HOT TOPICS for March/April 2016
This set starts in the cradle with early-years parental support before skipping to treatment of the problems this support might prevent. A seemingly basic prerequisite - individualising care - is not so unarguable as it seems, while regimentation of rewards and punishments is now recommended. Finally, one possibly beneficial way to (after the initial commitment) take patient choice out of the equation - naltrexone implants or injections which block heroin for up to several months.
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SHOULD WE START PREVENTION IN THE CRADLE?
Early-years parenting support and preschool education are major planks in British drug strategies. Evidence for effects on later substance use is thin, but gets more solid as we move up to the first years of primary schooling.
INDIVIDUALISING TREATMENT: AN OBVIOUSLY GOOD THING?
Individualising care might seem an obvious and basic prerequisite for any treatment service, but in practice services have often striven for the opposite.
SHOULD WE OFFER PRIZES FOR NOT USING DRUGS?
No surprise that inducing abstinence by offering often destitute patients housing, employment, money or goods, can have powerful effects, but is this a temporary boost achieved at the cost of intrinsic motivation and lasting change?
OPIATE-BLOCKING IMPLANTS: MAGIC BULLET OR DANGEROUS EXPERIMENT?
If opiate-type drugs are supports relied on by vulnerable individuals, naltrexone implants and injections suddenly remove this support, and make it difficult quickly to resurrect it. There are risks, but clear benefits too, especially when little else is on offer.
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