"INTERNET LAW BOOK REVIEWS" Provided by Rob Jerrard LLB LLM (London)

The Royal College of Psychiatrists, Books Reviewed in 2008

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Drug Misuse: Psychosocial Interventions - The NICE Guideline
National Collaborating Centre for Mental Health (NCCMH)
Edition: 1st
Format: Paperback + CD-ROM
Author: The NICE Guidelines
ISBN: 9781854334688
Publishers: Royal College of Psychiatrists
Price: £35
Publication Date: 2008
Publisher's Title Information

This evidence-based clinical guideline endorsed by the National Institute for Health and Clinical Excellence (NICE) presents guidance on physical, psychological and service-level interventions for healthcare staff on how to work with people who misuse drugs (specifically opioids, stimulants and cannabis) to significantly improve their treatment and care. Four million people in the UK use illicit drugs each year and drug misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.
 
It provides an overview of drug misuse and covers identification and recognition, brief interventions and reduction of injection and sexual risk behaviours, psychological interventions (including contingency management, behavioural couples therapy and cognitive behavioural therapy), and the settings where treatment takes place (residential, prison and inpatient care). The book contains a chapter on service-user experience and involvement in drug services and there is also advice for family members and carers of people with a drug problem.
 
This book has a 'sister title': Drug Misuse: Opioid Detoxification
 
NICE Mental Health Guidelines
 
These guidelines fromout clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions.
 
The book containsfull guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches.
 
The accompanying CD-ROM contains all the data used as evidence, including:
and excluded studies.

Profile tables that summarise both the quality of the evidence and the results of the evidence synthesis.
All meta-analytical data, presented as forest plots.
Detailed information about how to use and interpret forest plots.
 
Full Contents
Guideline Development Group members
 
1. Executive summary
General considerations
Identification and assessment of drug misuse
Brief interventions and self-help
Formal psychosocial interventions
Residential, prison and inpatient care
Research recommendations
 
2. Introduction
National guidelines
The national psychosocial interventions for drug misuse guideline
 
3. Introduction to drug misuse
Drug misuse
Epidemiology of drug misuse
Aetiology and maintenance of drug misuse
The course of drug misuse
The pharmacological effects of drug misuse
The public health impact of drug misuse
Identification and assessment of drug misuse
The aims of the treatment and management of drug misuse
Current care and treatment in the NHS
Service-user organisations
Drug misuse and the family
Economic impact of drug misuse
Clinical practice recommendations
 
4. Methods used to develop this guideline
Overview
The scope
The Guideline Development Group
Clinical questions
Systematic clinical literature review
Systematic economic literature review
Stakeholder contributions
Validation of this guideline
 
5. Service-user involvement and experience, and impact on carers
Introduction
Historical perspectives of service-user involvement
Service-user experience of services
Addressing the needs of families and carers
 
6. Identification and recognition
Introduction
Identification tools
 
7. Brief interventions and reduction of injection and sexual risk behaviours
Introduction
Brief interventions
Psychosocial interventions to improve concordance with physical healthcare
Psychosocial interventions to reduce injecting and sexual risk behaviours
 
8. Psychological interventions
Introduction
Outcomes
Psychological interventions alone for the management of drug misuse (cocaine, cannabis and opioids)
Psychological interventions in combination with opioid agonist maintenance treatment
Psychological interventions in combination with naltrexone maintenance treatment
Self-help groups
Coordination of care and case management
Multi-modal care programmes
Vocational interventions
 
9. Residential, prison and inpatient care
Introduction
Inpatient settings
Residential settings
Legally coerced treatment interventions
Prison
 
10. Appendices
11. Glossary
12. References
13. Abbreviations

Review

This important volume, authored by a panel of leading practitioners and clinicians in the field of substance misuse, reviews the literature detailing research evidence of the efficacy or otherwise of psychosocial interventions with a range of drug-using clients, focussing specifically on those misusing opioids, stimulants and cannabis. By doing so it provides a comprehensive guide as to what 'works', and what is less effective, that will be invaluable to all those involved in the management of drug services and those at the sharp end of service provision, together with students and others (including drug misusers) with an interest in the issues surrounding drug misuse and its treatment.
 
The volume consists of an Executive Summary, an Introduction and nine chapters together with a comprehensive set of appendices, the majority of which are to be found on a CD ROM. It is not possible in a short review of this book to provide detailed information on each of the chapters and so this reviewer will concentrate on a small number and provide a brief summary only of most chapters.
 
The Executive Summary and Introduction set out clearly the rationale behind the guidelines and their scope. Their stated aim is to consider the relevant research literature and use that to provide a set of recommendations and guidelines that “will be useful to clinicians and service commissioners in providing and planning high-quality care for people who misuse drugs”. In its painstaking review of the research literature it not only details the evidence underpinning its recommendations, but also sets out those areas where it perceives there to be weaknesses in available studies, e.g. “due to the lack of follow-up data, the model assesses only the short term effects of CBT on people who misuse cannabis; a comprehensive model should have a broader time horizon in order to assess the long-term effects of CBT” or significant gaps in the literature, e.g. “there is a lack of well-conducted studies assessing the efficacy of residential in comparison with community-based treatment for drug misuse and the efficacy of specific types of residential treatment” or “relatively few studies have evaluated the effectiveness of prison-based psychosocial interventions”.
 
Chapter 3 provides a clear and highly authoritative overview of drug misuse in the UK, and as such will be of interest to all those with an interest in this field. It presents an in-depth review of current drug misuse, exploring in turn the epidemiology of drug use, its typical course and pharmacological effects for the misuser, before moving on to consider the impact of drug misuse on public health together with its treatment and the economic implications of that treatment for the NHS.
 
Chapter 4 sets out in detail the methodology used in the literature review and how that review has been used to develop the guidelines, whilst Chapter 5 explores the involvement of drug misuse clients with those providing treatment, and their experience of that treatment. This chapter provides a fascinating selection of comments from clients on their treatment which help the reader to at least partially begin to see the issue from the perspective of the drug misuser, e.g. “the most important thing on your mind is to make yourself better so the first thing you do is go out and score”.
 
Chapter 6 explores the issue of drug screening and reviews the advantages and disadvantages of both self report questionnaires and biological testing for drug use, whilst chapters 7 to 9 provide detailed reviews of the research literature across a broad range of treatment situations from brief interventions through voluntary residential care to prison-based treatment, and use that literature to provide a clear set of clinical recommendations.
 
The appendices, particularly those contained on the CD ROM, provide a wealth of data relating to research studies in the field of substance misuse and its treatment. A good argument could be made for the suggestion that this data alone is worth the purchase price of this book! To anyone interested in academically rigorous research into this field, or in designing a future study that will have relevance in influencing clinical practice, this data is a veritable goldmine
 
David Emmett


Drug Misuse: Opioid Detoxification

Edition: 1st

Format: Paperback + CD-ROM

Author: The Society

ISBN:9781854334695

Publishers: The Royal College of Psychiatrists

Price: £35

Publication Date: Feb 2008

Publisher's Title Information


This evidence-based clinical guideline endorsed by the National Institute for Health and Clinical Excellence (NICE) presents guidance on physical, psychological and service-level interventions for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment and care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine, and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. The NICE guideline is an important tool in helping people to overcome their drug problem.

It provides an overview of drug misuse and opioid detoxification and covers assessment and testing, pharmacological and physical interventions used in detoxification, psychosocial interventions to support detoxification, and the settings in which the treatment can take place. The book contains experiences by people who have been dependent on opioids, and there is also advice for family members and carers of people with a drug problem.

This book has a 'sister title': Drug Misuse: Psychosocial Interventions

NICE Mental Health Guidelines

These guidelines from NICE set out clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions.

The book contains the full guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches.

The accompanying CD-ROM contains all the data used as evidence, including:

Included and excluded studies.

Profile tables that summarise both the quality of the evidence and the results of the evidence synthesis.

All meta-analytical data, presented as forest plots.

Detailed information about how to use and interpret forest plots.

Full Contents

1. Executive summary

General considerations

Assessment

Pharmacological interventions in opioid detoxification

Opioid detoxification in community, residential, inpatient and prison settings

Specific psychosocial interventions

Research recommendations

2. Introduction

National guidelines

The national opioid detoxification for drug misuse guideline

3. Introduction to drug misuse

Drug misuse and opioid dependence

Epidemiology of drug misuse

Aetiology and maintenance of drug misuse

The course of drug misuse

The pharmacology of opioids

The public health impact of drug misuse

Identification and assessment of drug misuse

The aims of the treatment and management of drug misuse

The development of detoxification services

Current care and treatment in the NHS

The experience of drug misuse – personal perspectives

Impact of drug misuse on families and carers

Economic impact of drug misuse

4. Methods used to develop this guideline

Overview

The scope

The Guideline Development Group

Clinical questions

Systematic clinical literature review

Systematic economic literature review

Stakeholder contributions

Validation of this guideline

5. Assessment and testing

Introduction

Clinical assessment in the management of detoxification

Drug testing

Psychometric assessment tools

6. Pharmacological and physical interventions in opioid detoxification

Introduction

Pharmacological interventions in detoxification

Overall clinical summary of pharmacological interventions in detoxification

Clinical practice recommendations

Ultra-rapid, rapid and accelerated detoxification using opioid antagonists

Clinical practice recommendations

Physical and complementary interventions during detoxification

7. Psychosocial interventions in opioid detoxification

Introduction

Current practice

Definitions

Outcomes

Databases searched and inclusion/exclusion criteria

Studies considered

Psychosocial interventions in combination with detoxification

Clinical summary

Literature review of health economics evidence

Economic modelling

Clinical practice recommendations

8. Settings for opioid detoxification

Introduction

Inpatient and community-based settings

Unassisted/self-detoxification

Prison-based detoxification

9. Appendices

10. Glossary

11. References

12. Abbreviations



Clinical Topics in Addiction: Updates from Advances in Psychiatric Treatment

Edition: paperback

Author: Edited by Ed Day

ISBN: 9781904671503

Publishers: RC PSYCH Publications

Price: £25

Publication Date: Oct 2007

Publisher’s Title Information


Addiction to psychoactive substances can lead to a range of biological, psychological and social problems, and the clinical management of these issues can often be complex.

 This book brings together papers from the College's popular journal Advances in Psychiatric Treatment, which have been updated to give systematic, authoritative and well-referenced accounts of over 20 key clinical topics relating to substance misuse. It is written by practitioners with extensive experience of managing these difficulties, and provides a handy synthesis of clinical, research and policy issues. Taking a very practical focus, the contents will be of use to any practitioner who comes across a patient with an addiction, and in particular to trainees in addiction psychiatry.


Topics covered include:

Gambling

All major psychoactive substances

Comorbidity with mental health problems

Addiction in special populations, including young people, pregnant women and offenders

Psychological and pharmacological treatments

Addiction policy.


Contents

Foreword by Nat Wright

Preface

 What works in drug addiction? - Jason Luty

The development of the drug treatment system in England - David Best, Sanju George and Ed Day

Stimulant use still going strong - Nicholas Seivewright, Charles McMahon and Paul Egleston

Adverse effects of khat: a review - Glenice Cox and Hagen Rampes

What the clinician needs to know about magic mushrooms - Nicholas Seivewright and Olawale Lagundoye

What works in alcohol use disorders? - Jason Luty

Management of alcohol detoxification - Duncan Raistrick

Nicotine addiction and smoking cessation treatments - Jason Luty

Pathological gambling: an overview of assessment and treatment - Sanju George and Vijaya Murali

Use of investigations in the diagnosis and management of alcohol use disorders - Colin Drummond, Hamid Ghodse and Sanjoo Chengappa

Laboratory investigations for assessment and management of drug problems - Kim Wolff, Sarah Welch and John Strang

Pharmacotherapy in dual diagnosis - Ilana B. Crome and Tracey Myton

Dual diagnosis: management within a psychosocial context - Mohammed T. Abou-Saleh

Treating depression complicated by substance misuse - Claire McIntosh and Bruce Ritson

Treating anxiety complicated by substance misuse - Anne Lingford-Hughes, John Potokar and David Nutt

An overview of psychological interventions for addictive behaviours - Adam Huxley and Alex Copello

Motivational interviewing - Janet Treasure

Substance misuse in adolescents - Harith Swadi and Sangeeta Ambegaokar

Management of drug misuse in pregnancy - Ed Day and Sanju George

Intoxication and legal defences - Quazi Haque and Ian Cumming

Substance misuse and violence: the scope and limitations of forensic psychiatry’s role - Peter Snowden

Literary and biographical perspectives on substance use - Ed Day and Iain Smith

 Index



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