|Titre :||Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism? [Addiction debate] (2017)|
|Auteurs :||E. DAY, Auteur ; L. MITCHESON, Auteur ; P. M. FLYNN, Auteur du commentaire ; C. J. STRIKE ; A. GUTA ; J. SELIN ; D. RAISTRICK ; E. DAY ; L. MITCHESON, Auteur du commentaire|
|Type de document :||Article : Périodique|
|Dans :||Addiction (Vol.112, n°8, August 2017)|
|Article en page(s) :||1329-1336|
|Note générale :||
- Pharmacotherapies as standalone treatments for addictions: why lessening won't work. Flynn P.M., p. 1337-1338.
- Patient-centred care and patient engagement to inform the use of psychosocial interventions with opioid substitution treatment: another path for Day & Mitcheson to follow. Strike C.J., Guta A., p. 1338-1339.
- Widening the perspective on opioid substitution treatment. Selin J., p. 1339-1340.
- Are UK opioid substitution treatment agencies fit for purpose? Raistrick D., p. 1340-1342.
- Response to commentaries: Neither optimism or nihilism... but reasons for hope. Day E., Mitcheson L., p. 1342-1344.
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASETRAITEMENT DE MAINTENANCE ; OPIACES ; INTERVENTION ; PSYCHOTHERAPIE ; TRAITEMENT ; FORMATION ; PRATIQUE PROFESSIONNELLE ; PHARMACOTHERAPIE
Background and Aims: Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'.
Analysis: We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice.
Conclusion: The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions.
|Domaine :||Drogues illicites / Illicit drugs|
|Refs biblio. :||76|
|Affiliation :||Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK|