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Time to consolidate the lessons of the five cells of row 3 in the Alcohol Treatment Matrix, all on the treatment of alcohol dependence in a medical context or involving medical care. The centrality of medications most clearly marks an intervention as medical, but for this ‘disease’, medications do not have reliable, mechanical effects. The evidence challenges us to place drugs in the context of the practitioners delivering them, managements and organisations which shape the therapeutic environment, and the local treatment system’s preparatory, supportive and follow-on care.
See the row highlighted at:
go straight to your chosen cell below.
Starts with the study which questioned the orthodoxy that ‘alcoholism’ demands intensive treatment, highlights trials of the UK’s three approved medications, then explores how to enable or encourage patients to take the pills, the status of disulfiram, most controversial of the mainstream pharmacotherapies, and the importance of the wrongly disparaged ‘placebo effect’.
Bedside manner is not just a conduit for treatment: to a substantial degree, it *is* the treatment. Learn from seminal studies that patients “sensitized to rejection” assess their clinicians as much as the reverse, and investigate what research can tell us about what makes a clinician ‘good’.
Key research on the management of medical interventions and treatments. Highlights the remarkable transformation of a US clinic in the 1950s by an open-minded manager, then addresses three key management issues: How do you identify effective clinicians? Worth ‘stepping up’ to more intensive treatment if initial treatment fails? Can research tell us which patients do best on which medication?
How treatment organisations affect the implementation and effectiveness of medical treatments. Asks whether evidence-based innovation is always a good thing, explores the evidence for and against integrating medical care with the treatment of alcohol dependence, and investigates the impact of quality in primary care practices.
Moves out to the level of whole treatment systems, highlighting the simple US innovation which routed detoxification recyclers into longer term remission. See if your vision of a ‘good’ service corresponds with that of an expert group, and explore whether Britain is making progress on organising care at the substantial overlap between problem drinking and mental illness.
Sent by Drug and Alcohol Findings to alert you to site updates and recent UK-relevant evaluations and reviews of drug/alcohol interventions. Course funded by Alcohol Change UK. Findings is also supported by the Society for the Study of Addiction and advised by the National Addiction Centre.