ‘psychosocial’ therapies, the mainstay of alcohol dependence treatment. Highlights the £1.5 million UK trial for which the researchers designed a therapy to better a standard motivational approach; why were their expectations confounded? Then asks whether therapists really can make things worse, argues that guidance has been misled into advocating research-packaged interventions, and invites you to question the American Psychological Association’s list of the most important things to do in addiction therapy.
Compared to ordinary care proceedings, a London court which adopted the problem-solving and collaborative approach of a family drug and alcohol court helped more mothers stop problem substance use and retain custody of their children, though still most children were placed in alternative care.