Excerpt

This guideline has been developed to advise on psychosocial interventions for drug misuse. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, service users, a carer and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high-quality care for people who misuse drugs while also emphasising the importance of the experience of care for people who misuse drugs and their carers.

Although the evidence base is rapidly expanding, there are a number of major gaps, and future revisions of this guideline will incorporate new scientific evidence as it develops. The guideline makes a number of research recommendations specifically to address gaps in the evidence base. In the meantime, it is hoped that the guideline will assist clinicians, people who misuse drugs and their carers by identifying the merits of particular treatment approaches where the evidence from research and clinical experience exists.

Contents

• GUIDELINE DEVELOPMENT GROUP MEMBERS
• 1. EXECUTIVE SUMMARY
  • KEY PRIORITIES FOR IMPLEMENTATION
  • 1.1. GENERAL CONSIDERATIONS
  • 1.2. IDENTIFICATION AND ASSESSMENT OF DRUG MISUSE
  • 1.3. BRIEF INTERVENTIONS AND SELF-HELP
  • 1.4. FORMAL PSYCHOSOCIAL INTERVENTIONS
  • 1.5. RESIDENTIAL, PRISON AND INPATIENT CARE
  • 1.6. RESEARCH RECOMMENDATIONS
• 2. INTRODUCTION
  • 2.1. NATIONAL GUIDELINES
  • 2.2. THE NATIONAL PSYCHOSOCIAL INTERVENTIONS FOR DRUG MISUSE GUIDELINE
• 3. INTRODUCTION TO DRUG MISUSE
  • 3.1. DRUG MISUSE
  • 3.2. EPIDEMIOLOGY OF DRUG MISUSE
  • 3.3. AETIOLOGY AND MAINTENANCE OF DRUG MISUSE
  • 3.4. THE COURSE OF DRUG MISUSE
  • 3.5. THE PHARMACOLOGICAL EFFECTS OF DRUG MISUSE
  • 3.6. THE PUBLIC HEALTH IMPACT OF DRUG MISUSE
  • 3.7. IDENTIFICATION AND ASSESSMENT OF DRUG MISUSE
  • 3.8. THE AIMS OF THE TREATMENT AND MANAGEMENT OF DRUG MISUSE
  • 3.9. CURRENT CARE AND TREATMENT IN THE NHS
  • 3.10. SERVICE USER ORGANISATIONS
  • 3.11. DRUG MISUSE AND THE FAMILY
  • 3.12. ECONOMIC IMPACT OF DRUG MISUSE
  • 3.13. CLINICAL PRACTICE RECOMMENDATIONS
• 4. METHODS USED TO DEVELOP THIS GUIDELINE
  • 4.1. OVERVIEW
  • 4.2. THE SCOPE
  • 4.3. THE GUIDELINE DEVELOPMENT GROUP
  • 4.4. CLINICAL QUESTIONS
  • 4.5. SYSTEMATIC CLINICAL LITERATURE REVIEW
  • 4.6. SYSTEMATIC ECONOMIC LITERATURE REVIEW
  • 4.7. STAKEHOLDER CONTRIBUTIONS
  • 4.8. VALIDATION OF THIS GUIDELINE
• 5. SERVICE USER INVOLVEMENT AND EXPERIENCE, AND IMPACT ON CARERS
  • 5.1. INTRODUCTION
  • 5.2. HISTORICAL PERSPECTIVES OF SERVICE USER INVOLVEMENT
  • 5.3. SERVICE USER EXPERIENCE OF SERVICES
  • 5.4. ADDRESSING THE NEEDS OF FAMILIES AND CARERS
• 6. IDENTIFICATION AND RECOGNITION
  • 6.1. INTRODUCTION
  • 6.2. IDENTIFICATION TOOLS
• 7. BRIEF INTERVENTIONS AND REDUCTION OF INJECTION AND SEXUAL RISK BEHAVIOURS
  • 7.1. INTRODUCTION
  • 7.2. BRIEF INTERVENTIONS
  • 7.3. PSYCHOSOCIAL INTERVENTIONS TO IMPROVE CONCORDANCE WITH PHYSICAL HEALTHCARE
  • 7.4. PSYCHOSOCIAL INTERVENTIONS TO REDUCE INJECTING AND SEXUAL RISK BEHAVIOURS
• 8. PSYCHOLOGICAL INTERVENTIONS
  • 8.1. INTRODUCTION
  • 8.2. OUTCOMES
  • 8.3. PSYCHOLOGICAL INTERVENTIONS ALONE FOR THE MANAGEMENT OF DRUG MISUSE (COCAINE, CANNABIS AND OPIOIDS)
  • 8.4. PSYCHOLOGICAL INTERVENTIONS IN COMBINATION WITH OPIOID AGONIST MAINTENANCE TREATMENT
  • 8.5. PSYCHOLOGICAL INTERVENTIONS IN COMBINATION WITH NALTREXONE MAINTENANCE TREATMENT
  • 8.6. SELF–HELP GROUPS
  • 8.7. COORDINATION OF CARE AND CASE MANAGEMENT
  • 8.8. MULTI-MODAL CARE PROGRAMMES
  • 8.9. VOCATIONAL INTERVENTIONS
  • 8.10. PSYCHOLOGICAL INTERVENTIONS FOR CARERS
• 9. RESIDENTIAL, PRISON AND INPATIENT CARE
  • 9.1. INTRODUCTION
  • 9.2. INPATIENT SETTINGS
  • 9.3. RESIDENTIAL SETTINGS
  • 9.4. LEGALLY COERCED TREATMENT INTERVENTIONS
  • 9.5. PRISON
• 10. APPENDICES
  • APPENDIX 1. SCOPE FOR THE DEVELOPMENT OF THE CLINICAL GUIDELINE
  • APPENDIX 2. DECLARATIONS OF INTEREST BY GUIDELINE DEVELOPMENT GROUP MEMBERS
  • APPENDIX 3. STAKEHOLDERS WHO RESPONDED TO EARLY REQUESTS FOR EVIDENCE
  • APPENDIX 4. STAKEHOLDERS AND EXPERTS WHO SUBMITTED COMMENTS IN RESPONSE TO THE CONSULTATION DRAFT OF THE GUIDELINE
  • APPENDIX 5. RESEARCHERS CONTACTED TO REQUEST INFORMATION ABOUT UNPUBLISHED OR SOON-TO-BE PUBLISHED STUDIES
  • APPENDIX 6. CLINICAL QUESTIONS
  • APPENDIX 7. SEARCH STRATEGIES FOR THE IDENTIFICATION OF CLINICAL STUDIES
  • APPENDIX 8. CLINICAL STUDY DATA EXTRACTION FORM
  • APPENDIX 9. QUALITY CHECKLISTS FOR CLINICAL STUDIES AND REVIEWS
  • APPENDIX 10. SEARCH STRATEGIES FOR THE IDENTIFICATION OF HEALTH ECONOMICS EVIDENCE
  • APPENDIX 11. QUALITY CHECKLISTS FOR ECONOMIC STUDIES
  • APPENDIX 12. DATA EXTRACTION FORM FOR ECONOMIC STUDIES
  • APPENDIX 13. EVIDENCE TABLES FOR ECONOMIC STUDIES
  • APPENDIX 14. CHARACTERISTICS OF REVIEWED STUDIES
  • APPENDIX 15. CLINICAL EVIDENCE FOREST PLOTS
  • APPENDIX 16. EVIDENCE PROFILE TABLES
• 11. GLOSSARY
• 12. REFERENCES
• 13. ABBREVIATIONS

Acknowledgements: The Guideline Development Group for Drug Misuse: Psychosocial Interventions and the National Collaborating Centre for Mental Health review team would like to thank the following people: Editorial assistance: Emma Brown

The views presented in this book do not necessarily reflect those of the British Psychological Society, and the publishers are not responsible for any error of omission or fact. The British Psychological Society is a registered charity (no. 229642).