Recent bulletins from the Findings drug and alcohol bank:
Alcohol fading from under-18s treatment in England
The diminishing youth treatment caseload in England is increasingly dominated by under-18s primarily being treated for cannabis use problems as the numbers of primary problem drinkers falls away to just 15% of the caseload.
As part of the alcohol treatment matrix:
‘Skid-row drunks’ take anti-drinking drug to avoid spell in jail
In the early 1960s in Atlanta in the USA, a pioneering trial tested whether faced with another spell in jail, repeat drunkenness offenders would instead take a drug which promotes abstinence by generating deterrent physical reactions to alcohol. Most did, belying their supposedly hopeless condition. This analysis was prepared for the seminal articles list of the Alcohol Treatment Matrix.
What if the therapist ... is also the jailer?
In an extreme form, the title poses the dilemma for alcohol treatment staff who may also be (seen as) working for authorities whose main role is to control or punish the ‘client’ or who may be threatening to remove their children. Explores whether exceptional abilities are needed to forge productive therapeutic relationships in these situations, and invites you to ‘stress test’ a proposed universal rule: The trickier the situation, the more the worker matters.
Treatment not for the patient but for the community
The final row of the Alcohol Treatment Matrix enters the domain of treatment organised not primarily for the patient, but to safeguard the wider community, encountering what seems a core contradiction depicted on the cover of WHO guidance on alcohol treatment in prison. Its subtitle (An opportunity for intervention) seems belied by a photo of barbed wire-topped concrete walls, yet the same walls create the ‘dry space’ in which effective intervention may be possible. Also explored is whether it can ever be safe to leave children with severely dependent drinkers, and from a tragic story we learn how important it is to researchers to get the ‘right’ results.
Time to consolidate the lessons of last five instalments of the online course on alcohol treatment research. Every treatment involves direct or indirect human interaction, but this row is about therapies in which interaction is intended to be the main active ingredient. Psychosocial or ‘talking’ therapies are the mainstay of alcohol dependence treatment. If they are suboptimal or misunderstood, we risk the bulk of patients doing less well than they could.
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