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Ibogaine therapy offers a viable alternative to mainstream treatment for opiate addiction. The combination of the addiction‐arresting and fast‐acting properties of ibogaine, with the slow and thoughtful conversation of psychoanalytical psychotherapy is a novel approach to what still remains a difficult condition to overcome.Safer than methadone, ibogaine use is steadily increasing world‐wide, and is becoming a more accepted treatment for opiate addiction. This year it has become a prescription medication in New Zealand. Howard Lotsof, who discovered the anti‐addictive properties of ibogaine 47 years ago, and who died in January 2010, devoted his life to improving access to ibogaine treatment, and instigated the first ibogaine providers' conference in Mexico in 2009.This paper explores the use of ibogaine and psychoanalytic psychotherapy in the clinic for the treatment of opiate dependency, the relationships between the two approaches, and how they differ from other treatment modalities.

The purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and Scotland.

Surveys were completed by serving prisoners in both countries and by those recently released from prison (England only). The survey findings were discussed in focus groups of people with lived experience. The combined findings from the surveys and focus groups were shared with an expert group of prison OAT providers and people with lived experience with the purpose of making recommendations for more accessible and effective OAT in custodial environments and continuity of OAT on release

The quality and accessibility of OAT varied considerably between establishments. It was reported to be harder to access OAT in Scottish prisons. It was often hard for people in prison to get the dosage of OAT they felt they needed and it was generally harder to access buprenorphine than methadone in English prisons. Only Scottish people in prison were aware of long-lasting forms of buprenorphine. People in English prisons had mixed experiences of the help available in prison, with no improvement recorded since a 2016 study. People in Scottish prisons were more likely to rate the help available as poor.

The number of people accessed while actually in prison (73) was reduced by the impact of the pandemic, making it more difficult to access people in prison and because some were resistant to participating on the basis that they had already been consulted for a wide variety of research projects focused on the impact of COVID. The Scottish cohort (a total of 19 individuals comprising 14 survey respondents and five focus group members) is clearly too small a number on which to base robust claims about differences in OAT provision between the English and Scottish prison systems..

The study identifies key barriers to accessing OAT in prisons and suggests key components of more user-friendly approaches.

This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release and offers valuable recommendations on how to make service provision more effective and consistent.

This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release in England and Scotland and offers valuable recommendations on how to make service provision more effective and consistent.

For most of those affected, the entrance into the 18‐month to two‐year long nightmare roller coaster ride precipitated by the onset of the diamorphine ‘shortage’ in late December 2004 was sudden. Alarmingly, as one patient's representative put it, most patients only found out that there was a problem on New Year's Eve of 2004 when they walked in to their pharmacists to make their regular collection of diamorphine ampoules only to be told either that there weren't any, or that supplies were becoming extremely scarce and hard to source.

The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.

A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).

Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.

Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.

The paper covers:• nature of the drug problem ‐ drug dependence, prevalence of misuse, distribution of problematic drug‐users (PDUs) across NOMS and how drug‐related offending manifests itself• drug strategy in prisons ‐ demand reduction, supply reduction and establishing through‐care linkages, clinical services, counselling, assessment, referral, advice and through‐care services (CARATs), drug rehabilitation programmes, drug testing programmes, supply reduction initiatives, DIP linkages and wider resettlement agenda• assessing need and planning for the future ‐ needs analysis, development of the collaborative drug treatment vision, initiatives planned or under way to improve quality and amount of treatment available, and mainstreaming/integration of services to reduce re‐offending and make public environment safer.

This paper challenges readers to reflect on the terms ‘dual diagnosis’ and ‘recovery’ and to consider how the language and concepts that inform practice and policy shape the way we think about our work and relate to service users.

To underscore the significance of international health care management, we focus on three themes: the problem of global blindness; global health care challenges and opportunities; and learning from international health care management. The problem of global blindness highlights how health care managers’ inattentional blindness to competitors’ operational performance and market strategies lead to avoidable and expensive failures. To address global challenges and opportunities, health care organizations are employing two different strategies: (1) building and marketing a world-class health care facility internationally, and (2) organizing and integrating multinational health care operations. The first strategy exploits the medical-tourism market. The second strategy requires either multinational health care networks or transnational health care organizations. One of the lessons to be learned from international health care management is that an organization can create a meta-national competitive advantage. Another lesson is that by examining best practices from around the world, health care organizations can obtain new insights and become more innovative within their home markets. A corollary and third lesson is that while health care organizations can learn a great deal from examining international best clinical practices, sometimes the most important management lessons are lost in clinical translations. The fourth and last lesson is that worst cases – serious international management failures – offer perhaps the most valuable insights into the role of culture, complexity, and leadership for health care organizations.