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Article
Publication date: 1 December 2007

Nick Heather

In times of information overload, researchers have found ways to synthesise a large amount of data from numerous studies bearing on the effectiveness of treatment for alcohol…

Abstract

In times of information overload, researchers have found ways to synthesise a large amount of data from numerous studies bearing on the effectiveness of treatment for alcohol problems. Two of these ways are discussed: formal meta‐analysis and the box‐score ‘mesa grande’. It is concluded that meta‐analysis cannot answer questions regarding which treatments give the best results in the alcohol field. The mesa grande has certain limitations, which are described, but is useful for the formation of treatment policies when a clear summary of the research evidence on treatment effectiveness is needed. By contrast, large multi‐centre randomised controlled trials with enough statistical power to detect small effects of treatment should normally be preferred when a decision has to be made as to which of two or more specified treatments should be implemented in practice. Unfortunately, two multi‐centre trials, one in the USA and one in the UK, have given rise to the ‘dodo bird’ verdict of equivalent effectiveness of four treatment modalities. The findings of the UK Alcohol Treatment Trial cannot be used to advise treatment providers and practitioners which one of two treatments, MET or SBNT, should be preferred in practice. In the absence of relevant research findings, four possible ways of making this decision are outlined, including the suggestion that MET should serve as the first step in a stepped‐care model of treatment provision.

Article
Publication date: 2 March 2015

Gil Kovac, Yasir Abbasi and David Owens

– The purpose of this paper is to retrospectively evaluate outcomes measured for patients attending the Leeds Addiction Unit (LAU) for cannabis use disorders.

Abstract

Purpose

The purpose of this paper is to retrospectively evaluate outcomes measured for patients attending the Leeds Addiction Unit (LAU) for cannabis use disorders.

Design/methodology/approach

The authors performed a retrospective evaluation of data for clients referred to LAU for cannabis use disorders. These clients are routinely allocated to a programme of social behaviour and network therapy (SBNT), and methods of monitoring treatment include four questionnaires completed by clients, and the collection of treatment outcomes profile (TOP) data. Data were compared using non-parametric statistical methods.

Findings

Of 158 clients included in the study, 20 completed the four questionnaires at assessment and follow-up. A statistically significant improvement was found for the outcome measuring level of dependence (p=0.013). TOP data showed significant reduction in the average number of days of cannabis use over the past four weeks (p<0.001) and improved median scores for the client's rating of overall quality of life (p<0.001).

Practical implications

These findings suggest that treatment using SBNT can result in clinical improvement in cannabis use disorders. The promising results of the UK Alcohol Treatment Trial naturally raised the question as to whether SBNT can be adapted to treat substance use disorders other than alcoholism. This study aims to add to the body of evidence for this proposal.

Originality/value

This is the first evaluation of the service to measure outcomes for the treatment of cannabis misuse. This study is especially relevant given the recent changes made to the Diagnostic and Statistical Manual of Mental Disorders regarding cannabis use disorders, and has triggered another evaluation of cannabis treatment at LAU looking into specific pharmacotherapy.

Details

Drugs and Alcohol Today, vol. 15 no. 1
Type: Research Article
ISSN: 1745-9265

Keywords

Open Access
Article
Publication date: 5 March 2018

Louca-Mai Brady, Lorna Templeton, Paul Toner, Judith Watson, David Evans, Barry Percy-Smith and Alex Copello

Young people’s involvement should lead to research, and ultimately services, that better reflect young people’s priorities and concerns. Young people with a history of treatment…

4481

Abstract

Purpose

Young people’s involvement should lead to research, and ultimately services, that better reflect young people’s priorities and concerns. Young people with a history of treatment for alcohol and/or drug problems were actively involved in the youth social behaviour and network therapy study. The purpose of this paper is to explore the impact of that involvement on the study and what was learnt about involving young people in drug and alcohol research.

Design/methodology/approach

The initial plan was to form a young people’s advisory group (YPAG), but when this proved problematic the study explored alternative approaches in collaboration with researchers and young people. Input from 17 young people informed all key elements of the study.

Findings

Involvement of young people needs to be dynamic and flexible, with sensitivity to their personal experiences. Engagement with services was crucial both in recruiting young people and supporting their ongoing engagement. This research identified a need to critically reflect on the extent to which rhetorics of participation and involvement give rise to effective and meaningful involvement for young service users. It also highlights the need for researchers to be more flexible in response to young people’s personal circumstances, particularly when those young people are “less frequently heard”.

Research limitations/implications

This research highlights the need for researchers to be more flexible in response to young people’s personal circumstances, particularly when those young people are “less frequently heard”. It highlights the danger of young people in drug and alcohol research being unintentionally disaffected from involvement through conventional approaches and instead suggests ways in which young people could be involved in influencing if and how they participate in research.

Practical implications

There is an apparent contradiction between dominant discourses and cultures of health services research (including patient and public involvement) that often do not sit easily with ideas of co-production and young people-centred involvement. This paper provides an alternative approach to involvement of young people that can help to enable more meaningful and effective involvement.

Originality/value

The flexible and young people-centred model for involvement which emerged from this work provides a template for a different approach. This may be particularly useful for those who find current practice, such as YPAG, inaccessible.

Details

Drugs and Alcohol Today, vol. 18 no. 1
Type: Research Article
ISSN: 1745-9265

Keywords

Article
Publication date: 6 July 2010

Liam North, Louise Gillard‐Owen, Debbie Bannigan and Chris Robinson

This paper provides an overview of the evidence base for alcohol‐related brain injury (ARBI) and describes how this has been used to develop a pilot programme for the treatment of…

Abstract

This paper provides an overview of the evidence base for alcohol‐related brain injury (ARBI) and describes how this has been used to develop a pilot programme for the treatment of ARBI. Key components include: detoxification, assessment, social behaviour network therapy, cognitive rehabilitation and systematic instruction. The programme is being delivered and evaluated in the north of England by Swanswell, a national drug and alcohol treatment charity.

Details

Advances in Dual Diagnosis, vol. 3 no. 2
Type: Research Article
ISSN: 1757-0972

Keywords

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