Community Treatment of Drug Misuse: More than Methadone by Nicholas Seivewright

By Nicholas Seivewright

Lately, methadone has been the remedy of selection for heroin dependency. This method has had substantial luck, yet accordingly different remedies were overlooked. This e-book attracts at the author's direct medical adventure and uses overseas learn findings to supply a finished and exact advisor to provider provision and therapy for drug misuse, together with methadone and replacement opiate substitutes, cleansing equipment, naltrexone and relapse prevention, and attainable ways with non-opiate clients. assurance locations emphasis on social elements in drug misuse and dependency, and the resultant remedy matters and sensible problems. Illustrative case experiences are featured in the course of the textual content. Combining a hugely functional method with a powerful study base, this e-book may be a necessary source for psychiatrists and different execs interested in the administration of drug misuse.

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The high number of seven had died, and two were untraceable. Of the remaining 50, 25 had successfully withdrawn from methadone, 19 at the first attempt. Of those, however, five had current substance misuse problems, mainly with alcohol. Twenty-five had resumed methadone maintenance and had usually achieved good stability, but quality of life measures were generally better in those who had succeeded in withdrawing from methadone. In this group who were very long-term drug users, therefore, it appeared that attempting to withdraw from maintenance treatment was The nature of methadone treatment 25 risky, with a tendency to substitute with other substances, but that if it could be achieved, it resulted in a better quality of life.

This study forms some of the basis for the often-quoted view that results of treatment are generally better the longer that individuals stay in the treatment, as that applied to various outcomes in this research. Retention rates were significantly better in methadone maintenance than the other modalities, and regular heroin use and crime in that group both dropped from high levels to less than 10% of individuals, 1–3 months into treatment. g. Ling et al. 1976, Ball & Ross 1991, Joe et al. 1991).

Notwithstanding the strong evidence for the original approach, which is discussed further below, there has generally been a gradual departure from this, for various reasons which are inter-related. The overall trends in provision have been towards lower dosage, fewer additional interventions and less acceptance of outright maintenance treatment although, importantly, these do not necessarily apply together. The dilution of the original approach within the USA has been partly due to financial and political considerations (Rosenbaum 1995), but many other influences have also affected services.

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