Saturday 18 December 2010
Sunday 28 November 2010
Gradualism and Addiction Treatment
Gradualism and Addiction Treatment
Scott Kellogg's work on the treatment of addiction
Home
Gradualism . . .
Seeks to utilize and integrate the best of the harm reduction, traditional, and scientific treatment approaches to create an effective and compassionate model for the treatment of drug and alcohol addictions;
Embraces the states of abstinence, moderation, or non-addictive use as the ultimate, if not necessarily the immediate, goal of the treatment process;
Understands that while some patients will make rapid and dramatic changes, others will need a slow process of change and healing;
Emphasizes that many patients need to work not only on their addictive behavior, but also on their psychological and emotional pain and anguish and that these issues may need to be addressed simultaneously or even first;
Celebrates the many wonderful recoveries that have come out of traditional and science-based treatment settings, while challenging these providers to work with active users in ways that will allow them to heal and change gradually;
Affirms the incredible connections and life-saving interventions that take place in harm reduction settings, while challenging harm reduction providers to embrace the ultimate goals of abstinence, moderation, or non-addictive use;
Understands that long-term recovery is built on the creation of meaningful and rewarding identities that will conflict with and replace those that are based on the addictive use of substances.
Wednesday 17 November 2010
Not4Me? Youth Drug Education and Prevention
Not4Me? Youth Drug Education and Prevention
Fear and abstinence only drug education?
The Canadian government's latest youth anti-drug "education" campaign (see: not4me.ca), continues to rely on the tired, ineffective messages of fear and abstinence. Unfortunately, this approach fails to capture the reality for many youth when it comes to drugs. For this reason, Canadian Students for Sensible Drug Policy felt it necessary to respond with this website.
Fear and abstinence only drug education?
It's not enough 4 me.
National Treatment Agency for Substance Misuse - Facing the future: Paul Hayes' speech to Drugscope conference
National Treatment Agency for Substance Misuse - Facing the future: Paul Hayes' speech to Drugscope conference
Harm reduction services will remain a cornerstone of a balanced drug treatment system even as it adopts a more recovery-oriented focus, according to Paul Hayes, NTA Chief Executive.
He told a DrugScope conference that government plans for the new Public Health Service to oversee drug and alcohol treatment services was a guarantee of the enduring importance of reducing blood-borne virus infections and drug-related deaths.
"The new Drug Strategy will be recovery-focussed but that does not mean it is abstinence-obsessed. There is no threat to harm reduction services," said Mr Hayes.
"There is no political appetite to challenge the maintenance of a balanced treatment system in which harm reduction services are the bedrock of what we do and a gateway into treatment and recovery. Our challenge for the future is adding recovery into what we do in a more systematic way, not subtracting harm reduction."
Mr Hayes spoke shortly before Anne Milton, the Public Health Minister, announced that the spending review had transferred some of the £600 million drugs budget from the Home Office and the Ministry of Justice to the Department of Health from next year.
"This gives us the chance to join up spending on drug treatment to improve support along the full course of a person's recovery," she told the conference on tackling drugs in the new decade.
"It also means we can avoid waste and duplication – to make sure every penny really works hard for service users." (Read Anne Milton's speech)
Earlier Mr Hayes confided that he was "not losing sleep" over the prospective level of the Pooled Treatment Budget next year, but he was worried about the threat of disinvestment by hard-pressed local authorities and primary care trusts who currently spend an extra £200 million on drug treatment in England.
He urged DrugScope members to lobby local politicians, councillors and decision-makers to maintain the level of local investment in drug treatment and ensure the new Public Health Service had local as well as national funding streams.
Mr Hayes said the NTA's role over the next 18 months was to manage the transition to the Public Health Service, into which the NTA itself would be incorporated. The NTA would continue to promote recovery, improve skills, incentivise performance, and ensure transparency and set out a business plan for 2011-12 once the Drug Strategy was published.
Mr Hayes added: "We want a recovery-oriented system that is ambitious for clients, focussed on outcomes, engaged with communities, and plumbed into mutual aid networks, so that people who go on this journey emerge not only drug-free but also have a job, somewhere to live, are in touch with their families and a stake in society."
Wednesday 27 October 2010
Monday 18 October 2010
Wednesday 6 October 2010
Facebook (25) | How the hepatitis C virus can infect brain cells on its own
Facebook (25) | How the hepatitis C virus can infect brain cells on its own
How the hepatitis C virus can infect brain cells on its own
Published on Wednesday, 06 October 2010 at 13:27
Hepatitis C (HCV Disease) is much more than a liver disease. The liver is the last to go.
Hep C can infect, damage brain tissues: Report
By Sarah O'Donnell, Edmonton Journal
EDMONTON — A virus best known for the damage it does to the liver can also damage brain cells, University of Alberta researchers report in a new study.
The research into the impact of hepatitis C on the brain is significant, they say, because it marks the first time scientists have been able to show that the virus can infect the brain.
"It has been a question for a long time," said Pornpun Vivithanaporn, a post-doctoral fellow in the U of A's Faculty of Medicine and Dentistry and first author of the hepatitis C study, which was published last week in the Public Library of Science One Journal.
"It proves the virus has implications on neurological disease," she said Tuesday.
Hepatitis C infects about 170 million people globally and about 300,000 in Canada. It targets the liver, causing inflammation and cirrhosis.
Researchers already knew that severe liver disease can affect a person's brain, but more recent research suggested that hepatitis C patients without serious liver problems also could suffer from brain-related issues such as memory loss, trouble concentrating, apathy and depression.
The new study allowed a team of researchers to show precisely how the hepatitis C virus can infect brain cells on its own.
"That had never been shown before," said lead researcher Dr. Christopher Power, a neurologist who works in the U of A's Faculty of Medicine and Dentistry. "It gets in there, it infects and it replicates. For a virologist, that's a really core observation. You can see infection of the cells and you can see replication."
To show how the hepatitis C virus infects brain cells, Power pointed to a computer screen in his U of A lab on Tuesday.
On one side of the screen, pictures of two healthy brain cells appeared in red. On the other side, those same cells appeared peppered with green dots. And in this picture, green is bad since it represents a buildup of viral proteins that eventually damage and kill the cell. In a way, Power explained, the virus can cause brain cells to drown in their own garbage.
The discovery is important, Power said for a couple of reasons.
First, he said, there are immediate clinical implications. "It tells us we need to be vigilant for neurological problems for people who have hepatitis C," he said.
That would mean taking such steps as ensuring patients have assess to a neurologist or psychologist on their team of physicians as well as a liver specialist.
"The second issue is it underscores the importance (of) developing new treatment for hepatitis C so we can prevent infection of the brain," said Power, whose research is funded by Alberta Innovates — Health Solutions and the Canadian Institutes of Health Research.
There is now no vaccine to prevent hepatitis C. Researchers have uncovered some treatments that work for a portion of patients infected with hepatitis C, but those also can have serious side effects for some people.
Michael Harmsworth, a hepatitis C sufferer who counts Power among his five doctors, said Tuesday he was extremely interested to learn about the research team's discovery. He said he hadn't realized that hepatitis C had the potential to affect the brain until Power showed him computer images of infected tissue samples.
Harmsworth, who was diagnosed about 13 years ago, said it all points toward progress.
"It's making me think, 'Hey, I may still have my time left here,'" Harmsworth said. "My little girl is nine years old and I want to be here when she turns 16 and goes to the prom."
© Copyright (c) The Edmonton Journalhttp://www.montrealgazette.com/health/infect+damage+brain+tissues+Report/3628505/story.html
Tuesday 5 October 2010
Monday 20 September 2010
Friday 17 September 2010
Monday 30 August 2010
Wednesday 21 July 2010
Facebook | National Users' Network
Facebook | National Users' Network
I thought you might be interested in Paul Hayes... See more’ latest-to service users via the Alliance. This is a copy of Peter McDermott’s account of the meeting, and if there’s one person I do trust to put the case for evidenced based treatment to government it is Peter. Here goes, FYI: Meetings with Paul Hayes « on: July 19, 2010, 05:09:22 PM » Last week, I had a couple of meetings with Paul Hayes talk about the issues raised by the remark in the NTA business plan regarding time limits on substitute prescribing. The first meeting was really a meeting with me as an NTA Board Member, in which he gave me some sense of the background and the political context in which all this takes place. He asked me to treat this discussion as being in confidence, and so I am. However, he went on to give me some additional background to the whole issue of time limits which he then shared with Alliance staff and a representative of the National User Network, which I'll share here today. According to Paul, the NTA have been increasingly concerned by the fact that we successfully get a lot of people into treatment, but we don't get quite as many out. They've got concerns, some of which I share personally, about the quality of the psychosocial input that many of these service users have been receiving. As I said, I think that this is, by and large, fair comment. He claims that nothing will take place prior to the establishment of an expert group that will take another look at the clinical guidance and try and assess what that person best needs. That group should recognize that some people will be in treatment for extended periods -- and for some people, perhaps even many people -- their involvement in treatment may be life-long. That said, abstinence is the primary objective treatment, and so there's a hope -- or an assumption -- that for most, that will be the primary goal. So, some of what Paul told us was partly reassuring. He claimed that the expert group will be pursuing an evidence-based approach to the issue. and nothing should make it in if it isn't supported by the evidence. He told us that the group would be chaired by an eminent clinician -- though it will also include some of the more vocal critics of methadone treatment. I suppose I have a couple of major concerns/objections to the issue at this stage. I'll try and list them here: 1.) The Alliance was initially established because of the poor quality of methadone maintenance here in the UK. Back in the 90's, inadequate access to prescribing, sub therapeutic doses and arbitrary time limits were common features of methadone treatment that we've fought long and hard to contest. 2.) Methadone treatment has long been stigmatized as a 'second class treatment' in certain quarters -- somehow inferior to abstinence-based treatment. From here, it's a relatively short step to the idea that people in pharmacologically-assisted recovery are somehow inferior, or that the quality of their recovery is somehow inferior, to abstinence based recovery. This attitude may well reduce the number of people who access methadone treatment, thereby depriving people of a treatment that has proven benefits re. the avoidance of overdose, the reduction in blood born virus infections and involvement in crime. 3.) Drug treatment providers in the UK do nuance and subtlety very poorly. Already, service users are being told by their service provider that treatment is being limited to two years for everybody. This is already beginning to cause anxiety and having an impact on people's stability. It's pretty clear to me that this agenda is being politically driven to some extent. While it is reasonable for politicians to set aspirations with regard to various aspects of health policy, issues concerning patient care currently are, and should remain, to be matters for discussion/negotiation between patient and clinician. In summary, while the picture might not be as bleak as it appeared last week, there are still some significant causes for concern. As usual, The Alliance will continue to monitor the situation on behalf of people who use the drug treatment system, campaign for maximum patient choice and for the availability of optimum care, and will continue to struggle against stigma and discrimination in the treatment system. We're interested in what's going on with regard to this agenda, so if you've been affected by it in some way -- please get in touch and let us know what's happening. mcd Oh, by the way, yesterday's Guardian carried a piece on this issue. No doubt the issue will arise again soon. Best wishes, Francis
I thought you might be interested in Paul Hayes... See more’ latest-to service users via the Alliance. This is a copy of Peter McDermott’s account of the meeting, and if there’s one person I do trust to put the case for evidenced based treatment to government it is Peter. Here goes, FYI: Meetings with Paul Hayes « on: July 19, 2010, 05:09:22 PM » Last week, I had a couple of meetings with Paul Hayes talk about the issues raised by the remark in the NTA business plan regarding time limits on substitute prescribing. The first meeting was really a meeting with me as an NTA Board Member, in which he gave me some sense of the background and the political context in which all this takes place. He asked me to treat this discussion as being in confidence, and so I am. However, he went on to give me some additional background to the whole issue of time limits which he then shared with Alliance staff and a representative of the National User Network, which I'll share here today. According to Paul, the NTA have been increasingly concerned by the fact that we successfully get a lot of people into treatment, but we don't get quite as many out. They've got concerns, some of which I share personally, about the quality of the psychosocial input that many of these service users have been receiving. As I said, I think that this is, by and large, fair comment. He claims that nothing will take place prior to the establishment of an expert group that will take another look at the clinical guidance and try and assess what that person best needs. That group should recognize that some people will be in treatment for extended periods -- and for some people, perhaps even many people -- their involvement in treatment may be life-long. That said, abstinence is the primary objective treatment, and so there's a hope -- or an assumption -- that for most, that will be the primary goal. So, some of what Paul told us was partly reassuring. He claimed that the expert group will be pursuing an evidence-based approach to the issue. and nothing should make it in if it isn't supported by the evidence. He told us that the group would be chaired by an eminent clinician -- though it will also include some of the more vocal critics of methadone treatment. I suppose I have a couple of major concerns/objections to the issue at this stage. I'll try and list them here: 1.) The Alliance was initially established because of the poor quality of methadone maintenance here in the UK. Back in the 90's, inadequate access to prescribing, sub therapeutic doses and arbitrary time limits were common features of methadone treatment that we've fought long and hard to contest. 2.) Methadone treatment has long been stigmatized as a 'second class treatment' in certain quarters -- somehow inferior to abstinence-based treatment. From here, it's a relatively short step to the idea that people in pharmacologically-assisted
Tuesday 18 May 2010
Mayday
May. My favourite month. Why is it so bloody cold here in the UK?May should be soft, warm sunshine on your cheeks, not hovering over the central heating's thermostat.
Sunday 9 May 2010
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